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Gungormus DB, Garcia-Moreno FM, Bermudez-Edo M, Sánchez-Bermejo L, Garrido JL, Rodríguez-Fórtiz MJ, Pérez-Mármol JM. A semi-automatic mHealth system using wearable devices for identifying pain-related parameters in elderly individuals. Int J Med Inform 2024; 184:105371. [PMID: 38335744 DOI: 10.1016/j.ijmedinf.2024.105371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/28/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Mobile health systems integrating wearable devices are emerging as promising tools for registering pain-related factors. However, their application in populations with chronic conditions has been underexplored. OBJECTIVE To design a semi-automatic mobile health system with wearable devices for evaluating the potential predictive relationship of pain qualities and thresholds with heart rate variability, skin conductance, perceived stress, and stress vulnerability in individuals with preclinical chronic pain conditions such as suspected rheumatic disease. METHODS A multicenter, observational, cross-sectional study was conducted with 67 elderly participants. Predicted variables were pain qualities and pain thresholds, assessed with the McGill Pain Questionnaire and a pressure algometer, respectively. Predictor variables were heart rate variability, skin conductance, perceived stress, and stress vulnerability. Multiple linear regression analyses were conducted to examine the influence of the predictor variables on the pain dimensions. RESULTS The multiple linear regression analysis revealed that the predictor variables significantly accounted for 27% of the variability in the affective domain, 14% in the miscellaneous domain, 15% in the total pain rating index, 10% in the number of words chosen, 14% in the present pain intensity, and 16% in the Visual Analog Scale scores. CONCLUSION The study found significant predictive values of heart rate variability, skin conductance, perceived stress, and stress vulnerability in relation to pain qualities and thresholds in the elderly population with suspected rheumatic disease. The comprehensive integration of physiological and psychological stress measures into pain assessment of elderly individuals with preclinical chronic pain conditions could be promising for developing new preventive strategies.
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Affiliation(s)
- Dogukan Baran Gungormus
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Francisco M Garcia-Moreno
- Department of Software Engineering, Computer Science School, University of Granada, Granada, Spain; Research Centre for Information and Communication Technologies (CITIC-UGR), University of Granada, Granada, Spain
| | - Maria Bermudez-Edo
- Department of Software Engineering, Computer Science School, University of Granada, Granada, Spain; Research Centre for Information and Communication Technologies (CITIC-UGR), University of Granada, Granada, Spain.
| | - Laura Sánchez-Bermejo
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - José Luis Garrido
- Department of Software Engineering, Computer Science School, University of Granada, Granada, Spain; Research Centre for Information and Communication Technologies (CITIC-UGR), University of Granada, Granada, Spain
| | - María José Rodríguez-Fórtiz
- Department of Software Engineering, Computer Science School, University of Granada, Granada, Spain; Research Centre for Information and Communication Technologies (CITIC-UGR), University of Granada, Granada, Spain
| | - José Manuel Pérez-Mármol
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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Fan A, Glace B, Pereira B, Malochet-Guinamand S, Couderc M, Mathieu S, Tournadre A, Soubrier M, Dubost JJ. Post-traumatic stress disorder prior to diagnosis is as rare in spondyloarthritis as in non-inflammatory rheumatic conditions and rheumatoid arthritis. Joint Bone Spine 2023; 90:105500. [PMID: 36574573 DOI: 10.1016/j.jbspin.2022.105500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/18/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Post-traumatic stress disorder (PTSD) may be a risk factor for the development of rheumatoid arthritis (RA). No data are available in spondyloarthritis (SpA). The aim of the present study was to investigate the frequency of traumatic events and PTSD in patients with SpA and its different phenotypes and to compare the results to patients with non inflammatory rheumatic disease and RA patients. METHODS This was an observational, cross-sectional and bi-centric study. Participants were patients diagnosed with SpA, non-inflammatory rheumatic or autoimmune disease (controls), or RA. Traumatic events were identified by the brief trauma questionnaire (BTQ). PTSD was defined as the presence of a traumatic event and ≥4 symptoms on the short PTSD checklist scale. RESULTS Among 1389 participants, 510 patients were diagnosed with SpA (167 ankylosing spondylitis, 140 psoriatic arthritis, 130 non-radiographic-axial SpA, and 51 peripheral SpA), 365 with non-inflammatory rheumatic disease and 514 patients with RA. The frequency of trauma in SPA patients was 33.7%, of which 30.5% in AS, 30.7% in PsA, 37.7% in nr-axSpA and 41.2% in peripheral SpA (P=NS). The prevalence of PTSD in SPA patients was 4.9%, (of which 3.6% in AS, 2.9% in PsA, 6.2% in nr-axSpA and 7.8% in peripheral SpA [P=NS]) and was not significantly different from the controls (after IPTW 4.8% vs. 6.7%). The frequency of trauma and PTSD was also comparable between RA and controls and between SPA and RA. CONCLUSION Traumatic events and PTSD occurring prior to diagnosis is as rare in SpA as in non-inflammatory rheumatic diseases and RA.
