Lower Leg Anterior and Lateral Intracompartmental Pressure Changes Before and After Classic Versus Skate Nordic Rollerskiing

Context Chronic exertional compartment syndrome (CECS) is a debilitating condition resulting in loss of function and a decrease in athletic performance. Cases of CECS are increasing among Nordic skiers; therefore, analysis of intracompartmental pressures (ICPs) before and after Nordic skiing is warranted. Objective To determine if lower leg anterior and lateral ICPs and subjective lower leg pain levels increased after a 20-minute Nordic rollerskiing time trial and to examine if differences existed between postexercise ICPs for the 2 Nordic rollerskiing techniques, classic and skate. Design Crossover study. Setting Outdoor paved loop. Patients or Other Participants Seven healthy Division I Nordic skiers (3 men, 4 women; age = 22.71 ± 1.38 y, height = 175.36 ± 6.33 cm, mass = 70.71 ± 6.58 kg). Intervention(s) Participants completed two 20-minute rollerskiing time trials using the classic and skate technique in random order. The time trials were completed 7 days apart. Anterior and lateral ICPs and lower leg pain scores were obtained at baseline and at minutes 1 and 5 after rollerskiing. Main Outcome Measure(s) Anterior and lateral ICPs (mm Hg) were measured using a Stryker Quic STIC handheld monitor. Subjective measures of lower leg pain were recorded using the 11-point Numeric Rating Scale. Results Increases in both anterior (P = .000) and lateral compartment (P = .002) ICPs were observed, regardless of rollerskiing technique used. Subjective lower leg pain increased after the classic technique for the men from baseline to 1 minute postexercise and after the skate technique for the women. Significant 3-way interactions (technique × time × sex) were observed for the anterior (P = .002) and lateral (P = .009) compartment ICPs and lower leg pain (P = .005). Conclusions Postexercise anterior and lateral ICPs increased compared with preexercise ICPs after both classic and skate rollerskiing techniques. Lower leg pain is a primary symptom of CECS. The subjective lower leg pain 11-point Numeric Rating Scale results indicate that increases in lower leg ICPs sustained during Nordic rollerskiing may increase discomfort during activity. Our results therefore suggest that Nordic rollerskiing contributes to increases in ICPs, which may lead to the development of CECS.

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CAN PATIENTS WITH SAGITTALLY WELL-COMPENSATED LUMBAR DEGENERATIVE KYPHOSIS BENEFIT FROM SURGICAL TREATMENT FOR INTRACTABLE BACK PAIN?

Neurosurgery ◽

10.1227/01.neu.0000335642.14527.26 ◽

2009 ◽

Vol 64 (1) ◽

pp. 115-121 ◽

Cited By ~ 28

Author(s):

Jee-Soo Jang ◽

Sang-Ho Lee ◽

Jung Mok Kim ◽

Jun-Hong Min ◽

Kyung-Mi Han ◽

...

Keyword(s):

Back Pain ◽

Oswestry Disability Index ◽

Lumbar Lordosis ◽

Rating Scale ◽

Numeric Rating Scale ◽

Leg Pain ◽

Compensatory Mechanisms ◽

The Mean ◽

Numeric Rating

Abstract OBJECTIVE To analyze pre- and postoperative x-rays of sagittal spines and to review the surgical results of 21 patients with lumbar degenerative kyphosis whose spines were sagittally well compensated by compensatory mechanisms but who continued to suffer from intractable back pain METHODS We performed a retrospective review of 21 patients treated with combined anterior and posterior spinal arthrodesis. Inclusion criteria were: lumbar degenerative kyphosis patients with intractable back pain and whose spines were sagittally well compensated by a compensatory mechanism, defined as a C7 plumb line to the posterior aspect of the L5–S1 disc of less than 5 cm. Outcome variables included: radiographic measures of preoperative, postoperative, and follow-up films; clinical assessment using the mean Numeric Rating Scale, Oswestry Disability Index, and Patient Satisfaction Index; and a review of postoperative complications. RESULTS All patients were female (mean age, 64.5 years; age range, 50–74 years). The mean preoperative sagittal imbalance was 19.5 (± 17.6) mm, which improved to −15.8 (± 22.2) mm after surgery. Mean lumbar lordosis was 13.2 degrees (± 15.3) before surgery and increased to 38.1 degrees (± 14.4) at follow-up (P < 0.0001). Mean thoracic kyphosis was 5.5 degrees (± 10.2) before surgery and increased to 18.9 degrees (± 12.4) at follow-up (P < 0.0001). Mean sacral slopes were 12.9 degrees (± 11.1) before surgery and increased to 26.3 degrees (± 9.6) at follow-up (P < 0.0001). The mean Numeric Rating Scale score improved from 7.8 (back pain) and 8.1 (leg pain) before surgery to 3.0 (back pain) and 2.6 (leg pain) after surgery (P < 0.0001). The mean Oswestry Disability Index scores improved from 56.2% before surgery to 36.7% after surgery (P < 0.0001). In 18 (85.5%) of 21 patients, satisfactory outcomes were demonstrated by the time of the last follow-up assessment. CONCLUSION This study shows that even lumbar degenerative kyphosis patients with spines that are sagittally well compensated by compensatory mechanisms may suffer from intractable back pain and that these patients can be treated effectively by the restoration of lumbar lordosis.

