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Bailey A, Diven M, Salvatore JR. The Use of Magnets, Magnetic Fields, and Copper Devices in a Veteran Population. Fed Pract 2023; 40:S106-S110a. [PMID: 38021101 PMCID: PMC10681013 DOI: 10.12788/fp.0397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background Complementary and alternative medicine (CAM) use is increasing in the US and throughout the world. The use of magnets, magnetic fields, and copper devices (MMFC) for health care are CAM therapies. Available information suggests significant consumer spending on MMFC therapy, but minimal information exists on usage patterns. Methods We created a brief questionnaire and distributed it to veteran patients at the Carl T. Hayden Veterans Affairs Medical Center infusion center in Phoenix, Arizona. The questionnaire categorized respondents by age groups, diagnostic groups by specialty (endocrinology, gastroenterology, hematology/oncology, neurology, rheumatology, and other), and whether MMFCs were being used and for what purpose. The questionnaire also asked whether the respondent would consider participating in a clinical study using MMFCs. Results Analyzing the 206 evaluable surveys, we found an overall use rate of about 1 in 4 respondents. The majority used copper devices, and the endocrinology group showed the highest percentage use. Many veterans reported that they would consider participating in MMFC clinical studies. For interest in clinical trial participation, the age groups with the highest response for magnets in clinical trials was 31 to 50 years (64%), and for magnetic fields 51 to 65 years (52%). Conclusions About 25% of surveyed veterans reported the use of MMFCs. Veterans reported that they are likely to participate in clinical studies using these CAM therapies.
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Affiliation(s)
- Andrea Bailey
- Division of Hematology/Oncology, Carl T. Hayden Veterans Affairs Medical Center, Phoenix, Arizona
| | - Morgane Diven
- Division of Hematology/Oncology, Carl T. Hayden Veterans Affairs Medical Center, Phoenix, Arizona
| | - Joseph R Salvatore
- Division of Hematology/Oncology, Carl T. Hayden Veterans Affairs Medical Center, Phoenix, Arizona
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Liu Y, Zhu J, Xu L, Wang B, Lin W, Luo Y. Copper regulation of immune response and potential implications for treating orthopedic disorders. Front Mol Biosci 2022; 9:1065265. [PMID: 36545506 PMCID: PMC9762617 DOI: 10.3389/fmolb.2022.1065265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Copper is an indispensable trace metal element in human body, and copper deficiency is rare in clinic. However, diseases associated with serum copper deficiency, such as leukopenia, neutropenia, arthritis, osteoporosis, and bone defects, are well known. Copper ions can also achieve the effect of fighting pathogenic bacteria through the "contact killing" characteristic. Copper ion is also an important cofactor of bone matrix synthase, plays an important role in the pathophysiology of orthopedic diseases. The present review highlights the biological functions of copper in immunity, bone diseases and stem cells, as well as potential drug development targeting copper status for diagnostics and therapeutics of copper-associated bone diseases.
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Affiliation(s)
- Yamei Liu
- College of Basic Medical, Guangzhou University of Chinese Medicine, Guangzhou, China
- Research Center of Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junlang Zhu
- Department of Trauma and Foot-Ankle Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liangliang Xu
- Lingnan Medical Research Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bin Wang
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weiping Lin
- The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yiwen Luo
- Department of Traumatology, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Schäfer C, Keyßer G. Lifestyle Factors and Their Influence on Rheumatoid Arthritis: A Narrative Review. J Clin Med 2022; 11:jcm11237179. [PMID: 36498754 PMCID: PMC9736780 DOI: 10.3390/jcm11237179] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
In recent years, a possible association of lifestyle factors with rheumatoid arthritis (RA) has attracted increasing public interest. The aim of this review is to provide an overview of the extent and the limitations of current evidence regarding lifestyle factors and RA. The PubMed medical database was screened for epidemiological and prospective studies investigating the contribution of lifestyle factors to the development and the course of the disease. Large epidemiological studies have identified smoking, unhealthy diet and adiposity, as well as a low educational level and low socioeconomic status, as factors that increase the incidence of RA. In addition, several lifestyle habits influence the response of RA to antirheumatic drugs. Among others, smoking, obesity and poor physical activity are associated with a worse treatment outcome. Methodological problems often impair firm conclusions with respect to the causal role of these factors in the risk and the course of RA. However, current evidence is sufficient to recommend a healthy diet, the prevention of obesity, the cessation of smoking and the maintenance of a high level of physical activity to support the effectivity of modern antirheumatic medication.
