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Menez C, Coquart J, Dodelin D, Tourny C, L'Hermette M. Effects of Orthotic Insoles on Gait Kinematics and Low-Back Pain in Patients with Mild Leg Length Discrepancy. J Am Podiatr Med Assoc 2021; 111:444065. [PMID: 32936288 DOI: 10.7547/18-093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Mild leg length discrepancy increases biomechanical asymmetry during gait, which leads to low-back pain. Orthotic insoles with a directly integrated heel lift were used to reduce this asymmetry and thus the associated low-back pain. The aim of this study was to analyze the biomechanical adaptations of the locomotor apparatus during gait and the subjective pain ratings before and after the establishment of orthotic insole use. METHODS Eight patients with mild leg length discrepancy (≤2.0 cm) underwent three-dimensional biomechanical analysis while walking before and after 3 weeks of orthotic insole use. Low-back pain was assessed separately before both measurement sessions using a visual analog scale. RESULTS Analysis of the kinematic parameters highlighted individual adaptations. The symmetry index of Dingwell indicated that orthotic insoles had no significant effect on the kinematic gait parameters and an unpredictable effect across patients. Orthotic insole use significantly and systematically (in all of the patients) reduced low-back pain (P < .05), which was correlated with changes in ankle kinematics (P = .02, r = 0.80). CONCLUSIONS The effects of orthotic insoles on gait symmetry are unpredictable and specific to each patient's individual manner of biomechanical compensation. The reduction in low-back pain seems to be associated with the improved ankle kinematics during gait.
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Bi Y, Hou X, Zhong J, Hu L. Test-retest reliability of laser evoked pain perception and fMRI BOLD responses. Sci Rep 2021; 11:1322. [PMID: 33446726 PMCID: PMC7809116 DOI: 10.1038/s41598-020-79196-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/02/2020] [Indexed: 11/23/2022] Open
Abstract
Pain perception is a subjective experience and highly variable across time. Brain responses evoked by nociceptive stimuli are highly associated with pain perception and also showed considerable variability. To date, the test–retest reliability of laser-evoked pain perception and its associated brain responses across sessions remain unclear. Here, an experiment with a within-subject repeated-measures design was performed in 22 healthy volunteers. Radiant-heat laser stimuli were delivered on subjects’ left-hand dorsum in two sessions separated by 1–5 days. We observed that laser-evoked pain perception was significantly declined across sessions, coupled with decreased brain responses in the bilateral primary somatosensory cortex (S1), right primary motor cortex, supplementary motor area, and middle cingulate cortex. Intraclass correlation coefficients between the two sessions showed “fair” to “moderate” test–retest reliability for pain perception and brain responses. Additionally, we observed lower resting-state brain activity in the right S1 and lower resting-state functional connectivity between right S1 and dorsolateral prefrontal cortex in the second session than the first session. Altogether, being possibly influenced by changes of baseline mental state, laser-evoked pain perception and brain responses showed considerable across-session variability. This phenomenon should be considered when designing experiments for laboratory studies and evaluating pain abnormalities in clinical practice.
