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Denis J Martin

Publications and source records attributed to Denis J Martin.

3 recordsLinked to original sources

Thermal perception thresholds recorded using method of limits change over brief time intervals.

Quantitative Sensory Testing (QST) of thermal perception thresholds assesses small afferent nerve function. QST has also been widely used to investigate the effects of interventions on the perception of activity within these nerve fibres, often over brief time periods. The natural variation in perception thresholds over brief time periods has not been determined, however, complicating accurate identification of induced changes. The present study therefore investigated changes in thermal perception threshold values within a 1-h period. Twenty-four healthy women volunteers aged 18-28 years (mean 20.6, SD 2.8) undertook cold sensation (CS), warm sensation (WS), cold pain (CP), and hot pain (HP) perception threshold measurements on the thenar eminence of the dominant hand during six 8-min experimental cycles. The order of stimulus presentation was randomized within pre-selected criteria. An adaptation temperature of 32 degrees C, a rate of temperature change of 0.5 degrees C/s, a 3 cm x 3 cm thermode, and a method of limits algorithm were used. Separate two-way ANOVAs with repeated measures showed statistically significant changes over time for WS, CS, and HP (p < 0.05), but not for CP (p = 0.232). The results indicate that WS, CS, and HP perception thresholds change significantly with repeated testing over a 1-h period. These results should be carefully considered when assessing the importance of observed changes in thermal perception thresholds. In research trials exclusion of a control group would be a fundamental flaw.

Adolescent↗

Effects of electric stimulation on C and A delta fiber-mediated thermal perception thresholds.

OBJECTIVE: To determine if interferential current (IFC) or transcutaneous electric nerve stimulation (TENS) alters C and A delta fiber-mediated thermal perception thresholds. DESIGN: Single-blind, randomized controlled trial. SETTING: Laboratory. PARTICIPANTS: One hundred forty healthy women volunteers (mean age +/- standard deviation, 20.6+/-2.7 y). INTERVENTIONS: Subjects were randomly and exclusively assigned to 1 of 7 groups (n=20 in each): 0, 5, and 100 Hz of IFC; 5 and 100 Hz of TENS; placebo and control stimulation. Stimulation was applied through 2 electrodes placed over the median nerve. Warm sensation, cold sensation, hot pain, and cold pain perception thresholds were measured from the thenar eminence by using a quantitative sensory testing device and a method of limits algorithm. MAIN OUTCOME MEASURES: Warm sensation, cold sensation, hot pain, and cold pain thresholds (degrees C) before, during, and after stimulation. RESULTS: There was a statistically significant effect of time for all 4 thermal perception thresholds (separate 2-way analyses of variance with repeated measures, all P<.001). There were no statistically significant differences between experimental groups, nor any interaction effects (all P>.05). CONCLUSIONS: Neither IFC nor TENS altered C and A delta fiber-mediated thermal perception thresholds. The results suggest that any analgesic mechanisms with these modalities are likely to be complex.

Adolescent↗

A focus group study of health professionals' views on phantom sensation, phantom pain and the need for patient information.

Focus groups with 32 health professionals from pre- and post-amputation care in central Scotland were used to explore perceptions of phantom sensation and pain, and current practice and potential improvements to patient information. Findings were compared to our parallel study of patients' experiences of phantom phenomena and information needs. Professionals' perceptions of phantom phenomena did not always match patient experiences: few professionals were fully aware of the nature, or the problems associated with phantom pain. There was uncertainty about who provided information and reported information was inconsistent and only weakly grounded in theory and mechanism-based management. Whilst there was awareness of the benefits of information, content, mode of delivery and co-ordination were all identified as areas for improvement. Our findings suggest that the information given to patients on phantom phenomena is inconsistent and insufficient. Possible solutions are the development of minimum standards of information and specifically targeted interprofessional education.

Amputation, Surgical↗