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PERBEDAAN TINGKAT NYERI DADA SEBELUM DAN SETELAH DILAKUKAN TERAPI MUROTALL AL-QURAN

Jurnal Keperawatan ◽

10.32583/keperawatan.v11i2.517 ◽

2019 ◽

Vol 11 (2) ◽

pp. 135-142

Author(s):

Priyanto Priyanto ◽

Idia Indar Anggraeni

Keyword(s):

Chest Pain ◽

Rating Scale ◽

Numeric Rating Scale ◽

P Value ◽

Pain Level ◽

Paired Sample ◽

Before And After ◽

Post Test ◽

The Difference ◽

Numeric Rating

Nyeri dada merupakan keluhan utama yang sering dirasakan oleh penderita penyakit jantung koroner. Nyeri dada muncul karena suplai oksigen ke miokardium menurun. Terapi murottal Al-Qur’an merupakan terapi religi dimana seseorang akan diperdengarkan ayat-ayat Al-Qur’an selama beberapa menit sehingga akan memberikan dampak positif bagi tubuh seseorang, salah satunya untuk mengurangi rasa nyeri. Penelitian ini bertujuan untuk mengetahui perbedaan tingkat nyeri dada sebelum dan setelah dilakukan terapi murottal Al-Qur’an. Desain penelitian ini menggunakan metode pre-experimental dengan desain one group Pre-test dan Post-test. Metode sampling yang digunakan adalah accidental sampling, dan jumlah sampel sebanyak 17 responden. Instrument penelitian yang digunakana dalah Numeric Rating Scale untuk mengukur skala nyeri sebelum dan setelah terapi murottal Al-Qur’an, pemberiannya sekali selama 20 menit. Uji statistic yang digunakan adalah paired sample T test. Hasil dari penelitian ini menunjukkan bahwa ada perbedaan yang bermakna tingkat nyeri dada sebelum dan setelah dilakukan terapi murottal Al-Qur’an dengan nilai p-value 0,000 (p < α (0,05)). Terapi murottal Al-Qur’an dapat menurunkan skala nyeri dada pasien. Kata kunci: nyeri dada, terapi murottal al-qur’an THE DIFFERENCE BETWEEN CHEST PAIN LEVEL BEFORE AND AFTER MUROTTAL AL-QUR'AN THERAPY ABSTRACT Chest pain is a major complaint that is often felt by people with coronary heart disease. Chest pain occurs because of decreased supply of oxygen to the myocardium. Murottal Al-Qur'an therapy is a religious therapy where someone will be heard verses of Al-Qur’an for a few minutes so it will have a positive impact on one’s body, one of them is to reduce pain. This study aims to find out the difference between chest pain level before and after murottal Al-Qur'an therapy.This research design used pre-experimental method with one grouppre-test and post-test. The sampling method was accidental sampling, the number of sampling were 17 respondents. The research instrument used the Numeric Rating Scale to measure pain scale before and after murottal Al-Qur'an therapy, giving it once for 20 minutes. The test statistic used is paired sample T test.The results of this study indicate that there are significan differences in chest pain levels before and after murottal Al-Qur'an therapy with a p-value of 0.004 (p <α (0.05)).Murottal Al-Qur'an therapy can reduce the scale of patient's chest pain. Keywords : chest pain, murottal al-qur’an therapy

