Eight-week stress management exercise program improves mental health and autonomic nervous system of adults exposed to chronic stress.

BACKGROUND: This study investigated a stress management exercise program's effect on mental health, muscle pain, and autonomic nervous system activity in adults exposed to chronic stress. METHODS: Thirty mothers between 40 to 59 years old raising children with disabilities were equally allocated into the yoga (YG) or control group (CG). The YG participated in 16 prop-assisted yoga sessions twice weekly for eight weeks, focusing on relaxing and strengthening neck, shoulder, back, and waist stress-related muscles. The Beck Depression Inventory, State-Trait Anxiety Inventory, Parenting Stress Scale, Stress Response Inventory, and Brief Resilience Scale assessed mental health variable changes. Visual Analog Scales (VAS) were used to self-report neck, shoulders, back, and waist pain and assess stress, anxiety, relaxation, and confidence. We also measured pain, psychological VAS, and Heart Rate Variability (HRV) immediately before and after each yoga session. RESULTS: The YG exhibited significant reductions in muscle pain, depression, stress response, fatigue, and frustration, whereas the CG expressed no change. Prop-assisted yoga immediately improved pain and psychological VAS. HRV analyses revealed instantly reduced heart rates and an R-R interval and standard deviation normal to normal (SDNN) increase. CONCLUSIONS: Prop-assisted yoga may serve as a viable, safe, and efficient alternative therapeutic modality for managing chronic stress-related conditions.

Systematic analysis of the nociceptive blink reflex: reliability and association with psychological factors / Análise sistemática do reflexo de piscar nociceptivo: confiabilidade e associação com fatores psicológicos

The present study aimed to estimate the reliability of the nociceptive blink reflex (nBR) and to evaluate the possible association between the nBR and various pain-related psychological measures: the Anxiety Sensitivity Index-3 (ASI-3), the Fear of Pain Questionnaire III (FPQ-III), the Pain Vigilance and Awareness Questionnaire (PVAQ), the Somatosensory Amplification Scale (SSAS), the Pain Catastrophizing Scale (PCS) and the Situational Pain Catastrophizing Scale (S-PCS). Twenty-one healthy participants were evaluated in two sessions. The nBR was elicited by a so-called "nociceptive-specific" electrode placed over the entry zone of the right supraorbital (V1R), infraorbital (V2R) and the mental (V3R) nerve and left infraorbital (V2L) nerve. The outcomes were: (a) individual electrical sensory (I0) and pain thresholds (IP); b) root mean square (RMS), area-under-thecurve (AUC) and onset latencies of R2 responses; and c) stimulus-evoked pain on a 0-10 numerical rating scale. The questionnaires ASI-3, FPQ-III, PVAQ, SSAS, PCS and S-PCS were also applied. Intraclass Correlation Coefficients (ICCs) and Kappa statistics were computed as a measure of the reliability (α=5%). Besides, Pearson correlation coefficient was used to associate the average of nBR measurements among all sites and the questionnaires. The significance level was set up after a Bonferroni correction (adjusted α=0.8%). ICCs were fair to excellent in 82% of the psychophysical measures and in 86% of V1R, V2R and V2L nBR parameters, whereas the V3R showed poor reliability in 52%. ICCs for intrarater reliability were fair to excellent in 70% of measurements (V3R showed the lowest values) and in 75% of interrater measurements. All kappa values showed at least fair agreement and the majority of the nBR measures (93%) were considered to have moderate to excellent reliability. There was no correlation for any pair of variables considering the adjusted significance level (p>0.008) and only a single significant correlation considering the standard significance level (p < 0.05), where the pain intensity (NRS) at 50% of IP presented a positive and small to moderate correlation with the PCS (r = 0.43, p = 0.047). The nBR and its associated psychophysical measures can be considered a sufficiently reliable test to assess the trigeminal nociceptive function. On the other hand, it seems not associated with psychological factors in healthy participants.

O presente estudo teve como objetivo estimar a confiabilidade do reflexo de piscar nociceptivo (nBR, sigla em inglês) e avaliar a possível associação entre o nBR e várias medidas psicológicas relacionadas à dor: o Anxiety Sensitivity Index-3 (ASI-3), o Fear of Pain Questionnaire III (FPQ-III), o Pain Vigilance and Awareness Questionnaire (PVAQ), o Somatosensory Amplification Scale (SSAS), o Pain Catastrophizing Scale (PCS) e o Situational Pain Catastrophizing Scale (S-PCS) (siglas e nomes em inglês). Vinte e um participantes saudáveis foram avaliados em 2 sessões. O nBR foi estimulado por meio de um eletrodo "nociceptivo específico" posicionado na zona de entrada do nervo supraorbital direito (V1D, sigla em inglês), infraorbital direito (V2D) e esquerdo (V2E) e mentual direito (V3R). As variáveis analisadas foram: a) limar elétrico sensorial (I0) e doloroso (IP); b) raíz quadrática média (RMS, sigla em inglês), área sobre a curva (AUC, sigla em inglês) e as latências da respostas R2; e c) dor provocada pelo estímulo em uma escala numérica de O a 10. Os questionários ASI-3, FPQ-III, PVAQ, SSAS, PCS e S-PCS também foram aplicados. Coeficiente de Correlação Intraclasse (ICC, sigla em inglês) e estatística Kappa foram calculados como medidas da confiabilidade (α=5%). Além disso, coeficiente de correlação de Pearson foi usado para associar a média do nBR entre todos os sítios de avaliação e os questionários. O nível de significância foi ajustado após correção de Bonferroni (α ajustado=0.8%). ICCs foram razoáveis à excelentes em 82% das medidas psicofísicas e em 86% dos parâmetros do nBR em V1D, V2D e V2E, enquanto que 52% das medidas em V3D apresentaram pobre confiabilidade. ICCs para confiabilidade intra-examinador foram razoáveis à excelente em 70% das medições (V3D apresentou os menores valores) e em 75% das medidas inter-examinadores. Todos os coeficientes Kappa apresentaram pelo menos razoável concordância e a maioria das medidas do nBR (93%) foram consideradas moderadas à excelente em termos de confiabilidade. Não houve correlação para nenhum par de variáveis considerando os valores ajustados de significância (p>0,008) e somente foi constatada uma correlação significante considerando o nível de significância padrão (p<0,005), em que a intensidade de dor em 50% do IP apresentou uma correlação positiva entre pequena e moderada com o PCS. O nBR e suas medidas psicofísicas associadas pode ser considerado um teste com suficiente confiabilidade para avaliar a função nociceptiva trigeminal. Por outro lado, parece que o nBR não está associado com fatores psicológicos em participantes saudáveis.