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Rigmor Jensen

Publications and source records attributed to Rigmor Jensen.

13 recordsLinked to original sources

Can quality of life be improved by pelvic floor muscle training in women with urinary incontinence after ischemic stroke? A randomised, controlled and blinded study.

The purpose of this study was to evaluate the effect of pelvic floor muscle training in women with urinary incontinence after ischemic stroke measured by quality of life (QoL) parameters. Three hundred thirty-nine medical records of stroke patients were searched. Twenty-six subjects were randomised to a Treatment Group or a Control Group in a single blinded, randomised study design. The intervention included 12 weeks of standardised pelvic floor muscle training. The outcome was measured by the Short Form 36 (SF-36) Health Survey Questionnaire and The Incontinence Impact Questionnaire (IIQ). Twenty-four subjects completed the study. The SF-36 and IIQ did not show significant difference between the two groups. Despite the high prevalence of stroke with urinary incontinence, it is difficult to include these patients in such studies. The samples were too small to detect any significant differences. Development of specific instruments for QoL in stroke patients with urinary incontinence can be recommended.

Female↗

Diagnosis, epidemiology, and impact of tension-type headache.

Although tension-type headache is the most prevalent headache and affects 78% of the general population, the substantial societal and individual burden associated with this primary headache has been overlooked. In contrast to migraine headache, there has been limited focus on tension-type headache. Most patients with the chronic form of tension-type headache, which affects 3% of the population, are left virtually without any specific treatment. Chronic tension-type headache differs from the episodic form in frequency, lack of effect to most treatment strategies, more medication overuse, and more loss of quality of life. Daily or near daily headaches also constitute a major diagnostic and therapeutic problem and distinguishing chronic tension-type headache from migraine headache and from medication-induced headache is a substantial diagnostic challenge because management strategies are completely different. Considerable benefits for the society can be gained by specific strategies leading to reductions in the amount of sickness absence and impaired working abilities. The burden on the affected patients' and their families' quality of life also may be improved by a general acceptance of the disorder and by the development of a specific treatment strategy.

Humans↗

Experimental muscle pain and tenderness following infusion of endogenous substances in humans.

Several human models of myofascial pain exist, but none are similar to clinical pain. The aim of the present study was to develop a clinically relevant model of prolonged human myofascial pain using infusion of the naturally occurring endogenous substances. Initially, bradykinin (Bk), serotonin (5-hydroxytryptamine (5-HT)), histamine (His), prostaglandin E(2) (PGE(2)), adenosine-tri-phosphate (ATP), and their combinations were infused into the trapezius muscle of 36 healthy subjects in a total of 67 sessions to identify substances, which could induce a moderate muscle pain. PGE(2), ATP, and a combination of Bk, 5-HT, His, and PGE(2) produced the intended moderate pain. These substances were further examined in a randomised, blinded, placebo-controlled dose-finding design in 15 healthy subjects in 68 sessions. PGE(2) (3, 6, and 12 nmol/ml) induced mild pain and tenderness not different from placebo. ATP (9000, 18,000, and 36,000 nmol/ml) induced pain of moderate to strong intensity (P=0.04) and the dose of 18,000 nmol/ml furthermore produced moderate local tenderness (P=0.04). Because of unacceptable side effects in subsequent examinations, further studies of ATP in humans were suspended. Infusion of the combination of Bk (92 nmol), 5-HT (156 nmol), His (140 nmol), and PGE(2) (1.95 nmol) produced a moderate pain intensity (P=0.04) and mild tenderness (P=0.04) without inducing unacceptable side effects. Intramuscular infusion of a combination of Bk, 5-HT, His, and PGE(2) induced a prolonged moderate pain and tenderness in healthy humans, and this model may be a valuable tool in future studies of the pathophysiological mechanisms of myofascial pain.

Adult↗

Does nociceptin play a role in pain disorders in man?

Nociceptin-immunoreactive cellbodies were detected in the human trigeminal ganglion, while no such fibers were identified in the temporal artery or in dermal tissue from the neck region. In four healthy subjects receiving nociceptin into the temporal muscle in an open labeled design no pain was detected. In 10 healthy subjects who received 200pmol of nociceptin into tender non-dominant trapezius muscles in a placebo-controlled, randomized, balanced, and double-blinded design local tenderness increased (P=0.025) while no pain was noted. Thus, the action of nociceptin should be searched for in the trigeminal ganglion and/or in the central nervous system (CNS).

Adult↗

Sleep and headache.

The relationship between sleep and headache has been known for over a century. Headache and sleeping problems are both some of the most commonly reported problems in clinical practice, and cause considerable social and family problems, as well as socio-economic impact and costs. There is a clear association between headache and sleep disturbances, especially headaches occurring during the night or early morning. The mechanism and causes are complex, multifactorial and poorly understood. Headache disorders like migraine, tension-type headache, cluster headache and hypnic headache all affect or are directly related to sleep disturbances and daytime functioning. Sleep fragmentation, insomnia and hypersomnia all show relations to headache. Primary sleep disorders like insomnia, hypersomnias including sleep disordered breathing are all associated with and may cause headache. Furthermore medical, psychiatric and rheumatic diseases are associated with sleep disturbances and headache. The current knowledge about headache and sleep is still sparse and further research is advocated.

Child↗

Tension-type Headache.

Primary headaches represent some of the most costly diseases in modern society, and epidemiologic studies indicate that tension-type headache and migraine represent two different diseases, although coexisting in many patients. Limited knowledge of the underlying pathophysiology of tension-type headache is not yet available, and there is no specific treatment. In this paper, the clinical presentation of tension-type headache is described, and treatment strategies for the acute episode as well as for the prophylaxis of chronic tension-type headache are summarized. Simple analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute headache and low dose tricyclic antidepressants are still the mainstays of treatment, although new promising therapies are emerging.