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Aldabbagh KAO, Al-Bustany DA. Relationship of serum copper and HLADR4 tissue typing to disease activity and severity in patients with rheumatoid arthritis: A cross sectional study. Ann Med Surg (Lond) 2022; 73:103193. [PMID: 35070279 PMCID: PMC8767240 DOI: 10.1016/j.amsu.2021.103193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/12/2021] [Accepted: 12/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background Objective Methods Results Conclusions Rheumatoid arthritis is a chronic disease associated with high burden on individuals. Serum copper increases in active disease. Assessment of disease activity helps in treatment and follow up. Positive HLADR4 tissue typing is associated with severe disease and complications.
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Rana A, Nandi S, Biswas S. Sulfonic acid functionalized zirconium-based metal–organic framework for the selective detection of copper( ii) ions. NEW J CHEM 2022. [DOI: 10.1039/d2nj01068b] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A sulphonic acid functionalized Zr(iv) MOF probe was used for the rapid, sensitive and selective sensing of Cu2+.
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Affiliation(s)
- Abhijeet Rana
- Department of Chemistry, Indian Institute of Technology Guwahati, 781039 Assam, India
| | - Soutick Nandi
- Department of Chemistry, Indian Institute of Technology Guwahati, 781039 Assam, India
- Department of Applied Science, Ghani Khan Choudhury Institute of Engineering & Technology, Malda, 732141 West Bengal, India
| | - Shyam Biswas
- Department of Chemistry, Indian Institute of Technology Guwahati, 781039 Assam, India
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Lei H, Pan Y, Wu R, Lv Y. Innate Immune Regulation Under Magnetic Fields With Possible Mechanisms and Therapeutic Applications. Front Immunol 2020; 11:582772. [PMID: 33193393 PMCID: PMC7649827 DOI: 10.3389/fimmu.2020.582772] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/28/2020] [Indexed: 11/13/2022] Open
Abstract
With the wide applications of magnetic fields (MFs) in medicine, researchers from different disciplines have gained interest in understanding the effect of various types of MFs on living cells and organisms. In this paper, we mainly focus on the immunological and physical aspects of the immune responses and their mechanisms under different types of MFs. Immune cells were slightly affected by low-frequency alternating MFs but were strongly influenced by moderate-intensity MFs and high-gradient MFs (HGMFs). Larger immune cells, such as macrophages, were more sensitive to HGMFs, which biased the cell polarization into the anti-inflammatory M2 phenotype. Subject to the gradient forces of varying directions and strength, the elongated M2 macrophage also remodeled the cytoskeleton with actin polymerization and changed the membrane receptors and ion channel gating. These alterations were very similar to changes caused by the small GTPase RhoA interference in macrophage. Regulation of iron metabolism may also contribute to the MF effects in macrophages. High MFs were found to regulate the iron content in monocyte-/macrophage-derived osteoclasts by affecting the expression of iron-regulation genes. On the other hand, paramagnetic nanoparticles (NPs) combined with external MFs play an important role in T-cell immunity. Paramagnetic NP-coated T-cells can cluster their T-cell receptors (TCRs) by using an external MF, thus increasing the cell–cell contact and communication followed by enhanced tumor killing capacity. The external MF can also guide the adoptively transferred magnetic NP-coated T-cells to their target sites in vivo, thus dramatically increasing the efficiency of cell therapy. Additionally, iron oxide NPs for ferroptosis-based cancer therapy and other MF-related therapeutic applications with obstacles were also addressed. Furthermore, for a profound understanding of the effect of MFs on immune cells, multidisciplinary research involving both experimental research and theoretical modeling is essential.
