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Cooper JL, Karduna AR. Experimentally Induced Pain Results in Reduced Activity of the Rotator Cuff Muscles in Healthy Subjects. J Appl Biomech 2024; 40:73-80. [PMID: 37935173 DOI: 10.1123/jab.2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 09/10/2023] [Accepted: 09/29/2023] [Indexed: 11/09/2023]
Abstract
Shoulder pain is a complex, prevalent problem that is multifactorial in nature. While there are many potential causes, one common suspect is the rotator cuff musculature. The purpose of the present study was to induce pain in the supraspinatus muscle of healthy subjects and observe the resulting changes in muscle activity. Eight muscles on 23 subjects were assessed using electromyography: anterior, middle, and posterior deltoid; pectoralis major; upper trapezius; latissimus dorsi; serratus anterior; supraspinatus; and infraspinatus. It was hypothesized that the rotator cuff muscles would display reduced activity during pain, and that reductions in activity would remain after the pain had dissipated. Both of the rotator cuff muscles measured did indeed display reduced activity in a majority of the dynamic, isometric, and maximal contractions. Many of those reductions remained after the pain had subsided.
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Affiliation(s)
- Jennifer L Cooper
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | - Andrew R Karduna
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
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Efstathiou MA, Giannaki CD, Roupa Z, Hadjisavvas S, Stefanakis M. Evidence of distorted proprioception and postural control in studies of experimentally induced pain: a critical review of the literature. Scand J Pain 2022; 22:445-456. [PMID: 35470647 DOI: 10.1515/sjpain-2021-0205] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/23/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Deficits in proprioception and postural control are common in patients with different musculoskeletal pain syndromes. It has been proposed that pain can negatively affect proprioception and postural control at a peripheral level, however research is limited to animal studies. Human studies have shown that it is more likely, that the link between pain and proprioceptive deficits, lies within changes in the central nervous system where noxious and non-noxious stimuli may overlap. In clinical studies, causality cannot be determined due to other factors which could confound the assessment such as pathophysiological features of the underlying musculoskeletal disorder and different psycho-social influences especially in patients with chronic pain. On the other hand, experimentally induced pain in healthy participants is able to control most of these confounding factors and perhaps offers an assessment of the effects of pain on proprioception and postural control. The aim of this paper is to critically appraise the literature related to the effect of experimentally induced pain on proprioception and postural control. Results from these studies are discussed and limitations are highlighted for future research. METHODS A search of databases (Medline, Scopus, PubMed) was conducted as well as reference check from relevant articles published since 2000. Fifteen studies which explored the effect of experimentally induced pain on postural control and ten studies which explored the effect of experimentally induced pain on proprioception were included. RESULTS We found that in the majority of the studies, postural control was negatively affected by experimentally induced pain. Results for proprioception were mixed depending on the body region and the way the painful stimuli were delivered. Kinesthesia was negatively affected in two studies, while in one study kinesthesia was enhanced. Joint position sense was not affected in four out of five studies. Finally, force sense was affected in three out of four studies. CONCLUSIONS From a clinical point of view, findings from the available literature suggest that experimentally induced pain impairs postural control and could potentially increases the risk for falls in patients. Interventions aiming to reduce pain in these patients could lead to preservation or improvement of their balance. On the other hand, the same conclusion cannot be drawn for the effect of experimentally induced pain on kinesthesia and joint position sense due to the limited number of studies showing such an effect.
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Affiliation(s)
| | | | - Zoe Roupa
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Stelios Hadjisavvas
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Manos Stefanakis
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
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Does Motor Cortex Engagement During Movement Preparation Differentially Inhibit Nociceptive Processing in Patients with Chronic Whiplash Associated Disorders, Chronic Fatigue Syndrome and Healthy Controls? An Experimental Study. J Clin Med 2020; 9:jcm9051520. [PMID: 32443565 PMCID: PMC7290436 DOI: 10.3390/jcm9051520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patients with chronic fatigue syndrome (CFS) and chronic whiplash associated disorders (cWAD) present a reduced ability to activate central descending nociceptive inhibition after exercise, compared to measurements before exercise. It was hypothesised that a dysfunctional motor-induced inhibition of nociception partly explains this dysfunctional exercise-induced hypoalgesia. This study investigates if engagement of the motor system during movement preparation inhibits nociception-evoked brain responses in these patients as compared to healthy controls (HC). METHODS The experiment used laser-evoked potentials (LEPs) during three conditions (no task, mental task, movement preparation) while recording brain activity with a 32-channel electroencephalogram in 21 patients with cWAD, 20 patients with CFS and 18 HC. Two-factor mixed design Analysis of variance were used to evaluate differences in LEP amplitudes and latencies. RESULTS No differences in N1, N2, N2P2, and P2 LEP amplitudes were found between the HC, CFS, and cWAD groups. After nociceptive stimulation, N1, N2 (only at hand location), N2P2, and P2 LEP amplitudes significantly decreased during movement preparation compared to no task (within group differences). CONCLUSION Movement preparation induces a similar attenuation of LEPs in patients with CFS, patients with cWAD and HC. These findings do not support reduced motor-induced nociceptive inhibition in these patients.