Journal Article↗

Mechanisms of spontaneous tension-type headaches: an analysis of tenderness, pain thresholds and EMG.

Pericranial muscle tenderness, EMG levels and thermal and mechanical pain thresholds were studied in 28 patients with tension-type headache and in 30 healthy controls. Each patient was studied during as well as outside a spontaneous episode of tension-type headache. Outside of headache, muscle tenderness and EMG levels were significantly increased compared to values in controls subjects, while mechanical and thermal pain thresholds were largely normal. During headache, muscle tenderness evaluated by blinded manual palpation increased significantly, while pressure pain thresholds remained normal and pressure pain tolerances decreased. Thermal pain detection and tolerance threshold decreased significantly in the temporal region, but remained normal in the hand. EMG levels were unchanged during headache. It is concluded that one of the primary sources of pain in tension-type headache may be a local and reversible sensitization of nociceptors in the pericranial muscles. In addition, a segmental central sensitization may contribute to the pain in frequent sufferers of tension-type headache.

Adult↗

Muscle palpation with controlled finger pressure: new equipment for the study of tender myofascial tissues.

While manual palpation is the most important method for evaluation of tender myofascial tissues, it lacks reliability. Therefore, we have developed an instrument, called a 'palpometer', which allows the measurement of pressure exerted during palpation. The palpometer consists of a thin pressure-sensitive plastic device attached to the palpating finger, and of a scale recording the pressure applied to the device. Known forces were applied to the pressure sensitive device under various experimental conditions and the corresponding values were read on the palpometer scale. Then 14 observers, blinded to the palpometer scale, palpated the temporal muscle on the same subject twice, with an interval of 1 week. A highly significant correlation was found between palpometer recordings and forces applied to the pressure-sensitive device (P < 0.0001). Exerted force at a given palpometer value varied 3.1% within and 7.2% between 2 observers. During palpation of the temporal muscle pressure intensities within the 14 observers did not differ significantly from week to week (P = 0.68). Between the 14 observers pressure intensities varied considerably with a range of 73.5-196 arbitrary units. Thus, a reliable instrument for measuring pressure intensities during palpation of myofascial tissue has been developed. The large variation in palpation pressures between observers indicates that palpation of tender myofascial tissue may be considerably improved by use of the palpometer. This instrument will be indispensable in research studies employing palpation and in the training of physicians to diagnose myofascial pain disorders.

Adult↗

Muscle tenderness and pressure pain thresholds in headache. A population study.

Tenderness and pain thresholds in pericranial muscles were studied in a random sample of 735 adults aged 25-64 years. This study was a part of a multifaceted, epidemiological study of different headache disorders. Manual palpation and pressure pain threshold were performed by observers blinded to the persons' history of headache. The aim of the study was to evaluate the possible role of pericranial myofascial nociception in headache pathogenesis. Tenderness in migraineurs did not differ from non-migraineurs. Subjects with episodic tension-type headache and females with chronic tension-type headache were more tender than the rest of the population, and males without any experience of headache were less tender than the rest of the male population. A strong positive correlation between tenderness and frequency of tension-type headache was found (males: P < 10(-4); females: P < 10(-5)), while no relation between tenderness and migraine frequency was seen (P = 0.43). In subjects having actual headache at the day of examination tenderness was 32% increased compared to a matched group with identical usual frequency of headache, but without headache during the examination. A significant relation of tenderness to the recency of last episode of headache was detected in both sexes after control for usual frequency and actual headache (males: P < 10(-3); females: P < 10(-4)). Pressure pain thresholds were largely normal indicating normal pain processing and contradicting the idea that tension-type headache mainly is due to generally increased pain sensitivity. This study supports the pathogenetic importance of muscular factors in tension-type headache, while muscular factors are of no primary importance in migraine.

Adult↗

Cephalic muscle tenderness and pressure pain threshold in a general population.

Tenderness and pain thresholds in pericranial muscles were studied in a general population. A random sample of 1000 adults aged 25-64 years was drawn as part of the Glostrup Population Studies, and 740 adults were examined. This study was part of a multifacetted, epidemiological study of different headache disorders according to the new headache classification. Manual palpation and pressure pain threshold with an electronic pressure algometer were performed by observers blinded to other information such as the person's history of headache, previous illness and mental state. The muscles most commonly tender to manual palpation were the lateral pterygoid (55%), the trapezius (52%), and the sternocleido-mastoid muscles (51%). Females were more tender than men in all the muscles examined by manual palpation. In total, the young age group was more tender than the old age group (P = 0.03). Pressure pain thresholds on temporal muscles showed lower thresholds in women than in men (P less than 10(-3)), and in the total population thresholds increased with age (P less than 0.05). No side-to-side difference in tenderness by manual palpation was found, while the right side showed increased pain thresholds in right-handed individuals (P less than 10(-4)). No side-to-side difference was found in left-handed persons. This study provides data about the normal population and forms the necessary basis for evaluating the importance of muscle tenderness in headache subjects and other selected groups.

Adult↗

Instrumental investigations in primary headache. An updated review and new perspectives.

While some instrumental techniques are clearly useful for differentiating symptomatic forms from primary headache, the usefulness of certain other techniques, neurophysiological investigations in particular, in clinical practice is still debated. A Task Force of the European Federation of Neurological Societies has recently proposed guidelines and recommendations on the use of neurophysiological tests and neuroimaging procedures in non-acute headache. This article reviews many of the most important literature references relevant to this topic and looks at the prospects for future research.

Blinking↗