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NUMERIC RATING SCALE ANALYSIS OF TRIGEMINAL NEURALGIA PATIENTS BEFORE AND AFTER MICROVASCULAR DECOMPRESSION

MNJ (Malang Neurology Journal) ◽

10.21776/ub.mnj.2021.007.01.4 ◽

2021 ◽

Vol 7 (1) ◽

pp. 17-19

Author(s):

Elena Ghentilis Fitri Amelia ◽

Agus Turchan ◽

Nancy Margarita Rehatta ◽

Hanik Badriyah Hidayati

Keyword(s):

Trigeminal Neuralgia ◽

General Hospital ◽

Microvascular Decompression ◽

Facial Pain ◽

Rating Scale ◽

Numeric Rating Scale ◽

Facial Reduction ◽

Normality Test ◽

Before And After ◽

Numeric Rating

Background: Trigeminal Neuralgia is a common condition of facial pain and its significantly affect patients’ daily life. Microvascular decompression is one of the interventional pain management for trigeminal neuralgia. There is still a little data obtained on evaluation of facial pain after microvascular decompression in Indonesia. Objective: This research aimed to evaluate facial pain after microvascular decompression of trigeminal neuralgia patients in Dr. Soetomo General Hospital, PHC Hospital, and Bangil General Hospital, Indonesia. Methods: The research design was a pretest-posttest with total sampling. Data were obtained from medical records from January 2018 until June 2019. Researches used Numeric Rating Scale (NRS) as pain measurement. The data obtained were analyzed by descriptive statistical test, normality test, and paired t-test. Results: Trigeminal Neuralgia patients that has been treated with microvascular decompression have an average facial reduction from 7.33±2.29 to 1.89±3.41 with p = 0.001. This result showed that the microvascular decompression has significantly reduce facial pain in patients with trigeminal neuralgia. Conclusion: Microvascular decompression significantly reduce the facial pain of trigeminal neuralgia patients.

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Clinical Effectiveness of Percutaneous Adhesiolysis Using Navicath for the Management of Chronic Pain Due to Lumbosacral Disc Herniation

January 2018 - Pain Physician ◽

10.36076/ppj.2012/15/213 ◽

2012 ◽

Vol 3;15 (3;5) ◽

pp. 213-223

Author(s):

Juan Hwan Lee

Keyword(s):

Chronic Pain ◽

Disc Herniation ◽

Predictive Factors ◽

Rating Scale ◽

Clinical Effectiveness ◽

Epidural Injection ◽

Numeric Rating Scale ◽

Leg Pain ◽

Transforaminal Epidural Injection ◽

Numeric Rating

Background: Epidural steroid injection has been frequently performed to treat chronic pain due to lumbosacral disc herniation (L-HIVD). However, a considerable number of patients do not achieve pain relief using this method because perineural or epidural adhesions prevent the spread of injectate into the epidural space. Percutaneous adhesiolysis (PA) is thought to be a useful method because it can eliminate the deleterious effects of adhesion. Objectives: This study aimed to evaluate the effectiveness of PA in managing chronic pain due to L-HIVD and the clinical and radiological predictive factors for the effectiveness of PA using NaviCath®. Study design: Retrospective study Setting: Spine hospital Methods: From a group of patients diagnosed with L-HIVD, we selected the 86 patients who underwent PA with NaviCath who had experienced chronic lower back or leg pain for at least 3 months and had failed to respond to anti-inflammatory medications or physical therapy of at least 1 month’s duration and fluoroscopy guided transforaminal epidural injection. We recorded the Numeric Rating Scale for back pain (NRS back) and leg pain (NRS leg) and the Oswestry Disability Index (ODI) at pretreatment, 2 weeks, and 3 months after treatment. Clinical data and magnetic resonance imaging (MRI) findings were obtained to assess the possible predictive factors for PA efficacy. Limitations: Retrospective chart review without a control group. Results: At 2 weeks after PA, significant improvement was observed in NRS back, NRS leg, and ODI compared with pretreatment. This improvement was maintained until 3 months after treatment. Among 86 patients, 61 (70.9%), 53 (61.6%) and 61 patients (70.9%) showed successful outcomes in NRS back, NRS leg, and ODI at 2 weeks, respectively. Among 74 patients who were followed up at 3 months, 47 (63.5%), 44 patients (59.5%), and 50 patients (67.6%) showed successful results in NRS back, NRS leg, and ODI at 3 months, respectively. A significantly higher proportion of patients with a history of previous lumbar surgery showed unsuccessful results on NRS back, NRS leg, and ODI scores at 2 weeks and 3 months. Co-existence of spinal stenosis was associated with a significantly higher proportion of unsuccessful results in NRS back and ODI at 2 weeks and 3 months, as well as NRS leg at 3 months. Patients with spondylolisthesis also showed a significantly higher proportion of unsuccessful results in NRS and ODI at 2 weeks. Conclusion: PA with NaviCath showed clinical effectiveness in the treatment of chronic pain due to L-HIVD that was not responsive to transforaminal epidural injection. Previous surgery and the presence of spinal stenosis or spondylolisthesis were poor prognostic predictors. This procedure may enable the physician to place the catheter tip and deliver medicine more precisely. Key words: Percutaneous adhesiolysis, lumbosacral disc herniation, Numeric Rating Scale, Oswetry Disability Index