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Carnavale BF, Fiogbé E, Farche ACS, Catai AM, Porta A, Takahashi ACDM. Complexity of knee extensor torque in patients with frailty syndrome: a cross-sectional study. Braz J Phys Ther 2020; 24:30-38. [PMID: 30587398 PMCID: PMC6994311 DOI: 10.1016/j.bjpt.2018.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 09/27/2018] [Accepted: 12/10/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Frailty syndrome is characterized by a marked reduction in physiological reserves and a clinical state of vulnerability to stress. Torque complexity analysis could reveal changes in the musculoskeletal systems that are the result of having the syndrome. OBJECTIVE The aim of this study was to evaluate the complexity of submaximal isometric knee extensor torque in frail, pre-frail, and non-frail older adults. A secondary aim was to analyze the torque complexity behavior in different force levels in each group. METHODS A cross-sectional study was conducted. Forty-two older adults were divided into three groups: non-frail (n=15), pre-frail (n=15), and frail (n=12). The data collected included body composition, five times sit-to-stand test, walking speed, and isometric knee extensor torque at 15, 30, and 40% of maximal voluntary contraction. The knee extensor torque variability was evaluated by coefficient of variation, and the torque complexity was evaluated by approximate entropy and sample entropy. RESULTS The frail group presented a reduction in body mass and peak torque value compared to the non-frail group. Also, the frail group showed worse physical performance (on the five times sit-to-stand test and walking speed) compared to the pre-frail and non-frail groups. In addition, the frail older adults showed reduced torque complexity compared to the non-frail group. Finally, the association between torque complexity and force levels remained similar in all groups. CONCLUSION Torque complexity is reduced in the presence of frailty syndrome.
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Affiliation(s)
- Bianca Ferdin Carnavale
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Elie Fiogbé
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ana Claudia Silva Farche
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Aparecida Maria Catai
- Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy; Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
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Abstract
INTRODUCTION Reorganized force control may be an important adaptation following painful traumas. In this study, force control adaptations were assessed in elbow pain patients. Increasing the contraction demand may overcome pain interference on the motor control and as such act as an internal control. It was hypothesized that elbow pain patients compared with controls would present greater change in the direction of force when increasing the demand of the motor task. METHODS Elbow pain patients (n=19) and asymptomatic participants (n=21) performed isometric wrist extensions at 5% to 70% of maximum voluntary contraction. Pressure pain thresholds were recorded at the lateral epicondyle and tibialis anterior muscle. Contraction force was recorded using a 3-directional force transducer. Participants performed contractions according to visual feedback of the task-related force intensity (main direction of wrist extension) and another set of contractions with feedback of the 3 force directions. Going from the simple to the detailed force feedback will increase the demand of the motor task. Force steadiness in all 3 dimensions and force directions were extracted. RESULTS Compared with controls, elbow pain patients presented lower pressure pain thresholds at both sites (P<0.05). Force steadiness was not significantly different between groups or feedback methods. The change in force direction when providing simple visual feedback in contrast with feedback of all force components at all contraction levels was greater for patients compared with controls (P<0.05). CONCLUSION The larger change in force direction in pain patients implies redistribution of loads across the arm as an associated effect of pain.
