Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

First Advisor

Bini Litwin

Date of original Performance / Presentation

January 2022

Publication Date / Copyright Date

1-1-2022

Abstract

BACKGROUND AND AIMS: The biopsychosocial nature of chronic pain conditions is well documented, with systemic biological, psychological and social factors interacting in an emergent fashion. Recent literature has highlighted the particular importance of pain catastrophizing and perceived injustice in the chronic pain experience. Autonomic nervous system dysregulation, reflected as decreased heart rate variability (HRV), is suggested to be a biomarker of systemic dysfunction. Previous research has demonstrated correlations between numerous chronic pain disorders and diminished HRV. This correlation has been less investigated in earlier stages of pain. The aim of this study was to determine the relationship between pain and HRV in acute pain, and to examine the indirect effects of psychosocial variables on the relationship between pain and HRV. METHODS: While seated quietly, 94 subjects completed a survey on an iPad as HRV was collected through a Polar H10 chest strap. The Pain Catastrophization Scale (PCS) and Injustice Experience Questionnaire (IEQ) were used to measure thoughts and behaviors regarding pain. Subjects rated current, worst, least, and average pain on the Numeric Pain Rating Scale (NPRS). Raw interbeat interval data collected through Elite HRV was then analyzed with Kubios software. Multiple linear regression was used to assess the relationship between mean pain intensity, total PCS and total IEQ scores with the natural log of high frequency power HRV (lnHFP). Potential mediating or moderating effects of PCS and IEQ was also assessed with linear regression. RESULTS: Lower pain intensity was associated with decreased HRV. Greater age and perceived injustice, higher income, and lower catastrophization were also associated with decreased HRV. CONCLUSIONS: Despite the correlations between diminished HRV and higher pain intensity in individuals with chronic pain, the relationship between these variables appears to be different in this acute pain sample. Further, the interaction of psychosocial variables appears to be different in acute pain experience as compared to chronic pain. The younger and more active characteristics of this sample may be influencing HRV, along with the mechanical nature of the musculoskeletal injuries.

Disciplines

Physical Therapy

Keywords

Acute Pain; Autonomic Nervous System; Catastrophization; Heart Rate Variability; Pain; Psychosocial Variables

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