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PENGARUH TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION DENGAN DAN TANPA TERAPI LATIHAN TERHADAP NYERI DAN KINERJA FISIK PADA PENDERITA OSTEOARTRITIS LUTUT

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.6.3.2014.6325 ◽

2014 ◽

Vol 6 (3) ◽

Cited By ~ 1

Author(s):

Inge Jiemesha ◽

Engeline Angliadi

Keyword(s):

Physical Performance ◽

Exercise Therapy ◽

Pharmacological Treatment ◽

Rating Scale ◽

Numeric Rating Scale ◽

Joint Disease ◽

Timed Up And Go ◽

Knee Oa ◽

Before And After ◽

Numeric Rating

Abstract: Osteoarthritis (OA) of the knee is a chronic degenerative joint disease which causes disability affecting the quality of life. Its management may include pharmacological and non-pharmacological treatment. In the non-pharmacological treatment there are a variety of treatment options. This study aimed to prove the effect of Transcutaneous Electrical Nerves Stimulation (TENS) with and without exercise on pain and physical performance in patients with knee OA. There were thirty five patients with knee OA who met the inclusion criteria that visited the Medical Rehabilitation Department of Prof. Dr. R.D. Kandou Hospital. The samples were divided into 2 groups: TENS with exercise therapy and TENS without exercise therapy. Each group undergone their therapy for 6 weeks with a frequency of 2 times per week. Pain was measured by using the Numeric Rating Scale (NRS) and physical performance was measured by using the Timed-Up and Go test (TUG) and the Stair Climb Test (SCT). There were 91.4% females meanwhile overweight and obese patients were 34.3%. The results showed that there were significant differences in pain and physical performance between before and after TENS with exercise (P <0.001) as well as before and after TENS without exercise (P < 0.001). There was no difference in pain and physical performance between the two groups. Conclusion: TENS with and without exercise can reduce pain and improve physical performance in patients with knee osteoarthritis.Keywords: knee osteoarhtritis, TENS, pain, physical performanceAbstrak: Osteoartritis (OA) lutut adalah penyakit degeneratif sendi yang bersifat kronis dan menyebabkan disabilitas yang memengaruhi kualitas hidup penderita. Tatalaksana OA lutut terdiri dari farmakologi dan non-farmakologi dengan bermacam-macam pilihan terapi. Penelitian ini bertujuan untuk membuktikan pengaruh Transcutaneous Electrical Nerves Stimulation (TENS) dengan dan tanpa terapi latihan terhadap nyeri dan kinerja fisik pada penderita OA lutut. Sebanyak 35 penderita OA lutut lama maupun baru yang memenuhi kriteria inklusi, yang berkunjung ke Poliklinik Rehabilitasi Medik RSUP Prof Dr. R.D. Kandou dan bersedia mengikuti penelitian. Sampel dibagi menjadi 2 kelompok: diberikan TENS dengan terapi latihan dan yang tanpa terapi latihan selama 6 minggu dengan frekuensi 2 kali per minggu. Nyeri diukur dengan Numeric Rating Scale (NRS) dan kinerja fisik diukur dengan Timed-Up and Go test (TUG) dan Stair Climb Test (SCT). Dari hasil analisis 35 subyek penelitian didapatkan 32 orang (91,4%) subyek wanita, serta indeks massa tubuh yang overweight dan obese sebanyak 34,3 %. Hasil uji perbedaan nyeri dan kinerja fisik sebelum dan sesudah TENS dengan terapi latihan memperlihatkan perbedaan bermakna (P <0,001). Hasil perbedaan nyeri dan kinerja fisik sebelum dan sesudah TENS juga memperlihatkan perbedaan bermakna (P <0,001). Pada hasil uji perbedaan nyeri dan kinerja fisik pada kedua kelompok didapatkan tidak terdapat perbedaan antara keduanya. Simpulan: TENS dengan dan tanpa terapi latihan dapat mengurangi nyeri dan meningkatkan kinerja fisik pada penderita osteoartritis lutut.Kata kunci: osteoartritis lutut, TENS, nyeri, kinerja fisik

