The Global Body Examination (GBE). A useful instrument for evaluation of respiration (original) (raw)
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Prevalence of Breathing Dysfunction in Musculoskeletal Complaints: A Cross Sectional Study
https://www.ijhsr.org/IJHSR\_Vol.12\_Issue.2\_Feb2022/IJHSR-Abstract.020.html, 2022
Breathing is the most vital and important function of our body which helps in the maintenance of homeostasis of our body. Breathing being the multifactorial function dependant on Biochemical, Biomechanical, Psychosocial and Neuromusculoskeletal components. The vector of all components results breathing as the complex yet crucial function of our body. This breathing can be affected in any of the conditions affecting any of the above mentioned components. One of the reason being the imbalance between parasympathetic (PNS) and sympathetic (SNS) component of Autonomous Nervous System(ANS). Imbalance between PNS and SNS can result in the “Flight and Fight mode” which keeps the Pain factor on resulting in faulty breathing leading to Breathing Dysfunction. In the present observational cross sectional study, 200 individuals with various musculoskeletal complaints were identified and given, “Self assessment of breathing questionnaire” and “Nijmegen Questionnaire” as these questionnaires covers Biomechanical and Psychosocial aspects of breathing respectively. Scoring for both the questionnaires were done for each individual and data was recorded and analysed using pie chart. we concluded that breathing dysfunction is present in various musculoskeletal complaints predominantly in back pain, followed by neck pain, shoulder pain, and knee pain. Most affected gender is female affecting the Biomechanical as well as psychosocial component. We recommend further research for detailed assessment of breathing in various musculoskeletal conditions.
Breathing patterns in longstanding pain disorders
Recognizing and Treating Breathing Disorders, 2014
Background 233 Theory 234 Somatocognitive therapy 235 Development of a Standardized Mensendieck Test (SMT) 236 Some results from studies using somatocognitive therapy in populations of pain patients 238 Conclusion 239 References 239 BACKGROUND Clinical exposure to patients with longstanding pain inadvertently brings to attention that their pattern of respiration is altered. Since these motor patterns to the eyes of the trained observer are rather striking, we have searched for tools for the practical evaluation of such patterns, applicable in clinical settings. The effect of the altered pattern of motor activity can be assessed by measuring the chemical consequences thereof for the composition of the blood or the exhaled air (pH, pO 2 , pCO 2). However, when looking for instruments that describe the movements proper, we came to draw from the Scandinavian tradition of body examinations (see below). Since these instruments are based on psychodynamic theories, and are rather extensive and time consuming for practical clinical work, we found that there was a need for a new instrument that could be used to assess quality of movements according to principles derived from functional anatomy, and in keeping with a theoretical framework based on the cognitive abilities of the conscious mental domains. Such an instrument should allow therapists who are thoroughly trained in observation and visual analysis of the quality of movements, to rate the different static and dynamic motor patterns, not only of breathing, but also of posture, gait and overall motor behaviours. Scandinavian countries also benefit from several decades of exposure to the Mensendieck tradition (Mensendieck 1954
Journal of Multidisciplinary Healthcare, 2013
To describe the use of a "workable" visual profile of function and disability, based on a modified Brief International Classification of Functioning, Disability and Health (ICF) Core Set for chronic widespread pain, for initial assessments in a clinical setting of interdisciplinary pain rehabilitation teams. Method: The Brief ICF Core Set was slightly adapted to meet the needs of an interdisciplinary rehabilitation medicine team working in a university outpatient clinic and admitting patients referred from primary care. The Core Set categories were made measurable by means of eg, assessment instruments and clinical investigations. The resulting profile was given a workable shape to facilitate rapid understanding of the initial assessment outcome. Results: Individual patients showed different profiles of problems and resources, which facilitated individual rehabilitation planning. At the level of the study group, the profiles for the Core Set component Body Functions showed that most patients had severe impairment in the sensation of pain and exercise tolerance categories of function, but most had resources in the motivation and memory categories of function. Likewise, for the component Activities, most patients had limitations in lifting and carrying objects and remunerative employment, but most had resources in intimate relationships and family relationships. At first, the use of the modified Brief ICF Core Set in the team conference was rather time consuming, but after a couple of months of experience, the team assessment took approximately 30 minutes to complete per patient. Conclusion: The profile of the modified Brief ICF Core Set for chronic widespread pain served as a common platform, facilitating cooperation between the rehabilitation team members and providing a uniform language, which helped in structuring the clinical work. The profile also provided an easily accessible, overall view of the patient's problems and resources, which helped in understanding the functioning situation of the patient. Dovepress submit your manuscript | www.dovepress.com Dovepress 311 O r I g I N a L r e S e a r C h open access to scientific and medical research Open access Full Text article http://dx.
