Dataset Information

Animal-Assisted Intervention Improves Pain Perception in Polymedicated Geriatric Patients with Chronic Joint Pain: A Clinical Trial.

ABSTRACT: Chronic joint pain is associated to an increase in the consumption of medication and decrease in life quality in elderly people, which requires developing non-pharmacological treatments. The aim of this study was to evaluate the effectivity of a group intervention, based on animal-assisted therapy and applied to elderly people with chronic joint pain and polymedication, regarding the decrease of chronic pain, use of analgesics and improvement of life quality. A randomized controlled trial, two arms and open-label was conducted in a Primary Health Center. Twelve weekly sessions of kinesitherapy; in the EG, these exercises were performed with the additional assistance of the therapy dog. A total of 52 participants (22 Control Group (CG), 30 EG), average age 77.50 (±7.3), women 90.4%. A significant reduction on post-intervention values of pain ? = -0.67(-1.27, -0.08), p = 0.03 and pain induced insomnia ? = -0.53(-1.01, -0.05), p = 0.03 was found in EG for increasing baseline values. Animal-assisted therapy leads to an additional reduction in the perception of pain and pain induced insomnia in individuals with higher baseline severity. The presence of the dog improves the attachment to intervention and the satisfaction of the participants.

SUBMITTER: Rodrigo-Claverol M

PROVIDER: S-EPMC6721103 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Animal-Assisted Intervention Improves Pain Perception in Polymedicated Geriatric Patients with Chronic Joint Pain: A Clinical Trial.

Rodrigo-Claverol Maylos M Casanova-Gonzalvo Carles C Malla-Clua Belén B Rodrigo-Claverol Esther E Jové-Naval Júlia J Ortega-Bravo Marta M

International journal of environmental research and public health 20190809 16

Chronic joint pain is associated to an increase in the consumption of medication and decrease in life quality in elderly people, which requires developing non-pharmacological treatments. The aim of this study was to evaluate the effectivity of a group intervention, based on animal-assisted therapy and applied to elderly people with chronic joint pain and polymedication, regarding the decrease of chronic pain, use of analgesics and improvement of life quality. A randomized controlled trial, two a ...[more]

PMID: 31395808

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Project description:The parabrachial (PB) complex mediates both ascending nociceptive signaling and descending pain modulatory information in the affective/emotional pain pathway. We have recently reported that chronic pain is associated with amplified activity of PB neurons in a rat model of neuropathic pain. Here we demonstrate that similar activity amplification occurs in mice, and that this is related to suppressed inhibition to lateral parabrachial (LPB) neurons from the CeA in animals of either sex. Animals with pain after chronic constriction injury of the infraorbital nerve (CCI-Pain) displayed higher spontaneous and evoked activity in PB neurons, and a dramatic increase in after-discharges, responses that far outlast the stimulus, compared with controls. LPB neurons in CCI-Pain animals showed a reduction in inhibitory, GABAergic inputs. We show that, in both rats and mice, LPB contains few GABAergic neurons, and that most of its GABAergic inputs arise from CeA. These CeA GABA neurons express dynorphin, somatostatin, and/or corticotropin releasing hormone. We find that the efficacy of this CeA-LPB pathway is suppressed in chronic pain. Further, optogenetically stimulating this pathway suppresses acute pain, and inhibiting it, in naive animals, evokes pain behaviors. These findings demonstrate that the CeA-LPB pathway is critically involved in pain regulation, and in the pathogenesis of chronic pain.SIGNIFICANCE STATEMENT We describe a novel pathway, consisting of inhibition by dynorphin, somatostatin, and corticotropin-releasing hormone-expressing neurons in the CeA that project to the parabrachial nucleus. We show that this pathway regulates the activity of pain-related neurons in parabrachial nucleus, and that, in chronic pain, this inhibitory pathway is suppressed, and that this suppression is causally related to pain perception. We propose that this amygdalo-parabrachial pathway is a key regulator of both chronic and acute pain, and a novel target for pain relief.

Project description:PurposeAdults with diabetes mellitus (DM) suffer often from chronic pain, yet evidence-based interventions for comorbid pain and DM are scarce. We tested the effect of a peer-led cognitive behavioral training (CBT) intervention on pain self-efficacy (PSE), pain intensity, and pain-related functional limitations (PRFL) in adults with DM, 1 year after trial initiation.MethodsThe yearlong "Living Healthy" cluster-randomized trial included 230 residents of rural Alabama with DM, who reported pain in the past month; communities were treated as clusters. Intervention participants received a peer-delivered 8-session structured CBT intervention in the context of diabetes self-management; attention control arm participants received a peer-delivered 8-session general health education program. Outcomes included PSE (Arthritis Self-Efficacy Scale, range 10-100); pain intensity (McGill Pain Questionnaire, range 0-45); and PRFL (Western Ontario and McMaster Universities Osteoarthritis Index scale, range 0-100). We examined control-intervention differences in changes in outcome scores from baseline to 3-month and 12-month follow-up, adjusted for clustering.FindingsThe 195 participants with follow-up data were aged 59 ± 10.4 years, 96% were African American, 79% were women, and 80% reported pain on the day of baseline data collection. At 3-month follow-up, PSE increased more for intervention (21-point increase) than control (5-point increase) participants (P for control-intervention (C-I) difference in change < .001); pain intensity decreased for both groups; and PRFL decreased only for intervention participants (-11 score; P for C-I difference in change < .001). Results were sustained at 12 months, and pain intensity significantly improved in only the intervention arm (P for C-I difference in change = .01).ConclusionsThis peer-delivered CBT intervention improved pain self-efficacy, pain-related functional limitations, and pain intensity over 12 months among rural participants with DM and chronic pain.

Dataset Information

Animal-Assisted Intervention Improves Pain Perception in Polymedicated Geriatric Patients with Chronic Joint Pain: A Clinical Trial.

Publications

Animal-Assisted Intervention Improves Pain Perception in Polymedicated Geriatric Patients with Chronic Joint Pain: A Clinical Trial.

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