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Stress-Related Anterior Lower Leg Pain: Evaluation with MRI and Intracompartmental Pressure Measurement

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00059525 ◽

2002 ◽

Vol 17 (S1) ◽

pp. S40-S40

Author(s):

MJ Kiuru ◽

MJ Mäntysaari ◽

HK Pihlajamäki ◽

JA Ahovuo

Keyword(s):

Pressure Measurement ◽

Lower Leg ◽

Leg Pain ◽

Intracompartmental Pressure ◽

Pain Evaluation ◽

Lower Leg Pain

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Evaluation of Stress-Related Anterior Lower Leg Pain with Magnetic Resonance Imaging and Intracompartmental Pressure Measurement

Military Medicine ◽

10.1093/milmed/168.1.48 ◽

2003 ◽

Vol 168 (1) ◽

pp. 48-52 ◽

Cited By ~ 2

Author(s):

Martti J. Kiuru ◽

Matti J. Mantysaari ◽

Harri K. Pihlajamaki ◽

Juhani A. Ahovuo

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Pressure Measurement ◽

Lower Leg ◽

Leg Pain ◽

Resonance Imaging ◽

Intracompartmental Pressure ◽

Lower Leg Pain

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A Survey of Chronic Pain Due to Spinal Dural Arteriovenous Fistulae

Neurosurgery ◽

10.1227/neu.0000000000000745 ◽

2015 ◽

Vol 77 (1) ◽

pp. 113-118 ◽

Cited By ~ 7

Author(s):

Toru Sasamori ◽

Kazutoshi Hida ◽

Toshiya Osanai ◽

Shunsuke Yano ◽

Toshitaka Seki ◽

...

Keyword(s):

Chronic Pain ◽

Rating Scale ◽

Numeric Rating Scale ◽

Leg Pain ◽

Spontaneous Pain ◽

Resonance Imaging ◽

Spinal Cord Atrophy ◽

The Mean ◽

Numeric Rating

Abstract BACKGROUND: Chronic pain due to spinal dural arteriovenous fistulae (SDAVF) during follow-up is a serious issue because it can affect patients' quality of life. The severity of posttreatment chronic leg pain in patients with SDAVF is unclear. OBJECTIVE: To investigate the prevalence, severity, and characteristics of chronic leg pain in patients with SDAVF and to examine the clinical factors associated with chronic pain. METHODS: We conducted a survey of their chronic posttreatment leg pain in 49 SDAVF patients. It consisted of a numeric rating scale and a neuropathic pain symptom inventory (NPSI). Of the 49 patients, 32 (65.3%) completed the questionnaire. There were 24 males and 8 females whose mean age was 69.1 years. The mean follow-up period was 86.3 months. RESULTS: Chronic leg pain was reported by 26 (81.3%) of 32 patients; 14 experienced pain before treatment and 12 had new-onset posttreatment pain. The pain was reported as moderate to severe by 21 (80.8%) of 26 patients; the mean numeric rating scale and NPSI scores were 6.0 ± 2.3 and 17.4 ± 10.3, respectively. The NPSI subscores were significantly higher for spontaneous pain and paresthesia/dysesthesia than for paroxysmal pain. We found no significant clinical factors related to chronic posttreatment pain; on magnetic resonance imaging scans we identified spinal cord atrophy in 8 patients with chronic pain. CONCLUSION: Most of our SDAVF patients reported moderate to severe chronic leg pain characterized by spontaneous pain and paresthesia/dysesthesia. Spinal cord atrophy on magnetic resonance imaging scans was a characteristic in patients with chronic pain.

