Biomedical subjects

R B Fillingim

Publications and source records attributed to R B Fillingim.

29 records · Page 2Linked to original sources

PubMed1996

Pain sensitivity in patients with temporomandibular disorders: relationship to clinical and psychosocial factors.

OBJECTIVE: We have previously reported that patients with temporomandibular disorders (TMD) exhibit enhanced sensitivity to experimentally evoked pain (1); however, the clinical relevance of this increased pain sensitivity remains unclear. The purpose of this study was to investigate the relationship of experimental pain sensitivity to clinical and psychosocial variables among patients with TMD. DESIGN: Thirty-six TMD patients were studied, half of whom were pain sensitive (PS) and the other half pain tolerant (PT), based on their ability to tolerate an ischemic pain task. Responses to painful thermal and nonpainful visual stimuli as well as clinical/diagnostic symptoms and psychosocial variables were compared for the two groups (i.e., PS vs. PT). RESULTS: Results indicated that, compared with PT patients, the PS group exhibited greater sensitivity to thermal pain and rated innocuous visual stimuli as more intense. PS patients also reported greater clinical pain, but in general the groups did not differ on diagnostic and psychosocial measures. CONCLUSIONS: The results suggest that ischemic pain tolerance is a clinically relevant marker of pain sensitivity in TMD patients. These findings are consistent with the hypothesis that impairments in CNS inhibitory pathways may contribute to the pain associated with TMD.

Adult↗

PubMed1992

Assessment of aerobic power in chronic pain patients before and after a multi-disciplinary treatment program.

Physical exercise is widely used in the treatment of chronic pain patients, and direct measurement of physical capabilities is needed to objectively document change. In this study, 46 residential chronic pain patients undergoing treatment at a multidisciplinary rehabilitation center were administered a cycle ergometer graded exercise test, using a Medical Graphics CAD/NET exercise system, to measure aerobic fitness and other physiological parameters before and after the four-week treatment program. Patients evinced highly statistically significant changes in all major indices of cardiopulmonary functioning, including MAXVO2 and METS, and a measure of lower body power (WATTS). Possible mechanisms underlying such dramatic changes in this short time period include improved physical fitness, learning or desensitization to symptoms associated with exertion, and improved effort. Documenting treatment-related changes is important, and metabolic exercise testing provides an objective method for assessing changes in functional capacities. Such changes may have important practical implications for these individuals. The importance of assessing and improving aerobic fitness in chronic pain populations is discussed.

Adult↗

PubMed1990

Acute emotional and cardiovascular effects of stressful mental work during aerobic exercise.

The acute effects of engaging in challenging mental work during a single session of aerobic exercise were examined on measures of subjective mood and cardiovascular function. Fifty-seven female subjects were randomly assigned to participate in either a 10-min aerobic exercise condition or a no-exercise control condition. Half of the subjects in each group performed digits backward problems during this time period, and no mental stressors were presented to the other subjects. The results indicated that the exercise and mental stress conditions had additive effects on subjective anxiety levels and on cardiovascular responses during exercise. Both exercise and mental stress increased heart rate. In addition, exercise had anti-anxiety and vasodilative effects, but both of these influences were attenuated by opposing main effects for mental stress exposure. No effects were found for exercise on measures of cardiovascular reactivity to a later digits backward stressor. The results are consistent with previous research in suggesting that exposure to mental stressors during aerobic exercise provides no acute psychological benefits but attenuates some of the mood improvements and vasodilative effects of the exercise activity.

Adolescent↗

PubMed1989

The effects of distraction on the perception of exercise-induced symptoms.

The purpose of this study was to investigate the effects of distraction tasks varying in attentional demand on the perception of exercise-induced symptoms and on exercise performance. Tasks were constructed to vary in attentional demand but not in emotional engagement in order to isolate the former. Sixty females rode a bicycle ergometer while they participated in one of three experimental conditions: high demand distraction, low demand distraction, or no systematic distraction. Measures of mood, perceived exertion during exercise, physical symptoms following exercise, and timed riding tolerance were collected and analyzed. Level of distraction had little effect on mood, which confirmed that the tasks were not differentially emotionally arousing. Contrary to theoretical predictions, level of distraction led to no differences in exercise performance or symptom reports across the three groups. Limitations of the 'competition of cues' explanation for the efficacy of distraction as an intervention to reduce symptom perception and increase exercise performance are discussed.

