source: The Journal of Pain

year: 2018

authors: M. Ezenwa, Y. Yao, M. Nguyen, M. Mandernach, C. Hunter, S. Yoon, A. Amador, A. Sylvera, R. Lamonge, D. Lyon, D. Wilkie

Pain is the major complication for the approximately 100,000 individuals with sickle cell disease (SCD) in the United States. Although opioid analgesics are the mainstay therapy for SCD pain, little is known about the use of self-managed modalities (e.g., relaxation) and the effects of relaxation on pain, stress, and autonomic responses in patients with SCD.

This pre-post randomized controlled trial was conducted to: 1) determine protocol feasibility: (a) issues of Pentablet computer use for relaxation intervention delivery; (b) acceptability of study procedures; and (c) percentage of missing data); and 2) estimate the size of the relaxation intervention effects on pain and stress and physiologic markers of relaxation (respiration, pulse, and skin temperature [mediators]).

Patients (N = 30, mean age 34.9 ± 10.4 years [22–59 years], 100% Non-Hispanic, 53% male) enrolled between June 2016 and March 2017 were randomized to Experimental (12 min Relaxation video clip) or Control (12 min SCD discussion) groups. Physiological markers and questionnaires (pain, stress) were completed before and after the intervention. Data were analyzed using the statistical software R.

All participants signing the consent completed the study; 93% of the 30 participants completed over 90% of the questionnaire items; 89% of control and 92% of experimental groups reported that the intervention was “Not hard at all;” and 83% of experimental group reported that they liked the intervention whereas 44% of control group did. Regression results controlling for baseline measure indicate a trend for positive relaxation intervention effects on pain (p = .09) and stress (p = .08). Relaxation indicators including respiration (p = .23), pulse (p = .79), and skin temperature (p = .60) were not significantly different between the two groups.

The study was feasible and the relaxation intervention was promising in reducing pain and stress. Future studies are warranted to test efficacy of the relaxation intervention and its mechanism in this population suffering with chronic disabling pain.

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