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Canlı K, Palmans T, Meeus M, De Meulemeester K. Excitation of the bottom-up pathways has no effect on remote muscle fatigue in healthy participants. Exp Brain Res 2024; 243:2. [PMID: 39601827 DOI: 10.1007/s00221-024-06958-w] [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: 05/03/2024] [Accepted: 10/21/2024] [Indexed: 11/29/2024]
Abstract
The aim of this study is to investigate the effect of induced excitation of the bottom-up pathways at the lateral elbow muscles on local muscle fatigue in the neck region in healthy participants. Eligible participants (n:55) were randomly allocated to an intervention group (n:28) or a control group (n:27). The fatigue of bilateral neck flexor(sternocleidomastoid) and extensor (upper trapezius) muscles was evaluated using surface electromyography, at baseline and immediately post-intervention during a neck flexor and extensor endurance test respectively. Excitation of the bottom-up pathways was performed at multiple lateral elbow muscles in the intervention group by using a temporal summation protocol of mechanical pain, and the pressure pain threshold was determined once in each of the multiple lateral elbow muscles in the control group. Linear mixed model analyses were performed for each outcome measure to evaluate changes over time and within- and between-group differences. No significant "group X time" interaction effects were detected for any of the outcome measures. Significant main effects for time was found for "amplitude over time" of the left upper trapezius (p:0.003) and right sternocleidomastoid muscle (p: 0.013), and for "amplitude changes" of the left upper trapezius muscle (p:0.021). Significant within-group changes were identified in some outcomes in the control group: increased "amplitude over time" of the right sternocleidomastoid muscle (p:0.024) and decreased "amplitude changes" of the left upper trapezius muscle (p:0.024), decreased "normalized median frequency slope over time" of the left UT (p: 0.013). There were no significant within-group changes in the intervention group. No significant between-group differences for any of the outcome measures were found. This study shows no effect of the induction of excitation of the bottom-up pathways at the lateral elbow muscles on the neck muscles' fatigue characteristics compared to a control intervention. Clinical Trial Number: NCT05146960. Date of Registration: December 7, 2021.
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Affiliation(s)
- Kübra Canlı
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Türkiye.
- , Ankara, Turkey.
| | - Tanneke Palmans
- Department of Rehabilitation Sciences, Spine, Pain and Head Research Unit Ghent, Ghent University, Ghent, Belgium
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Antwerpen, Belgium
- Pain in Motion International Research Group (www.paininmotion.be), Brussel, Belgium
| | - Kayleigh De Meulemeester
- Department of Rehabilitation Sciences, Spine, Pain and Head Research Unit Ghent, Ghent University, Ghent, Belgium
- Pain in Motion International Research Group (www.paininmotion.be), Brussel, Belgium
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Goodman LR, Dass R, Daniel E, Modarresi S, Carlesso L, Tang A, Macedo L. Quantitative sensory testing and exercise-induced hypoalgesia protocols in low back pain: A scoping review. THE JOURNAL OF PAIN 2024:104725. [PMID: 39532209 DOI: 10.1016/j.jpain.2024.104725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 10/23/2024] [Accepted: 10/30/2024] [Indexed: 11/16/2024]
Abstract
A significant driver of pain in individuals with low back pain (LBP) is alterations to endogenous pain modulation (EPM). EPM can be measured using quantitative sensory testing (QST), however; there are inconsistencies in the way QST has been implemented across the low back pain literature. The objective of this scoping review was to summarize protocols used to assess EPM using QST (pain pressure threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM)) or exercise-induced hypoalgesia (EIH) in LBP. Databases Medline, Embase, CINAHL and AMED were searched on June 15, 2023, for articles that used QST or EIH protocols in LBP populations. Data was extracted on participants, study design, setting and details on QST and EIH protocols. Of the 221 studies included in the review, 196 used PPT, 62 used TS and 60 used CPM; only 5 studies investigated EIH. For all QST, there was high variability in the type of equipment, timing, trials, and testing location with many studies not reporting this information. There were 4 testing modalities used for TS, and 7 different test stimuli, and 3 different conditioning stimuli used across the studies for CPM. For CPM and EIH, PPT was the most common testing modality. There were 4 types of exercises used across the 5 EIH studies. This scoping review provides a summary of QST and EIH protocols in LBP that may be used as a guide for assessment in future studies. These results demonstrate a need for the development of standardized protocols and reporting guidelines. PERSPECTIVE: This article presents a summary of measures used to assess EPM in LBP. The results show the wide variability of protocols used in the literature. Future research should focus on creating standardized protocols, reporting guidelines and providing more guidance for researchers in selecting appropriate tests for their research questions.
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Affiliation(s)
- Lee-Ran Goodman
- Faculty of Health Sciences, McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | - Ronessa Dass
- Faculty of Health Sciences, McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | - Eden Daniel
- Faculty of Health Sciences, McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | - Shirin Modarresi
- Faculty of Health Sciences, McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | - Lisa Carlesso
- Faculty of Health Sciences, McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | - Ada Tang
- Faculty of Health Sciences, McMaster University, School of Rehabilitation Sciences, Hamilton, Canada
| | - Luciana Macedo
- Faculty of Health Sciences, McMaster University, School of Rehabilitation Sciences, Hamilton, Canada.
