{"id":1217,"date":"2017-02-27T13:36:44","date_gmt":"2017-02-27T21:36:44","guid":{"rendered":"http:\/\/www.ramblemuse.com\/rmtp\/?p=1217"},"modified":"2017-02-27T13:36:44","modified_gmt":"2017-02-27T21:36:44","slug":"from-the-pain-summit-the-word-pair-use-top-50","status":"publish","type":"post","link":"https:\/\/www.ramblemuse.com\/rmtp\/2017\/02\/27\/from-the-pain-summit-the-word-pair-use-top-50\/","title":{"rendered":"From the Pain Summit: The Word-Pair use Top-50"},"content":{"rendered":"<p>For what&#8217;s likely to be my last summary of\u00a0 the <a href=\"http:\/\/www.ramblemuse.com\/conference_tweets\/\" target=\"_blank\">1811 tweets<\/a> from the <a href=\"https:\/\/sandiegopainsummit.com\/2017\/\" target=\"_blank\">San Diego Pain Summit 2017<\/a>\u00a0using various metrics of tweet importance, I created a <a href=\"http:\/\/www.ramblemuse.com\/conference_tweets\/sdpain_2017\/wordpairs.html\" target=\"_blank\">ranked word-pair vocabulary<\/a> from the body of tweets, where each word-pair had to occur within single tweets. With this pair-vocabulary in place, I then summed up the word-pair score for each tweet and sorted them into an order of decreasing scores. I&#8217;ve listed the top 50 tweets under this measure of importance below, in the sorted order.<\/p>\n<p>Note that this post is a follow-on to <a href=\"http:\/\/www.ramblemuse.com\/rmtp\/2017\/02\/24\/things-from-the-pain-summit-literally\/\" target=\"_blank\">\u201cThings\u201d from the Pain Summit (Literally)<\/a> and <a href=\"http:\/\/www.ramblemuse.com\/rmtp\/2017\/02\/25\/from-the-pain-summit-doubles-from-the-one-hundred\/\" target=\"_blank\">From the Pain Summit \u2014 Doubles from The One Hundred.<\/a><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li>We see small sample sizes, and small effect sizes, but why do we expect large effect sizes out of a singular treatment approach?<\/li>\n<li>Sleep hygiene, activity levels based on preference, set goals, graded activity (social), min of 4 times\/wk for 30 min<\/li>\n<li>Set small realistic goals to set up our patient for success. Small achievable goals to activate rewards systems in the brain.<\/li>\n<li>The cautionary tale of morphidex: tested only on male rats where it made a difference; on women it made no difference.<\/li>\n<li>Tenderness of the pelvic floor caused more disability than weakness of the pelvic floor<\/li>\n<\/ul>\n<ul>\n<li>Farmer, MindBody: When addressing fear of movement it is critical to determine the specific core belief underlying the fear.<\/li>\n<li>Pelvic floor rehab is orthopedics in a cave. It is not only a female problem. Everyone has a pelvic floor.<\/li>\n<li>Lots more rats than mice used in animal research. Genetics: most research is used on 1 kind of mouse and 1 kind of rat.<\/li>\n<li>Cognitive factors, emotional, social, physical lifestyle factors all influence pain. All are modifiable factors.<\/li>\n<li>Why would we expect to see large effect sizes from a single intervention &#8211; lots of interventions have small effect size.<\/li>\n<\/ul>\n<ul>\n<li>Koban: social factors that modulate pain\/relief: presence, social stress, cultural beliefs, therapeutic alliance, social norms.<\/li>\n<li>The issue of genetics: rats and mice are used in Pain research. And only on 1 kind of mouse or rat. Not a lot of diversity.<\/li>\n<li>It matters whether human presence is female or male! If human is male, mice grimace less.<\/li>\n<li>Lifesyle changes to work on: sleep hygiene, regular exercise to preference (activity), set goals, min 30m 4x wk.<\/li>\n<li>Physical factors &#8211; postural extension + cognitive factors &#8211; fear &#8211; tend to increase muscle contraction of lumbar muscles during movement.<\/li>\n<\/ul>\n<ul>\n<li>Barriers to exercise adherence: low self efficacy, envisaging lots of barriers to exercise.<\/li>\n<li>Cortisol levels in response to stress predict musculoskeletal pain: low response leads to increased inflammation response and pain.<\/li>\n<li>Lifting from a flexed position &#8211; back muscles work more efficiently. Lifting in lordosis increases work\/load.<\/li>\n<li>Ben &#8211; Minds change slowly. Rarely do patients have an epiphany. Sometimes you are never going to change people&#8217;s mind.<\/li>\n<li>CFT [Cognitive Functional Therapy] Management Plan sample: making sense of pain, exposure with control, lifestyle changes, give control over pain.<\/li>\n<\/ul>\n<ul>\n<li>Do people approach or avoid pain? Women sit away from people pretending to be sick and close to people in pain. Men could care less either way.<\/li>\n<li>And to humans. Male mice are standing in for human women. And women are the &#8220;real clinical problem&#8221;.<\/li>\n<li>Engram: the physical changes in the brain that represent a specific memory (memory trace).<\/li>\n<li>Increase in dendrite spine dictates where info goes. Learning changes neuron structure, spine growth\/pruning.