Assessment of stress markers in restrained individuals following physical stress with and without sham CED activation.

Christian Sloane, Deborah C Mash, Theodore C Chan, Fred Kolkhorst, Tom Neuman, Edward M Castillo, Daniel Lasoff, Gabriel Wardi, Xiaobin Xie, Gary M Vilke

Journal: Journal of forensic and legal medicine 2021;74():101982

PMID: 32658765

Full Text on Elsevier Science View on PubMed

Abstract

INTRODUCTION

Law enforcement and pre-hospital care personnel often confront individuals who must be physically restrained. Many are under the influence of illicit substances, and law enforcement officers may need to use a controlled electrical device (CED) to gain control of the individual and they are often placed into the prone maximum restraint (PMR) position. These techniques have previously been evaluated for their physiologic effects. The purpose of this study was to investigate the psychological effects of anticipating and experiencing a sham CED activation in healthy human subjects who were exercised and restrained compared with no sham activation by assessing the differences in a panel of several known biomarkers of stress.

METHODS

We performed a randomized, crossover controlled human subject trial to study the stress associated with exercise, physical exhaustion, and restraint with and without an added psychological stress simulating the field use of a CED. Twenty five total subjects; each subject performed two different trials each consisting of a brief period of intense exercise on a treadmill to exhaustion followed by placement in the PMR with and without induced psychological stress. Blood samples were collected for analysis pre and post exercise, as well as 10 min after completion of the exercise. A panel of hormones and stress markers were measured.

RESULTS

We found no significant differences in any of the stress biomarkers measured between the two study groups. A trend towards higher levels of copeptin was measured in the sham CED activation arm.

CONCLUSION

During a brief period of intense exercise followed by the psychological stress of anticipated CED application, there did not appear to be statistically significant changes in the stress panel of biomarkers measured, only a trend towards significance for higher copeptin levels in the patients exposed to the psychological stress.

Address: Department of Emergency Medicine, University of California, San Diego, CA, USA. Electronic address: [email protected].; Department of Neurology, Molecular and Cellular Pharmacology, University of Miami, Miami, FL, USA.; Department of Emergency Medicine, University of California, San Diego, CA, USA.; School of Exercise and Nutritional Sciences, San Diego State University San Diego, CA, USA.; Department of Emergency Medicine, University of California, San Diego, CA, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, University of California, San Diego, San Diego, CA, USA.

DOI: 10.1016/j.jflm.2020.101982

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MeSH Terms: Adolescent, Adrenocorticotropic Hormone, Adult, Biomarkers, Cross-Over Studies, Dopamine, Dynorphins, Electric Stimulation, Female, Forensic Medicine, Glycopeptides, Humans, Hydrocortisone, Male, Neuropeptide Y, Norepinephrine, Orexins, Oxytocin, Physical Exertion, Restraint, Physical, Stress, Physiological, Stress, Psychological, Young Adult