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Affiliation(s)
- Hong Lei
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Pan
- Center for Spintronics and Quantum Systems, State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an, China
| | - Rongqian Wu
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Lv
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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张 维, 王 焕, 刘 献, 王 涛, 陈 京, 孙 屹, 张 晓, 胡 浩, 许 克. [Primary development of visual uroflow scale]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2020; 52:684-687. [PMID: 32773801 PMCID: PMC7433610 DOI: 10.19723/j.issn.1671-167x.2020.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To develop the visual uroflow scale (VUS), analyze the relationship of VUS score and index of free uroflowmetry, assess urination function preliminarily and improve the work efficiency in the clinic. METHODS Male lower urinary tract symptoms (LUTS) patients, who attended the Department of Urology in Peking University People's Hospital from March 2016 to March 2017, were assessed for their urination function according to the Visual Uroflow Scale without help from clinicians before undertaking a free uroflowmetry test. And afterwards, a free uroflowmetry was undertaken, and variables including maximal flow rate (Qmax), the average flow rate (Qave) and voiding volume (VV) was obtained. During the study, 124 cases were collected and 53 cases met the inclusion and exclusion criteria and were included in the study cohort. The Spearman correlation analysis was used for analyzing the correlation of VUS scores with free uroflowmetry variables and age. The validity of VUS was evaluated. RESULTS Most of the patients could choose the very figure matched with self-condition by first instinct without any help from the clinician. The data were analyzed by Spearman correlation analysis. In the present study, voiding time was positively correlated with the VUS score (correlation coefficient, 0.62, P < 0.05). In the present cohort, the patients chose the third and fourth figures to take longer time to urinate, implying worse LUTS situation. Flow time and VUS scores were positively correlated (correlation coefficient, 0.61, P < 0.05). The patients with higher VUS scores would spend more time on urinate, no matter how long urinary hesitation was. Both Qmax and Qave were negatively correlated with the VUS score (correlation coefficient -0.54, -0.62, P < 0.05). The study illustrated that the VUS score suggested that the Qmax basically and further reflected the urination function. And its relationship to age revealed the decreased urination function of aging male, which had reached a consensus. CONCLUSION Development of VUS has helped the clinician assess the urination function preliminarily at the first time. Patients are assessed for a VUS score before getting surgery or receiving the drug for treatment, and can be re-assessed after. The VUS score can provide an objective quantitative basis to evaluate the treatment efficacy. In addition, considering that it is convenient, timesaving and easy to understand, the VUS is available for follow-up.
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Affiliation(s)
- 维宇 张
- />北京大学人民医院泌尿外科,北京 100044Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - 焕瑞 王
- />北京大学人民医院泌尿外科,北京 100044Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - 献辉 刘
- />北京大学人民医院泌尿外科,北京 100044Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - 涛 王
- />北京大学人民医院泌尿外科,北京 100044Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - 京文 陈
- />北京大学人民医院泌尿外科,北京 100044Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - 屹然 孙
- />北京大学人民医院泌尿外科,北京 100044Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - 晓鹏 张
- />北京大学人民医院泌尿外科,北京 100044Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - 浩 胡
- />北京大学人民医院泌尿外科,北京 100044Department of Urology, Peking University People's Hospital, Beijing, 100044, China
| | - 克新 许
- />北京大学人民医院泌尿外科,北京 100044Department of Urology, Peking University People's Hospital, Beijing, 100044, China
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Greater Postural Sway and Tremor during Balance Tasks in Patients with Plantar Fasciitis Compared to Age-Matched Controls. Healthcare (Basel) 2020; 8:healthcare8030219. [PMID: 32698455 PMCID: PMC7551341 DOI: 10.3390/healthcare8030219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 12/20/2022] Open
Abstract
Plantar fasciitis (PF) is a common condition found in men and women and can reoccur throughout life. PF is commonly diagnosed by prolonged foot pain lasting more than 3 months and a plantar fascia over 0.4 mm thick, as measured using ultrasound imaging. This study examined the ability to balance and the occurrence of muscle tremor during different balance tasks in patients with PF compared to their control counterparts. Fifty subjects (25 patients with PF and 25 control subjects) participated in this study. Subjective pain (measured with a visual analog scale (VAS)), pressure pain threshold (PPT), and postural sway and tremor during eight different balance tasks were measured. Postural sway was measured by a balance platform, while tremor was measured as the mechanical movement of the platform in the 8 Hz frequency range. Thickness of plantar fascia, subjective pain, and PPT were significantly greater in the PF group compared to the controls (p < 0.001). Postural sway and 8 Hz tremor were significantly greater in the PF group compared to the control group for all eight balance tasks (p < 0.01). These results indicate that the lack of plantar fascia elasticity is probably the cause of the reduced balance and increased muscle tremor.
