ABSTRACT
The aim of the present study was to investigate the influences of acute water and land exercises on pain, state anxiety and salivary cortisol concentration in chronic low back pain (LBP) patients. Ten myofascial LBP patients participated in the experiment. Their mean age was 60.2 (SD : 9.0) yrs, and their mean duration of pain was 5.6 (3.7) yrs. The water and the land exercise programs consisted of the same physical movements, and prescribed according to the intensity of ratings of perceived exertion (RPE) 11. The heart rate of the participants was measured during exercise to monitor exercise intensity. Results showed that the mean heart rate during exercises (except Warming up and Cooling down) were 88.1±1.6 bpm for water exercise, and 97.0±2.1 bpm for land exercise (p<0.01) . Significant decreases were found in pain score (visual analogue scale ; VAS, p<0.05) and state anxiety (p<0.01) after water exercise. Salivary cortisol concentration showed a significant increase after water exercise (p<0.05) . No significant changes were shown after land exercise in VAS, state anxiety and salivary cortisol concentration. From these results, we suggested that acute water exercise has the benefit in chronic LBP patients of decreasing pain and state anxiety compared with acute land exercise. In addition, salivary cortisol concentration might be much more influenced by exercise intensity than physical or psychological stress such as pain and anxiety.
ABSTRACT
The purpose of this study was to develop the basis of scientific nursing intervention by examining the changes of stress level with elapse of post chemotherapy in breast cancer patients. The design of this study was a longitudinal descriptive study. The subjects of this study was patients receiving chemotherapy from March 1, 1998 to June 30, 1998 at K university hospital in Taegu. The number of subjects was 14 and they were given treatment every 21 days, a cycle of chemotherapy. The changes of their stress with the elapse of chemotherapy were examined every other day. The changes of stress reaction were measured by fatigue and salivary cortisol level. The instrument used to measure fatigue was the revised Pipe Fatigue Scale which was developed by Piper(1984). The reliability of this instrument was Cronbach's alpha .997. The Salivary cortisol was meausured to examine the stress physiological reaction, analyzed using radioimmunoassay. Data was analyzed by computer using the SPSS WIN 7.0 program. Frequency, and Wilcoxon Singned Ranks test were used to examine the changes in degree of fatigue and salivary cortisol with the elapse of chemotherapy. The relationship between fatigue and salivary cortisol was examined using Spearman's rho. The results of this study were as follows: 1) The degree of fatigue was increased a little on the third day 5.64( +/- 1.86)(z=-1.85, p=.06) compared with that of fatigue on the basic day. After that, the degree of fatigue was continuously decreased. it had tendancy to increase a little as patients visited the clinic for next chemotherapy. 2) The mean of salivary cortisol concentration was the higest shortly before chemotherapy. 3) The relationship of fatigue and salivary cortisol was r= .4(p=.098). To sum up, the degree of fatigue was the highest on the third day and salvary cortisol was the highest shortly before chemotherapy. Because the stress reaction of cancer patient receiving chemotherapy was the higest within 3 days in one cycle, it will be effective to provide specified nursing interventions to reduce stress within 3 days after chemotherapy.