Changes in von Willebrand factor and fibrinolysis following a post-exercise cool-down

The purpose of this study was to determine the effect of a post-exercise active cool-down on von Willebrand factor and fibrinolysis. Ten subjects performed two maximal oxygen uptake (VO2max) tests followed by a 10-min passive (PC) or an active (AC) cool-down. Blood samples were obtained pre-exercise, post-exercise, post-PC/AC, and 1 h post-exercise and analyzed for von Willebrand factor antigen (vWf:Ag), tissue plasminogen activator (tPA) antigen and activity and plasminogen activator inhibitor-1 (PAI-1) activity. Data were analyzed using repeated measures analysis of variance. No significant differences were found between VO2max tests for treadmill time, VO2max, respiratory exchange ratio, maximal heart rate, or maximal blood lactate concentration. vWf:Ag was significantly elevated (P <0.05)following PC [198.4 (18.3)% normal] versus AC [174.5 (15.6)% normal] and remained elevated 1-h post-exercise [179.4 (16.4)% normal for PC vs 158.6 (13.8)% normal for AC]. There were no differences between tests for tPA or PAI-1 activity, although tPA antigen was significantly elevated following PC versus AC (P <0.05). Following the cool-down, hematocrit was higher (P <0.05) for the PC test [48.90 (0.36)] compared with AC [47.43 (0.51)]. An AC reduces post-exercise vWf:Ag and tPA antigen without affecting tPA or PAI-1 activity.

Multidisciplinary treatment of chronic pain patients: its efficacy in changing patient locus of control

OBJECTIVE

To assess the efficacy of multidisciplinary treatment in altering chronic pain patient locus of control beliefs.

DESIGN

A before-and-after treatment design including demographics.

PARTICIPANTS

Seventy-three chronic nonmalignant pain patients who completed study questionnaires both before and after treatment.

SETTING

Comprehensive, outpatient, multidisciplinary pain management program at a large Midwestern university medical center.

MAIN OUTCOME MEASURES

Pain Locus of Control Scale and Survey of Pain Attitudes Control subscale.

RESULTS

Patients' perceptions of personal control over pain increased from pretreatment to posttreatment, and patients' perceptions of external control over pain, such as fate or powerful others. decreased from pretreatment to posttreatment.

CONCLUSIONS

This study supports the efficacy of chronic pain management centers in altering patient beliefs about pain. The ability to increase patients' self-efficacy in their control over pain and to decrease external attributions are essential to successful pain management.