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Affiliation(s)
- Yanzhi Bi
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China
| | - Xin Hou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China
| | - Jiahui Zhong
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, 116029, China
| | - Li Hu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
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Menez C, L'Hermette M, Coquart J. Orthotic Insoles Improve Gait Symmetry and Reduce Immediate Pain in Subjects With Mild Leg Length Discrepancy. Front Sports Act Living 2020; 2:579152. [PMID: 33367275 PMCID: PMC7750876 DOI: 10.3389/fspor.2020.579152] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/11/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Mild leg length discrepancy can lead to musculoskeletal disorders; however, the magnitude starting from which leg length discrepancy alters the biomechanics of gait or benefits from treatment interventions is not clear. Research question: The aim of the current study was to examine the immediate effects of orthotic insoles on gait symmetry and pain on mild leg length discrepancy according to two groups of the leg length discrepancy (i.e., LLD ≤ 1 cm vs. LLD > 1 cm). Methods: Forty-six adults with mild leg length discrepancy were retrospectively included and classified into two groups (GLLD≤1cm or GLLD>1cm). All subjects underwent routine 3D gait analysis with and without orthotic insoles. The symmetry index was calculated to assess changes in gait symmetry between the right and left limbs. Pain was rated without (in standing) and with the orthotic insoles (after 30 min of use) on a visual analog scale. Results: There was a significant improvement in the symmetry index of the pelvis in the frontal plane (p = 0.001) and the ankle in the sagittal plane (p = 0.010) in the stance with the orthotic insoles independent from the group. Pain reduced significantly with the orthotic insoles independently from the group (p < 0.001). Significance: Orthotic insoles significantly improved gait symmetry in the pelvis in the frontal plane and the ankle in the sagittal plane, as well as pain in all subjects (both LLD ≤ 1 cm and LLD > 1 cm) suggesting that it may be appropriate to treat even mild leg length discrepancy.
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Affiliation(s)
- Charlotte Menez
- Normandie Univ, UNIROUEN, CETAPS, Rouen, France.,Orthodynamica Center, Mathilde Hospital 2, Rouen, France
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Shiro Y, Ikemoto T, Hayashi K, Arai YC, Deie M, Ueno T. Does monetary reward operantly enhance pain sensitivity over time? An experiment in healthy individuals. J Pain Res 2018; 11:2161-2167. [PMID: 30323650 PMCID: PMC6174898 DOI: 10.2147/jpr.s175494] [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] [Indexed: 11/23/2022] Open
Abstract
Aim Operant conditioning has long been believed to influence the pain experience through a psychological reward pathway. This study was formulated to test the hypothesis that pain sensitivity may be enhanced >3 months if a monetary reward works as a reinforcement. Methods Forty healthy subjects volunteered to participate in this study. The subjects repeatedly underwent pain testing via mechanical stimuli, and they rolled dice three (or six) times to gain money at the following five time points: baseline, three reinforcement sessions, and last session. The payoff was determined by roll of the dice. The subjects were instructed to roll the dice into a masked stand three times per session and informed that no one monitored the number of dice actually appeared. The subjects were also informed that they could roll the dice another three times when they reported strong pain during reinforcement sessions. Results The amount of individual payoff had significantly increased at last session compared with the values obtained at baseline; however, no changes were identified in terms of the pain ratings for mechanical stimuli during all sessions. Conclusion The results suggest that the psychological reward pathway does not always involve pain perception, and it is difficult to conclude whether pain sensitivity is operantly changed through the monetary reward in healthy individuals. Further investigation is required.
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Affiliation(s)
- Yukiko Shiro
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Aichi, Japan
| | | | - Kazuhiro Hayashi
- Department of Rehabilitation, Aichi Medical University, Aichi, Japan
| | - Young-Chang Arai
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, School of Medicine, Aichi Medical University, Aichi, Japan
| | - Masataka Deie
- Department of Orthopaedics, Aichi Medical University, Aichi, Japan,
| | - Takefumi Ueno
- National Hospital Organization Hizen Psychiatric Center, Saga, Japan
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Hayashi K, Ikemoto T, Ueno T, Arai YCP, Shimo K, Nishihara M, Suzuki S, Ushida T. Discordant Relationship Between Evaluation of Facial Expression and Subjective Pain Rating Due to the Low Pain Magnitude. Basic Clin Neurosci 2018; 9:43-50. [PMID: 29942439 PMCID: PMC6015640 DOI: 10.29252/nirp.bcn.9.1.43] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Introduction Facial expression to pain is an important pain indicator; however, facial movements look unresponsive when perceiving mild pain. The present study investigates whether pain magnitude modulates the relationship between subjective pain rating and an observer's evaluation of facial expression. Methods Twelve healthy volunteers were recruited to obtain 108 samples for pain rating with Visual Analogue Scale (VAS). Subjects underwent three different mechanical painful stimuli (monofilament forces of 100 g, 300 g, and 600 g) over three sessions and their facial expressions were videotaped throughout all sessions. Three observers independently evaluated facial expression of the subjects with a four-point categorical scale (no pain, mild pain, moderate pain, and severe pain). The correlations between subjective pain ratings and the evaluation of facial expression were analyzed in dichotomous group which was low pain ratings (VAS<30), or high pain rating (VAS≥30). Results Subjective pain ratings was significantly correlated with the evaluation of facial expression in high pain ratings, however no correlation was found between them in mild pain ratings. In mild pain ratings, most of the subjects (78%) were rated as no pain by observers, despite the fact that subjects reported pain. Conclusion The results suggest that the evaluation of facial expression of pain was difficult for the observer to detect pain severity when the subjects feel mild pain.