Attention↗

PubMed1989

Life events, fitness, hardiness, and health: a simultaneous analysis of proposed stress-resistance effects.

The effects of exercise participation, self-perceived fitness level, and dispositional hardiness for promoting stress resistance were examined in a sample of 373 college students. Self-report measures of stressful life experience and recent physical illness were positively correlated, and fitness and hardiness were negatively correlated with illness as expected. Multiple regression analyses indicated that neither fitness nor hardiness provided a stress-moderator effect because neither was found to significantly interact with stress in the prediction of illness scores. Structural equation analyses suggested that hardiness may affect health indirectly by first influencing either the occurrence or subjective interpretation of stressful life events. No direct effect on health was found for exercise participation, although exercise may reduce illness indirectly by improving fitness. Implications for the multivariate modeling of proposed stress-resistance-enhancing effects are discussed.

Adaptation, Psychological↗

PubMed1986

The effects of internal versus external information processing on symptom perception in an exercise setting.

The purpose of our study was to determine the effects of internal versus external attentional focus on symptom perception and performance in an exercise setting. Fifteen introductory psychology undergraduates ran 1 mile under each of three experimental conditions: "word-cue," in which subjects were required to focus externally by listening for a target word heard repeatedly over headphones; "breathing," in which subjects were directed to attend to their own breathing and heart rate; and a control. Results indicated that participants reported significantly less symptomatology, particularly exercise-relevant symptoms, in the word-cue condition than in the breathing or control conditions. The findings are discussed with reference to previous theory in this area, and methodological differences between this and earlier research are delineated.

Adolescent↗

PubMedDate not supplied

The effects of aerobic exercise on cardiovascular, facial EMG, and self-report responses to emotional imagery.

This study examined the effects of exercise on subsequent psychophysiological and self-report responses to emotional imagery, using excitation-transfer theory as a guiding conceptual model. Twenty-four female undergraduates engaged in aerobic exercise (stationary cycling) for 15 minutes, and an equal number of subjects rested quietly for the same time period. All subjects then engaged in anger and sadness imagery trials. Cardiovascular, facial electromyographic, and self-report responses to the imagery were assessed. The results indicated that the subjects in the exercise group showed less peripheral vasoconstriction in response to the imagery than did the quiet rest subjects. Subjects in both groups displayed greater electromyographic activity in the depressor and zygomatic muscle regions during anger than sadness imagery, and subjects in the exercise group tended to show greater corrugator tension during sadness than during anger imagery. Few differences between the groups were found on self-report measures. These findings are discussed with reference to previous research, theoretical implications, and future directions.

Adult↗

PubMedDate not supplied

The influence of resting blood pressure and gender on pain responses.

Recent research suggests that resting blood pressure is inversely related to pain sensitivity, even among normotensives; however, most of these studies have included only male participants. To determine whether this hypoalgesic effect of blood pressure was also present in females, we investigated thermal and ischemic pain responses in a group of age-matched, normotensive females and males as a function of resting blood pressure. Thermal pain threshold and tolerance were determined, and a cross-modality thermal magnitude matching procedure was conducted, after which ischemic pain threshold and tolerance were determined using the submaximal effort tourniquet procedure. Systolic pressure, diastolic pressure, and heart rate were obtained using an automated blood pressure monitor with a pneumatic cuff positioned around the left ankle. Females provided higher normalized thermal magnitude estimates and a shorter time to ischemic pain tolerance, but no gender differences emerged on other pain measures. Systolic, diastolic, and mean arterial pressures were significantly correlated with thermal and ischemic pain responses among males but not females, with higher blood pressure being associated with lower pain sensitivity. After adjusting for resting blood pressure, the gender difference in normalized magnitude estimates was only marginally significant, and the gender difference in ischemic pain tolerance became nonsignificant. These findings are consistent with previous research indicating an inverse relationship between blood pressure and pain sensitivity. Additionally, the findings also suggest that blood pressure may partially moderate gender differences in pain sensitivity. Potential mechanisms and clinical implications of the current findings are discussed.

Adult↗

PubMedDate not supplied

Ischemic but not thermal pain sensitivity varies across the menstrual cycle.