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Prevalence, Severity, and Impact of Foraminal and Canal Stenosis Among Adults With Degenerative Scoliosis

Neurosurgery ◽

10.1227/neu.0b013e31822a9aeb ◽

2011 ◽

Vol 69 (6) ◽

pp. 1181-1187 ◽

Cited By ~ 40

Author(s):

Kai-Ming G. Fu ◽

Prashant Rhagavan ◽

Christopher I. Shaffrey ◽

Daniel R. Chernavvsky ◽

Justin S. Smith

Keyword(s):

Oswestry Disability Index ◽

Rating Scale ◽

Numeric Rating Scale ◽

Leg Pain ◽

Foraminal Stenosis ◽

Degenerative Scoliosis ◽

Scoliosis Research Society ◽

Patient Reported ◽

The Mean ◽

Numeric Rating

Abstract BACKGROUND Management approaches for adult scoliosis are primarily based on adults with idiopathic scoliosis and extrapolated to adults with degenerative scoliosis. However, the often substantially, but poorly defined, greater degenerative changes present in degenerative scoliosis impact the management of these patients. OBJECTIVE To assess the prevalence, severity, and impact of canal and foraminal stenosis in adults with degenerative scoliosis seeking operative treatment. METHODS A prospectively collected database of adult patients with deformity was reviewed for consecutive patients with degenerative scoliosis seeking surgical treatment, without prior corrective surgery. Patients completed the Oswestry Disability Index, SF-12, Scoliosis Research Society 22 questionnaire, and a pain numeric rating scale (0–10). Based on MRI or CT myelogram, the central canal and foraminae from T6 to S1 were graded for stenosis (normal or minimal/mild/moderate/severe). RESULTS Thirty-six patients were included (mean age, 68.9 years; range, 51–85). The mean leg pain numeric rating scale was 6.5, and the mean Oswestry Disability Index score was 53.2. At least 1 level of severe foraminal stenosis was identified in 97% of patients; 83% had maximum foraminal stenosis in the curve concavity. All but 1 patient reported significant radicular pain, including 78% with discrete and 19% with multiple radiculopathies. Of those with discrete radiculopathies, 76% had pain corresponding to areas of the most severe foraminal stenosis, and 24% had pain corresponding to areas of moderate stenosis. CONCLUSION Significant foraminal stenosis was prevalent in patients with degenerative scoliosis, and the distribution of leg pain corresponded to levels of moderate or severe foraminal stenosis. Failure to address symptomatic foraminal stenosis when surgically treating adult degenerative scoliosis may negatively impact clinical outcomes.

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PACKAGE OF BIRTHING BALL, PELVIC ROCKING, AND ENDORPHIN MASSAGE (BPE) DECREASE THE FIRST STEP LABOR PAIN

INDONESIAN NURSING JOURNAL OF EDUCATION AND CLINIC (INJEC) ◽

10.24990/injec.v2i1.124 ◽

2017 ◽

Vol 2 (1) ◽

pp. 65

Author(s):

Nila Marwiyah ◽

Lenny Stia Pusporini

Keyword(s):

Rating Scale ◽

Sampling Technique ◽

Labour Pain ◽

Numeric Rating Scale ◽

Labor Pain ◽

Birth Mother ◽

Before And After ◽

Quota Sampling ◽

Numeric Rating ◽

First Stage Of Labor

Background and Purpose: Labor pain is unpleasant and frightening experience for birth mother. In addition, labor pain cause exhaustion and childbirth trauma.Birthing ball, pelvic rocking, and endorphin (B.P.E) massage are emerging as non-pharmacology methods of pain management in labor. The aimed of this study was to investigate the effect of package of BPE on labour pain during the first stage of labor. Method: This study was quasi-experiment. Total numbers of samples were 23 mothers who were in the first stage of labor. Samples were selected by using quota sampling technique. Instrument of this study was numeric rating scale (NRS). Result: Data analysis by using paired sample t-test revealed that there were significantly different between before and after the intervention of BPE on labour pain during the first stage of labor in this study (p <0.01). Conclusion and recommendation: This study showed that BPE is effective as non-pharmacology methods on pain relieve of first stage of labor. Further study need to investigate other variables such as anxiety of birth mother. Key Words: labor pain, package of birth ball, pelvic rocking, and endorphin massage(BPE), labor process.

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