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Adaptation to physical activity and mental stress in the context of pain. Psychobiological aspects
(2016)
The genesis of chronic pain is predominantly explained by a multidimensional pain model approach that is based on the dysfunctional influence of biological, psychological and social variables as key risk factors inducing aberrant long-term changes. Biological facets comprise adaptation processes on the neuronal, musculoskeletal and (psycho) biological level that can be influenced by physical training or psychosocial factors, such as stress. These factors can play a causative role in developing dysfunctional adaptation mechanisms, which in turn prepare the biological ground to facilitate negative long-term changes in the peripheral and central nervous systems. Hence, these processes can be assumed to be fundamentally involved in the transition from acute to chronic and persistent pain. The aim of this review article is to discuss hypotheses for the genesis of chronic pain and possible treatment strategies. Selected research results about maladaptive processes in chronic pain due to psychological stress and physical activity are presented in order to inspire discussions about the ideal dose-response relationship of physical activity and the combination of different therapeutic concepts.
Association of primary allostatic load mediators and metabolic syndrome (MetS): A systematic review
(2022)
Allostatic load (AL) exposure may cause detrimental effects on the neuroendocrine system, leading to metabolic syndrome (MetS). The primary mediators of AL involve serum dehydroepiandrosterone sulfate (DHEAS; a functional HPA axis antagonist); further, cortisol, urinary norepinephrine (NE), and epinephrine (EPI) excretion levels (assessed within 12-h urine as a golden standard for the evaluation of the HPA axis activity and sympathetic nervous system activity). However, the evidence of an association between the primary mediators of AL and MetS is limited. This systematic review aimed to critically examine the association between the primary mediators of AL and MetS. PubMed and Web of Science were searched for articles from January 2010 to December 2021, published in English. The search strategy focused on cross-sectional and case–control studies comprising adult participants with MetS, obesity, overweight, and without chronic diseases. The STROBE checklist was used to assess study quality control. Of 770 studies, twenty-one studies with a total sample size (n = 10,666) met the eligibility criteria. Eighteen studies were cross-sectional, and three were case–control studies. The included studies had a completeness of reporting score of COR % = 87.0 ± 6.4%. It is to be noted, that cortisol as a primary mediator of AL showed an association with MetS in 50% (urinary cortisol), 40% (serum cortisol), 60% (salivary cortisol), and 100% (hair cortisol) of the studies. For DHEAS, it is to conclude that 60% of the studies showed an association with MetS. In contrast, urinary EPI and urinary NE had 100% no association with MetS. In summary, there is a tendency for the association between higher serum cortisol, salivary cortisol, urinary cortisol, hair cortisol, and lower levels of DHEAS with MetS. Future studies focusing on longitudinal data are warranted for clarification and understanding of the association between the primary mediators of AL and MetS.
Association of primary allostatic load mediators and metabolic syndrome (MetS): A systematic review
(2022)
Allostatic load (AL) exposure may cause detrimental effects on the neuroendocrine system, leading to metabolic syndrome (MetS). The primary mediators of AL involve serum dehydroepiandrosterone sulfate (DHEAS; a functional HPA axis antagonist); further, cortisol, urinary norepinephrine (NE), and epinephrine (EPI) excretion levels (assessed within 12-h urine as a golden standard for the evaluation of the HPA axis activity and sympathetic nervous system activity). However, the evidence of an association between the primary mediators of AL and MetS is limited. This systematic review aimed to critically examine the association between the primary mediators of AL and MetS. PubMed and Web of Science were searched for articles from January 2010 to December 2021, published in English. The search strategy focused on cross-sectional and case–control studies comprising adult participants with MetS, obesity, overweight, and without chronic diseases. The STROBE checklist was used to assess study quality control. Of 770 studies, twenty-one studies with a total sample size (n = 10,666) met the eligibility criteria. Eighteen studies were cross-sectional, and three were case–control studies. The included studies had a completeness of reporting score of COR % = 87.0 ± 6.4%. It is to be noted, that cortisol as a primary mediator of AL showed an association with MetS in 50% (urinary cortisol), 40% (serum cortisol), 60% (salivary cortisol), and 100% (hair cortisol) of the studies. For DHEAS, it is to conclude that 60% of the studies showed an association with MetS. In contrast, urinary EPI and urinary NE had 100% no association with MetS. In summary, there is a tendency for the association between higher serum cortisol, salivary cortisol, urinary cortisol, hair cortisol, and lower levels of DHEAS with MetS. Future studies focusing on longitudinal data are warranted for clarification and understanding of the association between the primary mediators of AL and MetS.
BACK PAIN: THE STUDY OF MECHANISMS AND THE TRANSLATION IN INTERVENTIONS WITHIN THE MISPEX NETWORK
(2016)
Purpose:To cross-cultural translate the Cumberland Ankle Instability Tool (CAIT) to Taiwan-Chinese version (CAIT-TW), and to evaluate the validity, reliability and cutoff score of CAIT-TW for Taiwan-Chinese athletic population. Materials and methods:The English version of CAIT was translated to CAIT-TW based on a guideline of cross-cultural adaptation. 77 and 58 Taiwanese collegial athletes with and without chronic ankle instability filled out CAIT-TW, Taiwan-Chinese version of Lower Extremity Functional Score (LEFS-TW) and Numeric Rating Scale (NRS). The construct validity, test-retest reliability, internal consistency and cutoff score of CAIT-TW were evaluated. Results:In construct validity, the Spearman's correlation coefficients were moderate (CAIT-TW vs LEFS-TW: Rho = 0.39,p < 0.001) and strong (CAIT-TW vs NRS: Rho= 0.76,p < 0.001). The test retest reliability was excellent (ICC2.1= 0.91, 95% confidential interval = 0.87-0.94,p < 0.001) with a good internal consistency (Cronbach's alpha: 0.87). Receiver operating characteristic curve showed a cutoff score of 21.5 (Youden index: 0.73, sensitivity: 0.87, specificity 0.85). Conclusions:The CAIT-TW is a valid and reliable tool to differentiate between stable and instable ankles in athletes and may further apply for research or daily practice in Taiwan.
Back pain is a complex phenomenon that goes beyond a simple medical diagnosis. The aetiology and chronification of back pain can be best described as an interaction between biological, psychological, and social processes. However, to date, multimodal prevention and intervention programs for back pain that target all three aetiological factors have demonstrated limited effectiveness. This lack of supportive evidence for multimodal programmes in the treatment of back pain could be due to the fact that few programs are suitable for long-term and unsupervised use in everyday life. Moreover, in combining the elements from various therapies, little attention has been paid to the mechanisms underlying the synergistic effects of the separate components. In this contribution, we will describe the development of a new multimodal intervention for back pain that set out to address these limitations. To this end, the biological elements of neuromuscular adaptation is supplemented with cognitive behavioral and psychophysiological techniques in an intervention that can be followed at home as well as in clinics, and that is suitable for all grades of pain. The efficacy of this intervention will be tested in a multicentric randomized controlled longitudinal trial (n = 714) at five time points over a period of 6 months. Here we will describe the development and the content of this new intervention.