<\/li>\n<li>Rat grimace scale findings are skewed in presence of scent of male humans &#8211; simple things making reproduction of research difficult.<\/li>\n<\/ul>\n<ul>\n<li>With female mice that know each other, mouse in middle will spend time with mice in pain, lowering pain.<\/li>\n<li>&#8220;Pelvic floor dysfunction treatment belongs in the Orthopedic Division, not Women&#8217;s Health. This is orthopedics.&#8221; C Vandyken<\/li>\n<li>Barriers to exercise: Pain and anxiety re worsening, low self-efficacy, envisaging barriers (time, pessimism, dislike)<\/li>\n<li>Exercise: means of imparting progresive physical and psychological stresses; dose depends on bio, psych, and soc factors.<\/li>\n<li>A bit of geek heaven. Microglia studies done on male mice are positive, on female mice they are negative.<\/li>\n<\/ul>\n<ul>\n<li>With strange mice, stress goes up, blocking empathy. Blocking stress, empathy appears.<\/li>\n<li>Exercise doesn&#8217;t have to suck for it to be effective &#8211; set activity goals based on patient preference.<\/li>\n<li>Focus on finding gaps in others knowledge, not ignorance of knowledge. Identify opportunities to build confidence and trust.<\/li>\n<li>You don&#8217;t want to have an orgasm while you pee, and you don&#8217;t want pee while having an orgasm. Pelvic floor pain often undermines.<\/li>\n<li>Making sense of pain is really important for patients. Exposure with control. Lifestyle change. It&#8217;s a journey.<\/li>\n<\/ul>\n<ul>\n<li>Patient &#8220;It doesn&#8217;t feel normal it just feels unnatural &#8211; slouchy to sit like this. But it feels better.&#8221;<\/li>\n<li>Refer out for major depressive disorder, anxiety disorder, major social stressors, work with other HCPs, don&#8217;t abandon.<\/li>\n<li>First muscles to contract in a threatening situation are muscles of the pelvic floor &#8211; makes sense for survival https:\/\/t.co\/xB6n1Ohv9M<\/li>\n<li>Play the &#8220;long game&#8221;: Establish therapeutic alliance, find gaps in knowledge, Identify chances to build trust, lead gently.<\/li>\n<li>Never attempt to directly correct patients&#8217; or &#8216;clients&#8217; beliefs. Changing minds takes time. https:\/\/t.co\/QA2p4F7EBP<\/li>\n<\/ul>\n<ul>\n<li>So you see clusters. Times of rapid change &#8211; emergence at adolescence, physical, emotional, physiological change.<\/li>\n<li>Prof Pete O&#8217;Sullivan PT uses iPhone photos of the patient to show that relaxed posture (no pain) is still &#8220;good posture&#8221; to the patient.<\/li>\n<li>Do: Goal setting (get your interview skills up!), outcome measures (patient specific functional scale!), preferences, expectations.<\/li>\n<li>Can we think of cognitive bias as sensitized beliefs? Treat communication like we treat movement. Graded communication?<\/li>\n<li>The goal, to create frequent high quality communication and strong relationships. Open avenues of opportunity to be accurate.<\/li>\n<\/ul>\n<ul>\n<li>Negative beliefs about back pain, fear of movement, and decreased self efficacy are predictive of disability.<\/li>\n<li>Reviewing biomechanics of lifting &#8211; no clear benefit to different lifting methods in terms of load\/shear. Kingma 2010<\/li>\n<li>Spending time helping a person work out how they will plan for exercise is a worthwhile pursuit.\u00a0 Address barriers.<\/li>\n<li>Henderson Reframing exercise. Imparts progress in physical and psych Stress. Dosing is dependent upon a variety of factors.<\/li>\n<li>C. Vandyken &#8211; Data indicates that a large percent of women with LBP had pelvic floor dysfunction. (63% of n=1636, 78% of n=200)<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>For what&#8217;s likely to be my last summary of\u00a0 the 1811 tweets from the San Diego Pain Summit 2017\u00a0using various metrics of tweet importance, I created a ranked word-pair vocabulary from the body of tweets, where each word-pair had to occur within single tweets. With this pair-vocabulary in place, I then summed up the word-pair [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,5,9],"tags":[144,145,140],"class_list":["post-1217","post","type-post","status-publish","format-standard","hentry","category-embodiment","category-health","category-science","tag-sdpain","tag-pain-research","tag-san-diego-pain-summit"],"_links":{"self":[{"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/posts\/1217","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/comments?post=1217"}],"version-history":[{"count":7,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/posts\/1217\/revisions"}],"predecessor-version":[{"id":1224,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/posts\/1217\/revisions\/1224"}],"wp:attachment":[{"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/media?parent=1217"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/categories?post=1217"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/tags?post=1217"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}