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Tian A, Gao H, Wang Z, Li N, Ma J, Guo L, Ma X. Brain structural correlates of postoperative axial pain in degenerative cervical myelopathy patients following posterior cervical decompression surgery: a voxel-based morphometry study. BMC Med Imaging 2023; 23:136. [PMID: 37726693 PMCID: PMC10507911 DOI: 10.1186/s12880-023-01057-8] [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: 02/19/2023] [Accepted: 07/18/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVE To investigate the brain structural correlates of postoperative axial pain (PAP) in degenerative cervical myelopathy (DCM) following posterior cervical decompression surgery. METHODS Structural images with high-resolution T1 weighting were collected from 62 patients with DCM and analyzed, in addition to 42 age/gender matched subjects who were healthy. Voxel-based morphometry (VBM) was analyzed, grey matter volume (GMV) was computed. One-way ANOVA was performed to reveal the GMV differences among DCM patients with PAP, patients without PAP and healthy controls (HC). Post-hoc analyses were conducted to identify the pair-wise GMV differences among these three groups. Analyses of correlations were conducted to uncover the link between clinical measurements and GMV variations. Last, support vector machine (SVM) was conducted to test the utility of GMV for classifying PAP and nPAP DCM patients. RESULTS Three main findings were observed: [1] Compared to healthy controls, DCM patients showed a significantly lower GMV in the precuneus preoperatively. DCM patients with PAP also exhibited a lower GMV within precuneus than those without; [2] In DCM patients with PAP, the precuneus GMV was inversely related to the postoperative pain intensity; [3] Moreover, successful classification between PAP and nPAP were observed via SVM based on precuneus GMV as features. CONCLUSION In summary, our results indicate that precuneus GMV may be linked to PAP in DCM, and could be employed to forecast the emergence of PAP in DCM patients.
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Affiliation(s)
- Aixian Tian
- Orthopedic Research Institute, Tianjin Hospital, Tianjin University, Jiefang Nan Road 406, Hexi District, Tianjin, 300211, P. R. China
| | - Hongzhi Gao
- Radiology Department, Tianjin Hospital, Tianjin University, Jiefang Nan Road 406, Hexi District, Tianjin, 300211, P. R. China
| | - Zhan Wang
- Orthopedic Research Institute, Tianjin Hospital, Tianjin University, Jiefang Nan Road 406, Hexi District, Tianjin, 300211, P. R. China
| | - Na Li
- Orthopedic Research Institute, Tianjin Hospital, Tianjin University, Jiefang Nan Road 406, Hexi District, Tianjin, 300211, P. R. China
| | - Jianxiong Ma
- Orthopedic Research Institute, Tianjin Hospital, Tianjin University, Jiefang Nan Road 406, Hexi District, Tianjin, 300211, P. R. China
| | - Lin Guo
- Radiology Department, Tianjin Hospital, Tianjin University, Jiefang Nan Road 406, Hexi District, Tianjin, 300211, P. R. China.
| | - Xinlong Ma
- Orthopedic Research Institute, Tianjin Hospital, Tianjin University, Jiefang Nan Road 406, Hexi District, Tianjin, 300211, P. R. China.
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Schuttert I, Timmerman H, Petersen KK, McPhee ME, Arendt-Nielsen L, Reneman MF, Wolff AP. The Definition, Assessment, and Prevalence of (Human Assumed) Central Sensitisation in Patients with Chronic Low Back Pain: A Systematic Review. J Clin Med 2021; 10:5931. [PMID: 34945226 PMCID: PMC8703986 DOI: 10.3390/jcm10245931] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/29/2021] [Accepted: 12/15/2021] [Indexed: 12/15/2022] Open
Abstract
Central sensitisation is assumed to be one of the underlying mechanisms for chronic low back pain. Because central sensitisation is not directly assessable in humans, the term 'human assumed central sensitisation' (HACS) is suggested. The objectives were to investigate what definitions for HACS have been used, to evaluate the methods to assess HACS, to assess the validity of those methods, and to estimate the prevalence of HACS. Database search resulted in 34 included studies. Forty different definition references were used to define HACS. This review uncovered twenty quantitative methods to assess HACS, including four questionnaires and sixteen quantitative sensory testing measures. The prevalence of HACS in patients with chronic low back pain was estimated in three studies. The current systematic review highlights that multiple definitions, assessment methods, and prevalence estimates are stated in the literature regarding HACS in patients with chronic low back pain. Most of the assessment methods of HACS are not validated but have been tested for reliability and repeatability. Given the lack of a gold standard to assess HACS, an initial grading system is proposed to standardize clinical and research assessments of HACS in patients with a chronic low back.
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Affiliation(s)
- Ingrid Schuttert
- Pain Center, Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, 9750 RA Groningen, The Netherlands; (I.S.); (H.T.)
| | - Hans Timmerman
- Pain Center, Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, 9750 RA Groningen, The Netherlands; (I.S.); (H.T.)
| | - Kristian K. Petersen
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, DK-9220 Aalborg, Denmark; (K.K.P.); (M.E.M.); (L.A.-N.)
| | - Megan E. McPhee
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, DK-9220 Aalborg, Denmark; (K.K.P.); (M.E.M.); (L.A.-N.)
| | - Lars Arendt-Nielsen
- Center for Neuroplasticity and Pain, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, DK-9220 Aalborg, Denmark; (K.K.P.); (M.E.M.); (L.A.-N.)
- Department of Medical Gastroenterology (Mech-Sense), Aalborg University Hospital, DK-9220 Aalborg, Denmark
| | - Michiel F. Reneman
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, 9750 RA Groningen, The Netherlands;
| | - André P. Wolff
- Pain Center, Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, 9750 RA Groningen, The Netherlands; (I.S.); (H.T.)
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