Chronic pain affects over 100 million Europeans (WHO 2006-2016) and is one of the most under recognized and under-treated medical problems of the 21st century. Persistent pain seriously reduces quality of life for millions of sufferers and tears at the economic and social fabric of our culture. Chronic pain is defined as an unpleasant sensory and emotional experience lasting longer than three mont
hs and is the leading cause of disability in the work place. Chronic pain includes fibromyalgia, migraine/cluster headache, back pain, TMD, osteo- and rheumatoid arthritis, cancer pain, inflammatory muscle pain, and neuropathic pain. The SET (Systolic Extinction Training) protocol, which this project seeks to develop, acquires and stores heart rate, blood pressure, muscle tension, patient history, and other patient data in a central cloud server. The optimum stimulation and therapy parameters can then be downloaded to a treatment device. This intelligent, learning, database supported pain treatment model will revolutionize chronic pain treatment by 1) individualizing each patient’s treatment protocol and 2) adjusting the treatment based upon patient progress. The SET device stimulates the patient through the finger and saves and stores patient physical data. The device also calculates baroreceptor sensitivity (BRS). Chronic pain patients display a reduced BRS as compared to healthy controls. Using BRS as a biomarker, therapists can monitor the effectiveness of the SET protocol and treatment. Freedom from pain is associated with an increase in patient BRS. The SET behavioural therapy protocol was adapted by Dr. Thieme, from leading pain specialists Herta Flor and Niels Birbaumer, based upon work by Dennis Turk at the University of Washington, USA. The protocol is documented in a Moodle (open source) E-learning program for both patients and therapists. Both the stimulation and the E-learning program are flexible and can be modified from mined cloud data. The system learns and get
better as more and more therapy and patient experience is gathered. SET combines this stimulation with operant behavioral therapy to put in place healthy behaviours. During a 2-hour session, the SET device is attached to the patient for two 8-
minute periods. The operant approach is to learn by doing rather than directly attempting a cognitive change (CBT). The standard treatment requires 10 double sessions over 5 weeks (20 hours) with a behavioural therapist. A therapist and patient E-learning program defines the protocol, session by session, and tracks patient exercises, heart rate and variability, MPI scores, pain ratings, treatment progression and other
variables which permits health care professionals to put new pain patients into validated subgroups and administer treatment based upon the proper patient subgroup.
