Temperament as a modulating factor of pain sensitivity in combat sport athletes

Effects of Direct and Indirect Suggestions for Analgesia: The Role of Hypnotizability and Expectation of Pain Relief

Among the methods for cognitive control of pain, the suggestions for analgesia-direct or indirect-have been widely and successfully used in experimental and clinical trials. The primary aim of this study was to contribute to the debate about the difference in the effectiveness of indirect and direct suggestions for the management of experimental pain in the ordinary state of consciousness. The secondary aim of the study was to ascertain the role of hypnotizability and expectation of pain relief in the suggestions' effect. A sample of 65 healthy participants with different levels of direct (Harvard Group Scale of Hypnotic Susceptibility: A score) and indirect suggestibility level (Alman-Wexler Indirect Hypnotic Susceptibility Scale score) and different levels of declared expectation of pain relief was submitted to direct and indirect suggestions for analgesia during cold pressure test. The results showed that both direct and indirect suggestions increase the threshold of experimental pain and that the expectation of pain relief is relevant only to the effect of direct suggestions. PERSPECTIVE: Although the reported findings cannot be extended to clinical pain, they suggest that indirect suggestions can be effective independently from the expectation of pain relief, thus evading the possible negative effects of traits such as catastrophism or reactance. Thus, indirect suggestions should be preferred in clinical contexts.

Temperament structures and the effectiveness of individual play in football

Background

Regulatory Theory of Temperament distinguishes two traits involving the time course of responses and four relating to how energy is distributed and stored. This theory enables the presentation of entire structures of temperament traits and it is relevant for assessing an individual's ability to process stimulation and influence their performance during competitions. In our cross-sectional study, these structures are examined in relation to the offensive, defensive, and comprehensive effectiveness of an individual player's actions.

Methods

The study included 91 football players aged between 20 and 31 years, who had approximately 10 years of training experience. The Formal Characteristics of Behavior - Temperament Inventory was utilized to assess temperamental traits, while a simulation game was employed to evaluate the effectiveness of each individual player's actions.

Results

Research demonstrated that football players possessing a temperament structure that is closely aligned harmonized structure with a high capacity to process stimulation showed higher levels of individual efficacy in attack, defence, and comprehensive effectiveness of performance compared to football players with a harmonized temperament structure but a low capacity to process stimulation.

Conclusion

The obtained result emphasises the significance of specific temperament structures in terms of matching the individual's stimulation levels and the their ability to process it.

Association of Scapular Dyskinesis with Neck and Shoulder Function and Training Period in Brazilian Ju-Jitsu Athletes

Background and Objectives: Neck and shoulder injuries are common in Brazilian ju-jitsu (BJJ) athletes, and scapular dyskinesis (SD) is associated with these injuries. This study aimed to investigate the prevalence of SD in BJJ athletes, their neck and shoulder function and strength, and the BJJ training period. Materials and Methods: Forty-eight BJJ athletes participated in the study. Years of experience with BJJ, belt, shoulder internal and external rotation strength, neck strength, neck disability index (NDI), and SD were measured. Results: Approximately 31 BJJ athletes (64.6%) showed SD, and the nondominant arm showed a more obvious SD (n = 22, 45.8%) than the dominant arm (n = 18, 37.5%). Those with over five years of BJJ training experience showed a significantly higher rate of SD (p = 0.006) than those with less than five years of experience. Shoulder isometric internal rotation strength was significantly weaker in the obvious SD group than in the normal SD group (p = 0.014). Neck isometric strength and NDI did not differ significantly between individuals with or without SD. Conclusions: SD was common among BJJ athletes, and more experienced BJJ athletes exhibited higher rates of SD. Shoulder rotational strength was weaker with SD. Further studies are necessary on the neck and shoulders of BJJ athletes with SD.

Pain sensitivity is modulated by affective temperament: Results from the population-based CHRIS Affective Disorder (CHRIS-AD) study

BACKGROUND

Nociceptive pain modulation is related to psychological and psychiatric conditions. Evidence from clinical studies backs innate temperaments as potential precursors of mood symptoms and disorders, and pain sensitivity. Our study examines the modulation effect of affective temperaments on pain sensitivity in a general population adult sample, accounting for possible intervening mood symptoms, lifetime anxiety and depression, and pain treatments.

METHODS

The sample is part of the CHRIS-AD study, Italy. Primary outcomes were the pain sensitivity questionnaire PSQ-total intensity score and the experimental pressure pain threshold (PPT). Affective temperaments were evaluated with the TEMPS-M. Lifetime depression, anxiety, current mood disorders, and treatments were self-reported via rating-scales. Directed acyclic graphs theory guided linear and mixed linear regression model analyses.

RESULTS

Among 3804 participants (aged 18-65; response rate 78.4 %, females 53.3 %, mean age 38.4 years) for any given temperament, both the PSQ-total and the PPT were associated with temperament. The TEMPS-M four cyclothymic-related temperaments aligned on the pain-sensitive pole and the hyperthymic on the pain-resilient pole. The inclusion of current or lifetime mood symptoms, or pain drug use, as possible intervening pathways only partly diluted these associations, with stronger evidence for an effect of trait anxiety.