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Rahbar M, Salekzamani Y, Jahanjou F, Eslamian F, Niroumand A, Dolatkhah N. Effect of hippotherapy simulator on pain, disability and range of motion of the spinal column in subjects with mechanical low back pain: A randomized single-blind clinical trial. J Back Musculoskelet Rehabil 2019; 31:1183-1192. [PMID: 30056412 DOI: 10.3233/bmr-170832] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hippotherapy is a form of therapeutic exercise for conservative treatment of lumbar spine segmental instability and/or hypomobility in subjects with low back pain (LBP). OBJECTIVE The current study evaluates the effects of a hippotherapy simulator on pain, disability, and range of motion (ROM) of the spinal column in subjects with mechanical LBP. METHODS In a randomized clinical trial, 80 subjects were randomly assigned to either the control or intervention groups. All subjects underwent routine physiotherapy. In addition, the intervention group underwent hippotherapy with a hippotherapy simulator for 15 sessions, each lasting 15 minutes. Pain, disability, and ROM of the lumbar spinal column of the subjects were measured in the first and last physiotherapy sessions respectively. RESULTS Improvement in pain intensity was higher in the hippotherapy simulator group over the first eight days of treatment (Hippotherapy vs. Control Point changes: Day 12: p= 0.010; after treatment: p= 0.005). The hippotherapy simulator group had significantly higher improvement in disability score in comparison to the control group (p< 0.001); mean changes in the modified Schober test were not significant (p= 0.423). CONCLUSION The hippotherapy simulator decreased pain and disability in subjects with LBP; however, no additional improvement in lumbar spine ROM was observed.
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Affiliation(s)
- Mohammad Rahbar
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yaghoub Salekzamani
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Jahanjou
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Eslamian
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Niroumand
- Physical Medicine and Rehabilitation Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Dolatkhah
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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Sowah D, Balat F, Straube S. Work-related outcomes in randomized, double blind, placebo-controlled trials in osteoarthritis - are they adequately reported in journal publications? A systematic review. J Occup Med Toxicol 2018; 13:32. [PMID: 30377437 PMCID: PMC6195965 DOI: 10.1186/s12995-018-0215-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 10/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background Osteoarthritis (OA) has a high prevalence in Western societies and can affect an individual's life in a number of domains, including work. In our experience, treatment trials on OA, however, rarely report work-related outcomes. Here we conducted a systematic review to assess the reporting of work-related outcomes in randomized, double blind, placebo-controlled trials in OA. Our systematic review also compared two search strategies for identifying eligible publications, one where work-related terms were included in the database search string (A) and one where this was not the case and work-related outcomes were identified by searches of full text Portable Document Formats (PDFs) (B). Search strategy A would conventionally be used and would only identify publications where work-related terms were mentioned in the title or abstract. Search strategy B presents the innovation of full text PDF searching and would identify publications were work-related terms were reported in the full text, regardless of whether they are mentioned in the title and abstract or not. We hypothesize that search strategy B identifies more relevant publications than search strategy A. Methods Electronic database searching was performed in Medline (Pubmed) from database inception to February 23, 2017 to identify peer-reviewed articles of randomized, double blind, placebo-controlled treatment trials in OA of the hand, hip, or knee, available as full-text PDFs. For search strategy A, search terms to identify work-related outcomes were included in the database search string, while search strategy B did not have these terms included in the database search string, but instead involved full text PDF searching. We included English language articles only and only those articles where searchable PDFs were available, to enable a comparison between search strategies A and B. Additionally, included studies also needed to report on pain intensity in relation to the work-related outcomes. Results Search strategy A yielded 50 hits combined for hand, hip or knee OA that mentioned some work-related concept in the title or abstract; 12 articles had to be excluded because they were not available as searchable PDFs. Screening of the remaining 38 articles resulted in only two articles that satisfied our inclusion criteria. Search strategy B yielded 986 hits, out of which 201 articles were excluded because searchable full text PDFs were not available. PDF full text searching and further screening resulted in 10 articles that were considered eligible for our review. Conclusions Work-related outcomes are rarely reported in journal publication on randomized, double blind, placebo-controlled trials of hand, hip or knee OA. Searching full text PDFs yields more eligible articles than searching titles and abstracts only.