OBJECTIVE AND METHOD: Findings from both animal and human research suggest that pain sensitivity changes across the menstrual cycle; however, among humans the nature of these menstrual cycle effects remains unclear. The present study used a repeated-measures design to evaluate changes in thermal and ischemic pain responses during three phases of the menstrual cycle, midfollicular (postmenstrual), ovulatory, and mid-to-late luteal (premenstrual), in 11 healthy women. The cycle phase during which subjects began their participation was determined randomly. Plasma levels of estrogen, progesterone, luteinizing hormone (LH), testosterone, and beta-endorphin were determined at each experimental session. Participants also completed a daily diary of physical and emotional symptoms for two complete menstrual cycles before the experimental sessions. RESULTS: The results indicated that women showed less ischemic pain sensitivity during the midfollicular compared with the ovulatory and mid-to-late luteal phases, but thermal pain responses did not vary significantly across menstrual cycle phases. Physical and emotional symptoms were minimal and did not change significantly across the menstrual cycle. CONCLUSIONS: These findings indicate greater ischemic but not thermal pain sensitivity among women after the midcycle LH surge. The practical relevance and potential mechanisms of these findings are discussed.

Adult↗

PubMedDate not supplied

Ethnic differences in thermal pain responses.

OBJECTIVE: Although numerous studies have reported ethnic differences in the prevalence and severity of clinical pain, little is known about how these differences affect the perception of experimental pain. The present experiment examined the effects of ethnicity (African American vs. white) on thermal pain responses in a healthy undergraduate population. METHODS: Thirty white subjects (16 women and 14 men) and 18 African Americans (10 women and 8 men) participated in the study. Thermal testing included evaluation of the following: warmth thresholds, thermal pain thresholds, thermal pain tolerances, and magnitude estimates of both the intensity and unpleasantness of thermal pain (at 46 degrees, 47 degrees, 48 degrees, and 49 degrees C). RESULTS: Although no group differences emerged for warmth thresholds, thermal pain thresholds, or pain intensity ratings, African Americans demonstrated lower thermal pain tolerances than whites. In addition, African Americans had smaller slopes and larger intercepts than whites for ratings of pain unpleasantness. Additional analyses suggested that these findings were a consequence of group differences in thermal pain unpleasantness ratings at the lowest temperatures assessed (46 degrees and 47 degrees C); at these temperatures, African Americans rated the stimuli as more unpleasant than whites. Finally, group differences in thermal pain tolerance and thermal pain unpleasantness ratings seemed to partially account for greater self-reported daily pain symptoms among African Americans. CONCLUSIONS: Collectively, these findings seem to suggest ethnic differences in the perception of the affective-motivational dimension of thermal pain.

Adolescent↗

PubMedDate not supplied

Ethnic differences in pain tolerance: clinical implications in a chronic pain population.

OBJECTIVE: Although numerous studies have independently examined ethnic differences in clinical and experimental pain, few have investigated differences in both sensitivity to controlled noxious stimuli and clinical pain reports in the same sample. The present experiment examined the effects of ethnicity (African American vs. white) on experimental pain tolerance and adjustment to chronic pain. METHODS: Three hundred thirty-seven (68 African American and 269 white) patients with chronic pain referred to a multidisciplinary treatment center participated in the study. In addition to completing a number of standardized questionnaires assessing adjustment to chronic pain, participants underwent a submaximal effort tourniquet procedure. This experimental pain procedure yields a measure of tolerance for a controlled noxious stimulus (ie, arm ischemia). RESULTS: African American subjects reported higher levels of clinical pain as well as greater pain-related disability than white participants. In addition, substantial group differences were observed for ischemic pain tolerance, with African Americans demonstrating less tolerance than whites. Correlational analyses revealed a small but significant inverse relationship between ischemic pain tolerance and the reported severity of chronic pain. CONCLUSIONS: Collectively these findings support previous research revealing ethnic differences in responses to both clinical and experimental pain. Moreover, the present results suggest that enhanced sensitivity to noxious stimuli on the part of African Americans may be associated with ethnic differences in reported clinical pain, although the magnitude of ethnic differences was much greater for ischemic pain tolerance than for clinical pain measures.

Adult↗