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Affiliation(s)
- Angelique Fan
- Rheumatology department, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont Ferrand, France.
| | - Baptiste Glace
- Rheumatology department, Centre Hospitalier de Vichy, Vichy, France
| | - Bruno Pereira
- Biostatistics Unit, CHU Clermont-Ferrand, Clermont Ferrand, France
| | | | - Marion Couderc
- Rheumatology department, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont Ferrand, France
| | - Sylvain Mathieu
- Rheumatology department, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont Ferrand, France
| | - Anne Tournadre
- Rheumatology department, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont Ferrand, France
| | - Martin Soubrier
- Rheumatology department, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont Ferrand, France
| | - Jean-Jacques Dubost
- Rheumatology department, CHU Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont Ferrand, France
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Germain V, Scherlinger M, Barnetche T, Pichon C, Balageas A, Lequen L, Shipley E, Foret J, Dublanc S, Capuron L, Schaeverbeke T. Role of stress in the development of rheumatoid arthritis: a case-control study. Rheumatology (Oxford) 2021; 60:629-637. [PMID: 32533144 DOI: 10.1093/rheumatology/keaa216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/07/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The primary objective of this study was to assess the stressful life events preceding the onset of symptoms in RA. The secondary objectives were to assess how early RA patients perceive stress and cope with stressors. METHODS A case-control study was performed, comparing patients recently diagnosed with RA to age- and gender-matched control subjects recently hospitalized for an unplanned surgical procedure not known to be influenced by stress. The Social Readjustment Rating Scale assessed the cumulative stress induced by stressful life events in the year preceding the onset of symptoms. Coping strategies, stress and anxiety symptoms were evaluated using validated psychological scales. RESULTS Seventy-six subjects were included in each group. The mean Social Readjustment Rating Scale score was twice as high in cases compared with controls [respectively, 167.0 (172.5) vs 83.3 (124.4), P < 0.001]. The association between cumulative stress and RA was statistically significant only in women, with a dose-dependent association between stress and RA. While female patients with RA attributed more often the onset of symptoms to a life event than female controls (70.2 vs 24.5%, P < 0.001), no significant difference was found when comparing male RA patients with male controls (26.9 vs 18.5%, respectively, P = 0.46). Increased perceived stress score (P = 0.04) and coping based on emotions (P = 0.001) were found in cases compared with controls. CONCLUSION Patients with early RA reported more life events in the year preceding the onset of symptoms than controls. Gender specificities were found with a significant association between cumulative stress and RA only in women.
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Affiliation(s)
- Vincent Germain
- Service de Rhumatologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.,Université de Bordeaux, Bordeaux, France
| | - Marc Scherlinger
- Service de Rhumatologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.,Université de Bordeaux, Bordeaux, France
| | - Thomas Barnetche
- Service de Rhumatologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Clémence Pichon
- Centre Hospitalier de Pau, Service de Rhumatologie, Pau, France
| | | | - Laurence Lequen
- Centre Hospitalier de Pau, Service de Rhumatologie, Pau, France
| | - Emilie Shipley
- Centre Hospitalier de Dax, Service de Rhumatologie, Dax, France
| | - Jennifer Foret
- Centre Hospitalier de Dax, Service de Rhumatologie, Dax, France
| | - Stéphanie Dublanc
- Centre Hospitalier de Libourne, Service de Rhumatologie, Libourne, France
| | - Lucile Capuron
- Université de Bordeaux, Bordeaux, France.,Laboratoire de Nutrition et Neurobiologie Intégrée (NutriNeuro), UMR 1286, INRA, Université de Bordeaux, Bordeaux, France
| | - Thierry Schaeverbeke
- Service de Rhumatologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.,Université de Bordeaux, Bordeaux, France
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Polinski KJ, Bemis EA, Feser M, Seifert J, Demoruelle MK, Striebich CC, Brake S, O'Dell JR, Mikuls TR, Weisman MH, Gregersen PK, Keating RM, Buckner J, Nicassio P, Holers VM, Deane KD, Norris JM. Perceived Stress and Inflammatory Arthritis: A Prospective Investigation in the Studies of the Etiologies of Rheumatoid Arthritis Cohort. Arthritis Care Res (Hoboken) 2020; 72:1766-1771. [PMID: 31600025 DOI: 10.1002/acr.24085] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/01/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The aim of this study was to determine the association of perceived stress with incident inflammatory arthritis (IA) defined as having at least 1 joint consistent with rheumatoid arthritis (RA)-like synovitis based on examination. METHODS We conducted a prospective cohort study in the Studies of the Etiologies of Rheumatoid Arthritis cohort. Participants without IA were recruited if they were a first-degree relative of an RA proband or screened positive for anti-citrullinated protein antibody. Perceived stress was measured using the Perceived Stress Scale-14 (PSS-14), in which scores can range from 0 to 56, and a higher score indicates greater perceived stress. The total PSS-14 score, as well as 2 subscores indicative of perceived distress and self-efficacy, were averaged across all study visits until development of IA or the last follow-up. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) of IA associated with average PSS-14 scores were obtained using Cox proportional hazards models. RESULTS The mean total PSS-14 score was 20.4. We found that a 1-point increase in the perceived distress score was significantly associated with a 10-percent increase in the risk of IA (adjusted HR 1.10 [95% CI 1.02-1.19]). Total PSS-14 and self-efficacy were not associated with IA risk (adjusted HR 1.05 [95% CI 0.99-1.10] and 1.04 [95% CI 0.91-1.18], respectively). CONCLUSION An association between perceived distress and incident IA was observed in this at-risk cohort. Replication of this finding in other preclinical and at-risk RA populations is needed.
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Affiliation(s)
| | | | - Marie Feser
- University of Colorado School of Medicine, Aurora
| | | | | | | | | | | | | | | | - Peter K Gregersen
- Feinstein Institutes for Medical Research and North Shore-Long Island Jewish Health System, Manhasset, New York
| | | | - Jane Buckner
- Benaroya Research Institute at Virginia Mason, Seattle, Washington
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