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Affiliation(s)
- Kazuhiro Hayashi
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan.,Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Tatsunori Ikemoto
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan.,Institute of Physical Fitness Sports Medicine and Rehabilitation, Aichi Medical University, Nagakute, Japan
| | - Takefumi Ueno
- National Hospital Organization, Hizen Psychiatric Center, Kyushu, Japan
| | | | - Kazuhiro Shimo
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan.,Institute of Physical Fitness Sports Medicine and Rehabilitation, Aichi Medical University, Nagakute, Japan
| | - Makoto Nishihara
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
| | - Shigeyuki Suzuki
- Program in Physical and Occupational Therapy, Graduate School of Medicine, Nagoya University, Japan
| | - Takahiro Ushida
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan.,Institute of Physical Fitness Sports Medicine and Rehabilitation, Aichi Medical University, Nagakute, Japan
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Pereira IB, Oliveira MMMD, Ferreira PBP, Coutinho RP, Cameron LE, Porto IS. Ultra-structural evaluation of needles and their role for comfort during subcutaneous drug administration. Rev Esc Enferm USP 2018; 52:e03307. [PMID: 29846480 DOI: 10.1590/s1980-220x2017024003307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 11/13/2017] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the morphology of hypodermic needle bevels after drug aspiration, and the perception of comfort caused by the change or not of needles between preparation and subcutaneous drug administration. Method Experimental research carried out in two moments. Initially, hypodermic needles were analyzed by scanning electron microscopy, and then a pilot trial was conducted with the participants, which indicated the level of comfort perceived at the time of needle bevel penetration during subcutaneous administration. Results Forty-one adult inpatients participated in the study. Although the needles presented a slight to significant morphological alteration when evaluated by ultramicroscopy, the participants in this study were not able to report significant sensory changes during their penetration in the two techniques used. Conclusions The standardization of fixed needle syringes, or the use of a single needle for both the preparation and the subcutaneous drug administration should be considered as strategies to reduce the production of sharp-perforating residues, to decrease the cost per procedure, and to limit the risk of contamination of critical devices.
