An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
*note this definition says absolutely nothing about the cause of pain!!
The neural process of encoding and processing noxious stimuli. Nociceptive pain = Pain arising from activation of nociceptors
A sensory receptor of the peripheral somatosensory nervous system that is capable of transducing and encoding noxious stimuli.
Increased pain from a stimulus that normally provokes pain.
Pain due to a stimulus that does not normally provoke pain.
Increased responsiveness of neurons to their normal input or neuron response to normally sub-threshold inputs. (peripheral and central)
define neuropathic pain
Pain caused by a lesion or disease of the somatosensory nervous system.
what is the biopsychosocial model of pain?
- pain influenced by 3 factors, biological, psychological, social
what are Pain-related biological, psychological and social inputs are processed by?
is pain an output or inpot of the brain? why?
- inputs don't cause pain rather pain is dependant on how the brain responds to inputs
-How our brains respond to inputs is a unique function of who we are (genetics + learning)
what are the three neuron pathways?
what can cause nociception?
•Soft tissue strains/sprains
•Peripheral nerve irritation
describe nociception vs pain (1 word)
nociception = neural process
pain = experience
can nociception alone cause pain?
NO. nociception alone is neither sufficient nor necessary for pain
- phantom limb pain (no nociception, but pain)
- focusing on other things or shock (nociception but no pain)
name some influencing factors of pain associated with nociception and some not associated with nociception
describe sensitivity to physical activity for those with OA and chronic pain
OA: increased discomfort with longer walking
chronic pain: High SPA = A progressive increase in pain during a standardized physical activity
what does sensitivity to physical activity predict?
what are the implications for exercise prescription considering sensitivity to physical acivity?
order of stability for walking aids?
what requires higher energy demand, standard or wheeled walkers?
The oxygen demand per meter is increased by 104% and the heart rate per meter by 98
what percent of BW does a cane accept?
describe the timing of peak force in use of canes
Timing of peak force application may differ depending on functional use
1) Late-stance & toe off – compensate for p-flex
For example, patients with ankle arthroplasty apply peak cane force late in the stance phase suggesting that the cane is use to push forward.
2) early-stance Heel strike – reduce impact force (e.g., hip OA)
Patients with degenerative joint disease of the hip apply peak force early in the stance phase, suggesting that the cane was used for restraint.
how to use a cane or 1 crutch
Placing the cane on the ipsilateral side to the leg that needs assistance, increases the torque that the hip abductors need to stabilize the pelvis.
how to carry objects using cane (with hip problems, with back problems)
how to adjust crutches
describe the 3 walkign gaits for assistive devices
what percent of people abandon their assistive device after getting it? why?
- more than 50% of those people say its difficult and risky to use
- discomfort or pain with device
one study said use of mobility aid actually increases fall rick - why?
•Only those with balance impairment, functional decline, and/or falling risk are likely to be using a mobility aid
•May increase risk of falling by causing tripping or by disrupting balance control through other mechanisms (e.g., by competing for attentional resources)
•Walker doesn't allow for a stepping response
•Have to pick up device and move it
what are biomechanical benefits of supportive devices?
•Increases the BOS
•Allow stabilizing reaction forces at the hands
•In contralateral hand – reduces compressive force on hip force by up to 60%
what are demands or reverse biomechanical effects of supportive devices?