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首页> 外文期刊>BMC International Health and Human Rights >Pain when walking: individual sensory profiles in the foot soles of torture victims - a controlled study using quantitative sensory testing
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Pain when walking: individual sensory profiles in the foot soles of torture victims - a controlled study using quantitative sensory testing

机译：行走时疼痛：折磨受害者脚底的个别感觉特征-使用定量感觉测试的对照研究

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Background With quantitative sensory testing (QST) we recently found no differences in sensory function of the foot soles between groups of torture victims with or without exposure to falanga (beatings under the feet). Compared to matched controls the torture victims had hyperalgesia to deep mechano-nociceptive stimuli and hypoesthesia to non-noxious cutaneous stimuli. The purpose of the present paper was to extend the group analysis into individual sensory profiles of victims’ feet to explore possible relations between external violence (torture), reported pain, sensory symptoms and QST data to help clarify the underlying mechanisms. Methods We employed interviews and assessments of the pain and sensory symptoms and QST by investigators blinded to whether the patients, 32 male torture victims from the Middle East, had (n=15), or had not (n=17) been exposed to falanga. Pain intensity, area and stimulus dependence were used to characterize the pain. QST included thresholds for touch, cold, warmth, cold-pain, heat-pain, deep pressure pain and wind-up to cutaneous noxious stimuli. An ethnically matched control group was available.The normality criterion, from our control group data, was set as the mean +/? 1.28SD, thus including 80% of all values.QST data were transformed into three categories in relation to our normality range; hypoesthesia, normoesthesia or hyperesthesia/hyperalgesia . Results Most patients, irrespective of having been exposed to falanga or not, reported severe pain when walking. This was often associated with hyperalgesia to deep mechanical pressure. Hypoesthesia to mechanical stimuli co-occurred with numbness, burning and with deep mechanical hyperalgesia more often than not, but otherwise, a hypoesthesia to cutaneous sensory modalities did not co-occur systematically to falanga, pain or sensory symptoms. Conclusion In torture victims, there seem to be overriding mechanisms, manifested by hyperalgesia to pressure pain, which is usually considered a sign of centralization. In addition there was cutaneous hypoesthesia, but since there was no obvious correlation to the localization of trauma, these findings may indicate centrally evoked disturbances in sensory transmission, that is, central inhibition. We interpret these findings as a sign of changes in central sensory processing as the unifying pathological mechanism of chronic pain in these persons.
机译：背景技术最近，通过定量感官测试（QST），我们发现在遭受或未遭受暴露于法兰加（脚下跳动）的酷刑受害者群体之间，脚底的感觉功能没有差异。与配对对照相比，酷刑受害者对深层机械伤害感受性刺激有痛觉过敏，对非有害皮肤刺激有感觉不足。本文的目的是将群体分析扩展到受害人脚的各个感官特征，以探索外部暴力（酷刑），报告的疼痛，感官症状和QST数据之间的可能关系，以帮助阐明潜在的机制。方法我们接受了调查员的访谈和评估，对疼痛，感觉症状和QST进行了调查，他们不知道患者（32名来自中东的男性酷刑受害者）是否曾暴露于（flanga）（n = 15）（n = 17） 。使用疼痛强度，面积和刺激依赖性来表征疼痛。 QST包括触觉，感冒，温暖，冷痛，热痛，深压痛和发炎至皮肤有害刺激的阈值。可以使用一个种族匹配的对照组。根据我们的对照组数据，将正态性标准设置为平均值+ /?。 1.28SD，因此包括所有值的80％。QST数据相对于我们的正态范围分为三类;感觉不足，感觉正常或感觉过敏/痛觉过敏。结果大多数患者，不论是否接触过法兰，都在行走时感到剧烈疼痛。这通常与痛觉过敏和深机械压力有关。对机械刺激的感觉低下通常与麻木，灼热和深部机械性痛觉过敏同时发生，但除此之外，对皮肤感觉方式的感觉低下并未系统地发生于眼睑，疼痛或感觉症状。结论在酷刑受害者中，似乎存在压倒一切的机制，表现为痛觉过敏的痛觉过敏，通常被认为是集中化的标志。此外，还有皮肤感觉不足，但是由于与创伤的位置没有明显的相关性，因此这些发现可能表明感觉传递的中枢性紊乱，即中枢抑制。我们将这些发现解释为中枢感觉过程改变的标志，这些改变是这些人慢性疼痛的统一病理机制。

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