Sep
5
2023
J Clin Nurs. 2011 Mar;20(5-6):635-44. doi: 10.1111/j.1365-2702.2010.03548.x.
Physical exercise: does it help in relieving pain and increasing mobility among older adults with chronic pain?
Tse MM, Wan VT, Ho SS.
Authors: Mimi MY Tse, PhD, RN, Assistant Professor, School of Nursing, The Hong Kong Polytechnic University; Vanessa TC Wan, MSc, RN, Registered Nurse, M&G, Prince Margaret Hospital; Suki SK Ho, BSN, RN, Research Associate, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
Abstract
Aim. To provide a physical exercise programme for older adults living in nursing homes. Background. Pain is common among older persons and for those already in long-term care and having difficulty in coping with pain will be at risk of further reducing their optimal independent function. Design. A quasi-experimental single group pretest-posttest design. Method. Older persons from a nursing home were invited to join an eight-week physical exercise programme. Each session lasted an hour and sessions were conducted once a week by physiotherapist and nurses. Physical exercise programme consisted of stretching, strengthening, balancing, towel dancing and self-administered massage to various acupressure points. On completion of each session, older persons were given a pamphlet with pictures to illustrate the exercise of the day and they were encouraged to practise these exercises by themselves. Outcome measures including pain intensity, range of movement, activities of daily living and mobility were collected before and after the physical exercise programme. Results. There were 75 older adult participants (57 female and 18 male, mean age 85·14 SD 5·30). Seventy-three percent (n = 55) of them had pain in the previous three months and were referred as pain group, while 25% (n = 20) were no pain group. Pain scores of 4·89 (on a 10-point scale) indicated medium pain intensity before the intervention for the pain group; the location of pain was mainly in the knee, back and shoulder. On completion of the physical exercise programme, there was a significant decrease in pain intensity to 2·89 (SD 2·14) (p < 0·01). There was a significant increase in range of movement in the neck, shoulder, back, hip and knee rotation, flex and abduction (p < 0·01). Mobility level was significantly increased post intervention, yet activities of daily living remained unchanged. Conclusions. The present study demonstrated the effectiveness of a physical exercise programme in relieving pain and enhancing functional mobility for older persons. Relevance to clinical practice. It is important to educate older persons, especially those living in nursing homes, on the importance of engaging in regular physical exercise and maintaining mobility.
Sep
5
2023
Effectiveness of Pain Management Following Electrical Injury
Li, Adrienne L. K. BASc; Gomez, Manuel MD, MSc; Fish, Joel S. MD, MSc, FRCS(C)
Journal of Burn Care & Research:
January/February 2010 – Volume 31 – Issue 1 – pp 73-82
doi: 10.1097/BCR.0b013e3181cb8e94
The purpose of this study was to evaluate the effectiveness of pain management after electrical injury. A retrospective hospital chart review was conducted among electrically injured patients discharged from the outpatient burn clinic of a rehabilitation hospital (July 1, 1999, to July 31, 2008). Demographic data, numeric pain ratings (NPRs) at initial assessment and discharge, medications, nonpharmacologic modalities, and their effects before admission and after rehabilitation were collected. Pain management effects were compared between high (≥1000 v) and low (<1000 v) voltage, and between electrical contact and electrical flash patients, using Student’s t-test and χ2, with a P < .05 considered significant. Of 82 electrical patients discharged during the study period, 27 were excluded because of incomplete data, leaving 55 patients who had a mean age ±SD of 40.7 ± 11.3 years, TBSA of 19.2 ± 22.7%, and treatment duration of 16.5 ± 15.7 months. The majority were men (90.9%), most injuries occurred at work (98.2%), mainly caused by low voltage (n = 32, 58.2%), and the rest caused by high voltage (n = 18, 32.7%). Electrical contact was more common (54.5%) than electrical flash (45.5%). Pain was a chief complaint (92.7%), and hands were the most affected (61.8%), followed by head and neck (38.2%), shoulders (38.2%), and back torso (38.2%). Before rehabilitation, the most common medication were opioids (61.8%), relieving pain in 82.4%, followed by acetaminophen (47.3%) alleviating pain in 84.6%. Heat treatment was the most common nonpharmacologic modality (20.0%) relieving pain in 81.8%, followed by massage therapy (14.5%) alleviating pain in 75.0%. During the rehabilitation program, antidepressants were the most common medication (74.5%), relieving pain in 22.0%, followed by nonsteroidal antiinflammatory drugs (61.8%), alleviating pain in 70.6%. Massage therapy was the most common nonpharmacologic modality (60.0%), alleviating pain in 75.8%, and then cognitive behavioral therapy (54.5%), alleviating pain in 40.0%. There were pain improvements in all anatomic locations after rehabilitation except for the back torso, where pain increased 0.7 ± 2.9 points. Opioids were more commonly used in high voltage (P < .05), and cognitive behavioral therapy in low-voltage injuries (P < .05). Opioids were used in both electrical flash and electrical contact injuries. Pain in electrically injured patients remains an important issue and should continue to be addressed in a multimodal way. It is hoped that this study will guide us to design future interventions for pain control after electrical injury.