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Mista CA, Laugero SJ, Adur JF, Andersen OK, Biurrun Manresa JA. A new experimental model of muscle pain in humans based on short‐wave diathermy. Eur J Pain 2019; 23:1733-1742. [DOI: 10.1002/ejp.1449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Christian A. Mista
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB) CONICET‐UNER Oro Verde Argentina
- Laboratory for Rehabilitation Engineering and Neuromuscular and Sensory Research (LIRINS) National University of Entre Ríos Oro Verde Argentina
| | - Silvio J. Laugero
- Department of Bioengineering National University of Entre Ríos Oro Verde Argentina
| | - Javier F. Adur
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB) CONICET‐UNER Oro Verde Argentina
- Department of Bioengineering National University of Entre Ríos Oro Verde Argentina
| | - Ole K. Andersen
- Center for Neuroplasticity and Pain (CNAP), SMI®, Faculty of Medicine Aalborg University Aalborg Denmark
| | - José A. Biurrun Manresa
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB) CONICET‐UNER Oro Verde Argentina
- Laboratory for Rehabilitation Engineering and Neuromuscular and Sensory Research (LIRINS) National University of Entre Ríos Oro Verde Argentina
- Center for Neuroplasticity and Pain (CNAP), SMI®, Faculty of Medicine Aalborg University Aalborg Denmark
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Norheim KL, Samani A, Bønløkke JH, Omland Ø, Madeleine P. The effects of age and musculoskeletal pain on force variability among manual workers. Hum Mov Sci 2019; 64:19-27. [PMID: 30641456 DOI: 10.1016/j.humov.2018.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 12/18/2018] [Accepted: 12/22/2018] [Indexed: 10/27/2022]
Abstract
The present study investigated the influence of age and musculoskeletal pain on force variability during a continuous isometric handgrip force task performed at 30% of maximal voluntary contraction carried out until failure. We recruited 96 male manual workers aged 51-72 years. The participants were stratified according to their age (50-59 and 60+ years) and by pain status (no pain, acute pain and chronic pain). The amplitude and structure of variability expressed as respectively standard deviation (SD) and coefficient of variation (CV), and sample entropy (SaEn) were calculated from the endurance task. The oldest group had an approximately 18% longer endurance time than the youngest group. No between-group differences were found in SD or CV, whereas a significant interaction between age and pain stage was found for SaEn. The youngest group showed lower SaEn than the oldest for both those with chronic pain and those without pain, indicating less force complexity, whereas a tendency for the opposite was found in the acute pain group. Within the pain stage groups, workers with acute pain had higher SaEn compared with both the no pain and chronic pain groups. These findings suggest that age and musculoskeletal pain differentially affects the structure of force variability in manual workers.
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Affiliation(s)
- Kristoffer Larsen Norheim
- Sport Sciences, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark.
| | - Afshin Samani
- Sport Sciences, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
| | - Jakob Hjort Bønløkke
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark.
| | - Øyvind Omland
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark.
| | - Pascal Madeleine
- Sport Sciences, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
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Luo J, Sun W, Wu Y, Liu H, Wang X, Yan T, Song R. Characterization of the coordination of agonist and antagonist muscles among stroke patients, healthy late middle-aged and young controls using a myoelectric-controlled interface. J Neural Eng 2018; 15:056015. [PMID: 30010089 DOI: 10.1088/1741-2552/aad387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Cowley JC, Gates DH. Influence of remote pain on movement control and muscle endurance during repetitive movements. Exp Brain Res 2018; 236:2309-2319. [PMID: 29869692 DOI: 10.1007/s00221-018-5303-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/31/2018] [Indexed: 12/26/2022]
Abstract
During fatiguing tasks, people adapt their movement strategies to offset effects of muscle fatigue. Painful stimuli may compete for cognitive resources during this process, impairing fatigue adaptation. This study determined how pain affected movement control and muscle endurance during a repetitive task and how pain catastrophizing moderated these effects. Twenty-two healthy young adults performed timed reaching movements until voluntary exhaustion on two separate days. On 1 day, subjects simultaneously experienced ischemic pain in the contralateral arm. Subjective pain, and effort were recorded at regular intervals. Timing errors, distance and speed were calculated for each movement. Detrended fluctuation analysis was used to quantify temporal persistence in each time series. Subjects made shorter, slower movements during the last compared to the first minute of fatigue on both days (p < 0.001). Deviations in movement speed were corrected faster in the no pain condition compared to the pain condition (p = 0.042), but only early during the condition. Time to fatigue was influenced by pain and the order of testing. Subjects performed the task longer on the second day whether the condition was pain or no pain. This effect was larger when the pain condition was first (3.4 compared to 1.1 min. increase). Subjects with high and low pain catastrophizing responded similarly to the painful stimuli. The results suggest that pain causes people to adopt more conservative movement strategies which can affect the fatigue rate, but these effects depend on familiarity with the painful stimulus and the fatiguing task.
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Affiliation(s)
- Jeffrey C Cowley
- School of Kinesiology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Deanna H Gates
- School of Kinesiology, University of Michigan, Ann Arbor, MI, 48109, USA.
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA.
