Osteopathic stress increase pain? An algometric comparison of pain perception within the upper shoulder musculature in osteopathic students, contrasted with a random control sample, to distinguish whether osteopathic exam/ clinic stress increase pain perc

Item

Title
Osteopathic stress increase pain? An algometric comparison of pain perception within the upper shoulder musculature in osteopathic students, contrasted with a random control sample, to distinguish whether osteopathic exam/ clinic stress increase pain perc
Author(s)
Morley, R
Abstract
Introduction In today’s society, especially within the western world, there is a strong expectation for life to run to a strict time controlled environment. With the excessive need to be at a certain place at a certain time, it soon takes a toll on the human form. In regards to the body's pain perception under different types of stress, there is very little scientific basis for what really happens within humans. This dissertation aimed to explore the relationship between osteopathic examination stress and pain, as well as seeing if one had a significant influence on the other. The global hypothesis proposed that “there will be a statistically significant increase in pain pressure threshold (PPT) found for osteopathic students (Groups A&B), contrasted with the control, after an academic summer vacational break; compared to results taken during an intense examination and study period”. When stress levels decrease, pain pressure threshold (PPT) should increase. The null global hypothesis apposed the statement above. This aim was achieved using both an extensive search of related literature as well as producing theoretical hypotheses examined within this practical study. Method For this small quantitative, non-crossover clinical trial, an algometer was used to measure PPT levels of shoulder musculature within three independent variable groups. The groups under investigation were the “Immediate stressor” (Group A), which was tested just before undertaking an osteopathic examination and “Long term stressor” (Group B), that was assessed after participating in 5 weeks of intense clinic work. The Control group (Group C) was tested during this period away from the ESO site. Each group contained 20 subjects with an even distribution of males and females. Groups A & B were selected from the ESO population and the control, from areas outside of the University. Measurements were taken during the above as well as after a vacational break. This allowed the author to contrast “before” and “after” data allowing correlations and differences to be evaluated. Stress data was acquired through Lickert Scale questionnaires, which were given at the same time as algometric data collection. Results taken from each stress questionnaire were summed together and divided by the number of questions (12) asked. This produced each participant's overall before and after mean (parametric) score, allowing the author to roughly monitor the participants stress levels during each testing. Results A large significant difference was seen within mean results of groups A & B, with up to a 27.41% increase in PPT and 18.55% decrease in stress levels after the vacational period. With regards to the control, a very minimal change was met with a 6.46% increase in PPT but also a 2.68% increase within stress levels. The author tested to see if theses differences could be seen as significant, using parametric paired t-tests and non-parametric Wilcoxon tests where appropriate. P-value’s resulted in clear significant differences within groups A & B (α = 0.05), with p= 0.00 and 0.02 for algometric data and p=0.006 for stress levels. With regards to group C, insignificant results were calculated, p=0.32 (algometric data) and p= 0.483 (stress). This would allow the author to accept the hypotheses that exam stress effected osteopathic student’s PPT levels, contrasted with the control. However, some anomalous results did present, with group C (right shoulder) showing a significant difference of p=0.02 which was not expected. However, due to having such a low sample size and wide environmental differences within group C, this was put down to experimental error. In regards to correlation significance between algometric pain data and stress, the outcome was not what the author had hoped for. Pearson’s Product Moment and Spearman’s Rank Correlation (applied as appropriate) established negative correlations between each pair of results as the author had expected. However, only the control groups showed any significance. Leaving the author no choice but to accept that no significant correlations were found between osteopathic examination stress and PPT. Power values calculated within group C were very low. Groups A & B had high power values ranging from 0.65 to 0.70 (algometric) and 0.40 to 0.47 (stress). Group C’s power values were calculated at just 0.10 to 0.15 (algometric) and 0.05 (stress). This outcome was likely due to the Control having relatively high standard deviations to begin with and only very small differences between means. This increases the chances of developing anomalous results, as well as the chances of committing a Type II error (Ellis 2010). A larger sample size would overcome this, resulting in larger differences between “before” and “after” results. However, for this reason a type II error may have been made. Discussion Existing literature revealed many ways in which pain perception could be modulated as well as enhanced, with information covering Melzac & Wall’s 1965 pain-gaiting theory and Wood’s 2008 study into hormonal influences. Wager et al’s 2004 study taking psychological factors into consideration was another key interest. More recent studies into chronic stress influencing pain and disease were also beneficial with McEwen’s 2006 “allostasis” theory highlighting ways in which stress affected the body. However, these stated benefits were only found in a handful of studies, making it very difficult for the present author to find reasoning as to why pain levels possibly increase with stress. Conclusion The global hypothesis was accepted, the conclusion being that osteopathic examination stress does affect PPT, however, although a negative correlation could be seen between stress and PPT this was not statistically significant. Maybe with a larger sample size different results would be seen.
presented at
European School of Osteopathy
Date Accepted
2014
Date Submitted
20.1.2015 16:43:40
Type
osteo_thesis
Language
English
Submitted by:
62
Pub-Identifier
15516
Inst-Identifier
1229
Keywords
Algometer, Student well-being, Pain.
Recommended
0
Item sets
Thesis

Morley, R, “Osteopathic stress increase pain? An algometric comparison of pain perception within the upper shoulder musculature in osteopathic students, contrasted with a random control sample, to distinguish whether osteopathic exam/ clinic stress increase pain perc”, Osteopathic Research Web, accessed May 17, 2024, https://www.osteopathicresearch.com/s/orw/item/648