Category: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Pain Rehabilitation; Measurement
The purpose of this comparative study is to evaluate the efficiency of Heart Coherence (HC) on pain during an injection of botilinum toxin.
Design : randomized controlled trial, multicenter.
Setting : Three PMR centers (primary care general hospital, private clinic and university hospital).
Participants (or Animals, Specimens, Cadavers) : Patients included with injection of botulinum toxin (A) during the year 2018.
Group « Heart Coherence » (HC) : realization of therapeutic practice with the help of a simple software program on a tablet, during the injection.
Control group: viewing of a documentary film on US state parks.
Main Outcome Measure(s) :
Heart Rate (HR) recorded before, during and after the application.
Hospital Anxiety and Depression (HAD) scale.
Evaluation is done at the end of the treatment by answering a questionnaire. (visual analogue scales ).
Statistic analysis : Wilcoxon rank sum test .
87 patients including 54 Poststrokes . Average age 58,4 y.o. ( 13.4 ) . The two groups were comparable. For the entire population: the index of satisfaction of the course of the treatment , raises to the level of : 8,9/10 (+/-1.7 ) and a low level of pain : 2,96/10 (+/-2.2).Between the groups, no significative difference for the following scores: pain level , satisfaction of the course of the treatment, HR. There was no influence on the results from the number of injections, the locations, the time laps nor the anxiety and depression.
There was significant result in favor of HC, to the item : « request to renew the technic for the following injections » ( p= 0,006 ).
The HC, establishing a respiratory control, modulates the variability of the HR resulting in rebalancing sympatic and parasympatic systems, benefiting the latter leading to a better emotional control. This requires a learning experience. The none modification of the HR in the HC group is in favor of a simple distractif exercise instead of the application of the Coherence method. However the HC exercise is more active, appears more “ technical ” than the passive visual film projection. This can explain the patients desire to renew the use of the HC for the futur applications. Thus the high level of satisfaction in the two groups encourage to suggest during the application of HC, as a simple and rapid distractibility technic.
Charles Cowan– Medical Chief, General Hospital, Dax, Aquitaine
Alice De Almeida– Medical Doctor, General Hospital, Dax, Aquitaine
Anne Delaubier– Medical Chief, University Hospital, Poitiers, Poitou-Charentes
Charles Peltier– MD, University Hospital, Poitiers, Poitou-Charentes
Philippe Foucault– PMR, PMR Clinic Croix Rouge, LA ROCHELLE, Aquitaine