Clinical applications of visual analogue scales: a critical review
ABSTRACT Visual Analogue Scales (VAS) provide a simple technique for measuring subjective experience. They have been established as valid and reliable in a range of clinical and research applications, although there is also evidence of increased error and decreased sensitivity when used with some subject groups. Decisions concerned with the choice of scoring interval, experimental design, and statistical analysis for VAS have in some instances been based on convention, assumption and convenience, highlighting the need for more comprehensive assessment of individual scales if this versatile and sensitive measurement technique is to be used to full advantage.
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ABSTRACT: Background Pain is a negative factor in the recovery process of postoperative patients. It causes pulmonary alterations and complications, and it also affects functional capacity. Several studies have investigated the effects of transcutaneous electrical nerve stimulation (TENS) during the postoperative period. However, no studies have assessed the effects of TENS on kidney donors. Thus, the aim of the present study was to evaluate the effect of TENS on pain, walking function, respiratory muscle strength and vital capacity in kidney donors.Methods Seventy-four patients were randomly allocated into two groups: active TENS or placebo TENS. All patients were assessed for pain intensity, respiratory muscle strength, vital capacity and walking function before and after the TENS application on the first day of the postoperative period.ResultsThe use of active TENS significantly reduced pain at rest (p = 0.006), during the measurement of maximal inspiratory pressure (p = 0.006), during maximal expiratory pressure (p = 0.004) and during vital capacity (p = 0.013). Active TENS also produced a significant increase in maximal expiratory pressure when compared with the placebo TENS group (p = 0.001). Maximal inspiratory pressure, vital capacity and walking function were not significantly different between the two treatment groups.Conclusions These results suggest that TENS decreases pain intensity at rest and during respiratory manoeuvres and increases maximal expiratory pressure during the postoperative period in kidney donors after open nephrectomy.European journal of pain (London, England) 01/2015; 19(1). DOI:10.1002/ejp.521 · 3.22 Impact Factor
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ABSTRACT: In polio survivors with calf muscle weakness, dorsiflexion-restricting ankle-foot orthoses (DR-AFOs) aim to improve gait in order to reduce walking-related problems such as instability or increased energy cost. However, evidence on the efficacy of DR-AFOs in polio survivors is lacking. We investigated the effect of DR-AFOs on gait biomechanics, walking energy cost, speed, and perceived waking ability in this patient group. Sixteen polio survivors with calf muscle weakness underwent 3D-gait analyses to assess gait biomechanics when walking with DR-AFOs and with shoes only. Ambulant registration of gas-exchange during a 6-minute walk test determined walking energy cost, and comfortable gait speed was calculated from the walked distance during this test. Perceived walking ability was assessed using purposely-designed questionnaires. Compared with shoes-only, walking with DR-AFOs significantly increased forward progression of the center of pressure (CoP) in mid-stance and it reduced ankle dorsiflexion and knee flexion in mid- and terminal stance (p < 0.05). Furthermore, walking energy cost was lower (-7%, p = 0.052) and gait speed was higher (p = 0.005). Patients were significantly more satisfied, felt safer and less exhausted with the DR-AFO, compared to shoes-only (p < 0.05). DR-AFO effects varied largely across patients. Patients who walked with limited forward CoP progression and persisting knee extension during the shoes-only condition seemed to have benefitted least from the DR-AFO. In polio survivors with calf muscle weakness, DR-AFOs improved gait biomechanics, speed and perceived walking ability, compared to shoes-only. Effects may depend on the shoes-only gait pattern, therefore further study is needed to determine which patients benefit most from the DR-AFO.Gait & posture 07/2014; 40(3):391-398. DOI:10.1016/j.gaitpost.2014.05.016 · 2.30 Impact Factor
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ABSTRACT: Effects of exercise on dynamic aspects of sleep have not been studied. We hypothesized exercise altered dynamic sleep morphology differently for healthy controls relative to chronic fatigue syndrome (CFS) patients. Sixteen controls (38 ± 9 years) and 17 CFS patients (41 ± 8 years) underwent polysomnography on baseline nights and nights after maximal exercise testing. We calculated transition probabilities and rates (as a measure of relative and temporal transition frequency, respectively) between sleep stages and cumulative duration distributions (as a measure of continuity) of each sleep stage and sleep as a whole. After exercise, controls showed a significantly greater probability of transition from N1 to N2 and a lower rate of transition from N1 to wake than at baseline; CFS showed a significantly greater probability of transition from N2 to N3 and a lower rate of transition from N2 to N1. These findings suggest improved quality of sleep after exercise. After exercise, controls had improved sleep continuity, whereas CFS had less continuous N1 and more continuous rapid eye movement (REM) sleep. However, CFS had a significantly greater probability and rate of transition from REM to wake than controls. Probability of transition from REM to wake correlated significantly with increases in subjective fatigue, pain, and sleepiness overnight in CFS - suggesting these transitions may relate to patient complaints of unrefreshing sleep. Thus, exercise promoted transitions to deeper sleep stages and inhibited transitions to lighter sleep stages for controls and CFS, but CFS also reported increased fatigue and continued to have REM sleep disruption. This dissociation suggests possible mechanistic pathways for the underlying pathology of CFS.11/2013; 1(6):e00152. DOI:10.1002/phy2.152