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Affiliation(s)
- Daniel Sowah
- Division of Preventive Medicine, Department of Medicine, University of Alberta, 5-30 University Terrace, 8303-112 Street, Edmonton, AB T6G 2T4 Canada
| | - Flora Balat
- Division of Preventive Medicine, Department of Medicine, University of Alberta, 5-30 University Terrace, 8303-112 Street, Edmonton, AB T6G 2T4 Canada
| | - Sebastian Straube
- Division of Preventive Medicine, Department of Medicine, University of Alberta, 5-30 University Terrace, 8303-112 Street, Edmonton, AB T6G 2T4 Canada
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Leopold SS. Editorial: Getting Evidence Into Practice--or Not: The Case of Viscosupplementation. Clin Orthop Relat Res 2016; 474:285-8. [PMID: 26573320 PMCID: PMC4709311 DOI: 10.1007/s11999-015-4632-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 11/06/2015] [Indexed: 01/31/2023]
Affiliation(s)
- Seth S Leopold
- Clinical Orthopaedics and Related Research®, Philadelphia, PA, 19103, USA.
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Sharma AK, Kumar A, Taneja G, Nagaich U, Deep A, Rajput SK. Synthesis and preliminary therapeutic evaluation of copper nanoparticles against diabetes mellitus and -induced micro- (renal) and macro-vascular (vascular endothelial and cardiovascular) abnormalities in rats. RSC Adv 2016. [DOI: 10.1039/c6ra03890e] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Current study synthesized and investigated the effect of low-dose copper nanoparticles (CuNPs) against diabetes mellitus and -induced experimental micro- (nephropathy) and macro-vascular (cardio and endothelium) complications.
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Affiliation(s)
- Arun K. Sharma
- Cardiovascular Pharmacology Division
- Department of Pharmacology
- Amity Institute of Pharmacy
- Amity University
- Noida
| | - Ashish Kumar
- Department of Nanomedicine and Pharmaceutics
- Amity University
- Noida
- India
| | - Gaurav Taneja
- Cardiovascular Pharmacology Division
- Department of Pharmacology
- Amity Institute of Pharmacy
- Amity University
- Noida
| | - Upendra Nagaich
- Department of Nanomedicine and Pharmaceutics
- Amity University
- Noida
- India
| | - Aakash Deep
- Department of Pharmaceutical Chemistry
- Chaudhary Bansi Lal University
- Bhiwani 127021
- India
| | - Satyendra K. Rajput
- Cardiovascular Pharmacology Division
- Department of Pharmacology
- Amity Institute of Pharmacy
- Amity University
- Noida
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13
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Kersten P, White PJ, Tennant A. Is the pain visual analogue scale linear and responsive to change? An exploration using Rasch analysis. PLoS One 2014; 9:e99485. [PMID: 24921952 PMCID: PMC4055724 DOI: 10.1371/journal.pone.0099485] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 05/15/2014] [Indexed: 01/13/2023] Open
Abstract
Objectives Pain visual analogue scales (VAS) are commonly used in clinical trials and are often treated as an interval level scale without evidence that this is appropriate. This paper examines the internal construct validity and responsiveness of the pain VAS using Rasch analysis. Methods Patients (n = 221, mean age 67, 58% female) with chronic stable joint pain (hip 40% or knee 60%) of mechanical origin waiting for joint replacement were included. Pain was scored on seven daily VASs. Rasch analysis was used to examine fit to the Rasch model. Responsiveness (Standardized Response Means, SRM) was examined on the raw ordinal data and the interval data generated from the Rasch analysis. Results Baseline pain VAS scores fitted the Rasch model, although 15 aberrant cases impacted on unidimensionality. There was some local dependency between items but this did not significantly affect the person estimates of pain. Daily pain (item difficulty) was stable, suggesting that single measures can be used. Overall, the SRMs derived from ordinal data overestimated the true responsiveness by 59%. Changes over time at the lower and higher end of the scale were represented by large jumps in interval equivalent data points; in the middle of the scale the reverse was seen. Conclusions The pain VAS is a valid tool for measuring pain at one point in time. However, the pain VAS does not behave linearly and SRMs vary along the trait of pain. Consequently, Minimum Clinically Important Differences using raw data, or change scores in general, are invalid as these will either under- or overestimate true change; raw pain VAS data should not be used as a primary outcome measure or to inform parametric-based Randomised Controlled Trial power calculations in research studies; and Rasch analysis should be used to convert ordinal data to interval data prior to data interpretation.
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Affiliation(s)
- Paula Kersten
- Person Centred Research Centre, School of Rehabilitation and Occupation Studies, Auckland University of Technology, Auckland, New Zealand
- * E-mail:
| | - Peter J. White
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Alan Tennant
- Department of Rehabilitation Medicine, University of Leeds, Leeds, United Kingdom
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