The assessment of musculoskeletal pain in the clinical setting
Rheumatic Disease Clinics of North …, 2008
Pain is a primary symptom in musculoskeletal conditions, and aspects of the pain experience (eg, severity) are key considerations in clinical decision-making and in the outcome of trials and interventions. Consequently, appropriate assessment of pain is essential. This article reviews the measures most commonly used in rheumatology practice, arguing that many are significantly limited in their ability to reflect the complexity of the patient's experience. The authors provide examples of alternative approaches, concluding that there is real scope for improving assessment and measurement of musculoskeletal pain in the clinical setting.
The Clinical Journal of Pain, 2008
(1) To integrate the scientific literatures of the biopsychosocial model of chronic musculoskeletal pain and of stress-induced physiologic wound and muscle changes, and (2) to propose a clinical assessment and treatment model that incorporates this dual literature into the management of chronic musculoskeletal pain. English language literature search from January 1990 to February 2008 using the MEDLINE and PsycINFO databases and the keywords "wound healing," "musculoskeletal injury," "skeletal muscle injury," "psychological," "social," "stress," "anxiety," and "pain." An illustrative case report is introduced. Review of the scientific literature revealed that psychologic stress is associated with slower or delayed wound healing in stressed older adults, restrained mice, socially isolated hamsters, adults with leg wounds, and surgical patients. One study showed that expressive writing positively affected the healing of a small skin puncture. Psychosocial stress affected aspects of muscle activity and spinal loading. Slaughter studies demonstrated that high preslaughter stress in pigs negatively affected postslaughter meat quality. A clinical model for the treatment of selected patients with painful musculoskeletal symptoms is offered. Important links exist between psychologic and social factors and recovery from insults to the "soft tissues." Identifiable biochemical and physiologic processes mediate this relationship. It is time to rethink and refine views of the role of psychologic and social factors in musculoskeletal illness, chronicity, and pain.
British Journal of Anaesthesia, 2008
Valid and reliable assessment of pain is essential for both clinical trials and effective pain management. The nature of pain makes objective measurement impossible. Acute pain can be reliably assessed, both at rest (important for comfort) and during movement (important for function and risk of postoperative complications), with one-dimensional tools such as numeric rating scales or visual analogue scales. Both these are more powerful in detecting changes in pain intensity than a verbal categorical rating scale. In acute pain trials, assessment of baseline pain must ensure sufficient pain intensity for the trial to detect meaningful treatment effects. Chronic pain assessment and its impact on physical, emotional, and social functions require multidimensional qualitative tools and health-related quality of life instruments. Several diseaseand patient-specific functional scales are useful, such as the Western Ontario and MacMaster Universities for osteoarthritis, and several neuropathic pain screening tools. The Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials recommendations for outcome measurements of chronic pain trials are also useful for routine assessment. Cancer pain assessment is complicated by a number of other bodily and mental symptoms such as fatigue and depression, all affecting quality of life. It is noteworthy that quality of life reported by chronic pain patients can be as much affected as that of terminal cancer patients. Any assessment of pain must take into account other factors, such as cognitive impairment or dementia, and assessment tools validated in the specific patient groups being studied.