MY TOP 2 ARTICLES OF 2016 – PART 2
The articles that made me reflect the most in 2016
My top 2 articles in 2016 that made me reflect the most are the following:
1) “Rate of force development: physiological and methodological considerations” 
2) “Low-grade inflammation may moderate the effect of behavioral treatment for chronic pain in adults” 
The pilot study conducted by Lasselin et al. looked at the concentration of inflammatory markers together with psychosocial factors pre and post two behavioural treatments(BT) (Applied Relaxation [AR] and Acceptance and Commitment Therapy [ACT]). Blood samples were taken at the pre-treatment assessment and immediately after the last treatment session.
The research Team wanted to investigate whether a low grade inflammation could modulate the efficacy of behavioural treatments. Low-grade inflammation per definition is “the chronic production, but a low-grade state, of inflammatory factors”.
WHAT THEY HAVE DONE
They recruited subjects who had longstanding pain (>6 months). However, a clear description of the conditions treated was not provided. The interventions consisted of 12 weekly group sessions (90 minutes) conducted by psychologists and a pain physician.
Pain intensity and disability, Psychological Inflexibility, Health Related Quality of Life, Anxiety and Depressive symptoms were the self-reported measures used for the statistical analysis.
WHAT THEY HAVE FOUND
They discovered that the combined concentrations of IL-6 and TNF-α were associated with lesser improvement in pain intensity following treatment. Also, a higher levels of IL-6 and TNF-α concentrations was associated with lower improvement in psychological inflexibility.
In conclusion, behavioural treatment was found to have an effect on psychological inflexibility and mental health-related quality of life in patients with lower inflammatory status before treatment, but not in subjects with higher inflammatory status.
WHAT DOES THIS MEAN?
This pilot study made me reflect about the interaction between the immune system, chronic pain and behavioural responses.
It may also suggest that screening the combined concentrations of IL-6 and TNF-α during the initial assessment may be beneficial in terms of prognosis.
Furthermore, if this “low grade inflammation” is found to promote a state of resistance to behavioural treatment for chronic pain, an effective therapy able to decrease it may be beneficial before commencing behavioural treatments.
1. Maffiuletti, N.A., et al., Rate of force development: physiological and methodological considerations. Eur J Appl Physiol, 2016. 116(6): p. 1091-116.
2. Lasselin, J., et al., Low-grade inflammation may moderate the effect of behavioral treatment for chronic pain in adults. J Behav Med, 2016. 39(5): p. 916-24.