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Affiliation(s)
| | - Mair Machado Medeiros de Oliveira
- Centro e Ciências da Saúde, Departamento de Histologia, Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | | | - Lys Eiras Cameron
- Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Isaura Setenta Porto
- Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Shiro Y, Arai YC, Ikemoto T, Hayashi K. Stool consistency is significantly associated with pain perception. PLoS One 2017; 12:e0182859. [PMID: 28793322 PMCID: PMC5549932 DOI: 10.1371/journal.pone.0182859] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/25/2017] [Indexed: 12/12/2022] Open
Abstract
Background Commensal as well as pathogenic bacteria can influence a variety of gut functions, thereby leading to constipation and diarrhea in severe cases. In fact, several researchers have reported evidence supporting the association between stool consistency or constipation and the Gut microbiome (GM) composition and dysbiosis. GM influences the human health and disease via the gut-brain axis. We thus hypothesized that the pathogenic bacteria increases pain perception to some extent, which means that there could be an association between stool consistency or constipation and pain perception of healthy subjects. Design Observational study. Objectives The aim of the present study was to investigate the association between stool consistency or constipation and pain perception of healthy subjects. Methods Thirty-eight healthy subjects participated in this study. The participants were assessed on their usual stool form (the Bristol Stool Form Scale: BSFS), constipation (the Cleveland Clinic Constipation score: CCS), degree of obesity, pain perception by mechanical stimulus, cold pain threshold, and a questionnaire on psychological state. Results The BSFS was significantly and positively associated with pain perception, and showed a significant association with anxiety states. Furthermore, pain perception was significantly associated with anxiety states. However, there were no significant associations between the CCS and any independent variables. In addition, we found that a significant predictor to the pain perception was BSFS. Moreover, there were significant relationships among the psychological states, BSFS and obesity. Conclusion These results suggest that the stool form is associated with pain perception and anxiety status.
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Affiliation(s)
- Yukiko Shiro
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Nagoya, Japan
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
| | - Young-Chang Arai
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, School of Medicine, Aichi Medical University, Nagakute, Japan
- * E-mail:
| | - Tatsunori Ikemoto
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
- Institute of Physical Fitness, Sports Medicine and Rehabilitation, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Kazuhiro Hayashi
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Japan
- Institute of Rehabilitation, Aichi Medical University Hospital, Nagakute, Japan
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Hayashi K, Ikemoto T, Ueno T, Arai YCP, Shimo K, Nishihara M, Suzuki S, Ushida T. Higher pain rating results in lower variability of somatosensory cortex activation by painful mechanical stimuli: An fMRI study. Clin Neurophysiol 2016; 127:1923-8. [PMID: 26971472 DOI: 10.1016/j.clinph.2016.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 12/30/2015] [Accepted: 01/07/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to find pain-related brain activity which corresponds to self-report pain ratings based on degree of response and repeatability. METHODS Three painful mechanical stimuli were applied to the right hands of 25 healthy volunteers using monofilaments (forces of 0.98N, 2.94N, and 5.88N). Simultaneously, brain activities were evaluated using functional MRI for a constant stimulus conducted three times in a session. In first assessment, the average percent signal change (PSC) of neuronal response was measured for each region of interest (ROI), secondary repeatability of PSC conducted three times over the session was evaluated for each ROI. RESULTS Although the average PSCs for trice stimuli conducted in one session increased in accordance with pain ratings in the somatosensory cortex (S1) and anterior cingulate cortex (ACC), there was a different response between S1 and ACC when subjects rated intense pain; a stable response in S1 against a variable response in ACC. CONCLUSIONS These results imply that there are different cognitive responses between sensory discrimination and affective component to constant painful stimulus each time. SIGNIFICANCE Consistency of brain activity based on PSC may be an important biomarker which, along with its neuronal activity, gauges self-report pain ratings.
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Affiliation(s)
- Kazuhiro Hayashi
- Multidisciplinary Pain Center, Aichi Medical University, Japan; Department of Rehabilitation, Nagoya University Hospital, Japan.
| | - Tatsunori Ikemoto
- Multidisciplinary Pain Center, Aichi Medical University, Japan; Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Japan
| | - Takefumi Ueno
- National Hospital Organization, Hizen Psychiatric Center, Japan
| | | | - Kazuhiro Shimo
- Multidisciplinary Pain Center, Aichi Medical University, Japan; Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Japan
| | | | - Shigeyuki Suzuki
- Department of Physical and Occupational Therapy, Graduate School of Medicine, Nagoya University, Japan
| | - Takahiro Ushida
- Multidisciplinary Pain Center, Aichi Medical University, Japan; Institute of Physical Fitness, Sports Medicine and Rehabilitation, Aichi Medical University, Japan
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