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Wang WE, Roy A, Misra G, Archer DB, Ribeiro-Dasilva MC, Fillingim RB, Coombes SA. Motor-Evoked Pain Increases Force Variability in Chronic Jaw Pain. THE JOURNAL OF PAIN 2018; 19:636-648. [DOI: 10.1016/j.jpain.2018.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/15/2018] [Accepted: 01/22/2018] [Indexed: 11/26/2022]
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Suda EY, Madeleine P, Hirata RP, Samani A, Kawamura TT, Sacco ICN. Reduced complexity of force and muscle activity during low level isometric contractions of the ankle in diabetic individuals. Clin Biomech (Bristol, Avon) 2017; 42:38-46. [PMID: 28088014 DOI: 10.1016/j.clinbiomech.2017.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 12/19/2016] [Accepted: 01/03/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study evaluated the structure and amount of variability of surface electromyography (sEMG) patterns and ankle force data during low-level isometric contractions in diabetic subjects with different degrees of neuropathy. METHODS We assessed 10 control subjects and 38 diabetic patients, classified as absent, mild, moderate, or severe neuropathy, by a fuzzy system based on clinical variables. Multichannel sEMG (64-electrode matrix) of tibialis anterior and gastrocnemius medialis muscles were acquired during isometric contractions at 10%, 20%, and 30% of the maximum voluntary contraction, and force levels during dorsi- and plantarflexion were recorded. Standard deviation and sample entropy of force signals were calculated and root mean square and sample entropy were calculated from sEMG signals. Differences among groups of force and sEMG variables were verified using a multivariate analysis of variance. FINDINGS Overall, during dorsiflexion contractions, moderate and severe subjects had higher force standard deviation and moderate subjects had lower force sample entropy. During plantarflexion, moderate subjects had higher force standard deviation and all diabetic subjects had lower entropy. Tibialis anterior presented higher root mean square in absent group and lower entropy in mild subjects. For gastrocnemius medialis, entropy was higher in severe and lower in moderate subjects. INTERPRETATION Diabetic neuropathy affects the complexity of the neuromuscular system during low-level isometric contractions, reducing the system's capacity to adapt to challenging mechanical demands. The observed patterns of neuromuscular complexity were not associated with disease severity, with the majority of alterations recorded in moderate subject.
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Affiliation(s)
- E Y Suda
- Laboratory of Biomechanics of Human Movement, Dept. Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - P Madeleine
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark
| | - R P Hirata
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark
| | - A Samani
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark
| | - T T Kawamura
- Laboratory of Biomechanics of Human Movement, Dept. Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - I C N Sacco
- Laboratory of Biomechanics of Human Movement, Dept. Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
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Mista CA, Bergin MJG, Hirata RP, Christensen SW, Tucker K, Hodges P, Graven-Nielsen T. Effects of Prolonged and Acute Muscle Pain on the Force Control Strategy During Isometric Contractions. THE JOURNAL OF PAIN 2016; 17:1116-1125. [PMID: 27480383 DOI: 10.1016/j.jpain.2016.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 05/16/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED Musculoskeletal pain is associated with multiple adaptions in movement control. This study aimed to determine whether changes in movement control acquired during acute pain are maintained over days of pain exposure. On day 0, the extensor carpi radialis brevis muscle of healthy participants was injected with nerve growth factor (NGF) to induce persistent movement-evoked pain (n = 13) or isotonic saline as a control (n = 13). On day 2, short-lasting pain was induced by injection of hypertonic saline into extensor carpi radialis brevis muscles of all participants. Three-dimensional force components were recorded during submaximal isometric wrist extensions on day 0, day 4, and before, during, and after saline-induced pain on day 2. Standard deviation (variation of task-related force) and total excursion of center of pressure (variation of force direction) were assessed. Maximal movement-evoked pain was 3.3 ± .4 (0-10 numeric scale) in the NGF-group on day 2 whereas maximum saline-induced pain was 6.8 ± .3 cm (10-cm visual analog scale). The difference in centroid position of force direction relative to day 0 was greater in the NGF group than in the control group (P < .05) on day 2 (before saline-induced pain) and day 4, reflecting changes in tangential force direction used to achieve the task. During saline-induced pain in both groups, tangential and task-related force variation was greater than before and after saline-induced pain (P < .05). PERSPECTIVE Persistent movement-evoked pain changes force direction from the pain-free direction. Acute pain leads to increased variation in force direction irrespective of persistent movement-evoked pain preceding the acutely painful event. These differences provide novel insight into the search for and consolidation of new motor strategies in the presence of pain.
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Affiliation(s)
- Christian A Mista
- Center for Neuroplasticity and Pain, SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Michael J G Bergin
- University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Queensland, Australia
| | - Rogerio P Hirata
- Center for Neuroplasticity and Pain, SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Steffan W Christensen
- Center for Neuroplasticity and Pain, SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Kylie Tucker
- University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Queensland, Australia; University of Queensland, School of Biomedical Sciences, Queensland, Australia
| | - Paul Hodges
- University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Queensland, Australia
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain, SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
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Hirata R, Salomoni S, Christensen S, Graven-Nielsen T. Reorganised motor control strategies of trunk muscles due to acute low back pain. Hum Mov Sci 2015; 41:282-94. [DOI: 10.1016/j.humov.2015.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 02/05/2015] [Accepted: 04/02/2015] [Indexed: 10/23/2022]
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