LIMITATIONS

The main limitations were the lack of experimental measures of suprathreshold pain intensity perception, and detailed information on affective disorders in the study population.

CONCLUSIONS

These findings support the hypothesis of a biological dichotomous diathesis of affective temperaments towards pain sensitivity; hyperthymic suggesting protection, whereas cyclothymic suggesting predisposition.

Pain Perception in Contact Sport Athletes: A Scoping Review

Contact sports athletes are regularly facing acute physical pain in part of their sport; however, the literature investigating pain perception in these athletes remains scarce. This scoping review aimed to explore the literature surrounding pain perception in contact sport athletes and to compile and understand how it is studied. The search strategy consisted of using index terms and keywords in the MEDLINE, EMBASE, SPORTDiscus, Web of Science, PsycINFO, CINAHL and ProQuest Dissertations & Theses Global search engines. Results from 11 studies revealed that a mix of team contact sports and combat sports are studied and are included under the umbrella of contact sports. These athletes are being compared with non-athletes as well as athletes from non-contact sports. The cold pressor test and the pain pressure test are the two predominant methods used to investigate physical pain. This review highlights the need to clearly define sports based on contact levels expected in play to better define the types of pain athletes are facing in their practice. Athletes' level of play as well as years of experience should also be more rigorously reported. While contact sport athletes seem to have a higher level of pain tolerance than both active controls and non-contact athletes, the methods of pain testing are not always justified and appropriate in relation to the pain induced during contact sports. Future experimental studies should use pain testing methods relevant to the pain experienced during contact sports and to better justify the rationale for the choice of these methods.

No Association between Genetic Variants of the COMT and OPRM1 Genes and Pain Perception among Patients Undergoing Total Hip or Knee Arthroplasty for Primary Osteoarthritis

Each year approximately 1 million total hip replacements are performed worldwide. The most common indications to choose this procedure are rest pain and pain after activity as well as functional limitations influencing daily activities. Experimental pain is highly variable by individuals, which is partly due to genetics. The aim of the study was to investigate a possible association of the catechol-O-methyltransferase (COMT) and μ-opioid receptor (OPRM1) genotypes with pain perception in patients undergoing total hip replacement and total knee replacement taking into account aspects such as age, sex and diabetes. The study included 207 patients (119 females, 88 males, median age 65 years, range 33−77) that qualified for surgical treatment (total hip replacement and knee arthroplasty) due to osteoarthritis. Pain sensitivity measurement was performed using a standard algometer. The genomic DNA was extracted from the buccal cells.. Single locus analysis was conducted using a general linear model. In the study group, we did not find statistically significant genetic associations between variants of COMT and OPRM1 and pain thresholds/pain tolerance. The analysis of subjective pain perception using the visual analog scale did not show any relationship between the OPRM1 rs1799971A>G variant and COMT rs4680, rs4633, rs4818 and rs6269.

A Feasibility Study of the Usefulness of the TEMPS-A Scale in Assessing Affective Temperament in Athletes

Background and objectives: Current studies show an important role of affective temperament in sport performance. The aim of this study was to assess the feasibility of the use of the TEMPS-A scale, by using it to examine five dimensions of affective temperament in three groups of athletes. We hypothesized that temperament may be a predisposing factor to the level of commitment and type of training. Materials and methods: The study group (N:71, 33 female) consisted of professional canoeists (N:25, aged 18–30), sports pilots (N:21, aged 19–57) and non-professionals regularly performing aerobic exercises (N:25, aged 23–33). The Affective Temperament of Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) was used to evaluate affective temperament dimensions. Statistical analysis was performed using non-parametric tests. Results: The TEMPS_A scale shows good internal consistency; a hyperthymic temperament was associated with different factors compared to other temperament traits. The most prevalent trait in the study group was hyperthymic temperament. The study group scored higher on hyperthymic and lower on depressive and anxious temperaments when compared with the general population. Canoeists scored higher on cyclothymic temperament compared with non-professional athletes and on cyclothymic and irritable dimensions in comparison with pilots. Pilots obtained significantly lower scores on irritable and anxious temperaments than non-professional athletes. Females scored higher on both hyperthymic and irritable dimensions. No significant differences were found in respect of depressive, cyclothymic and anxious traits. Age was negatively correlated with cyclothymic and irritable temperament scores. Conclusions: TEMPS-A scale is a useful tool for assessing affective temperament in athletes. The results suggest that affective temperament may be a factor influencing physical activity engagement. Different types of activities may be connected with different temperament dimensions. Younger athletes present a higher tendency to mood lability and sensitivity to environmental factors. However, further research is needed, involving larger numbers of subjects.

Comparisons of Mood States Associated With Outcomes Achieved by Female and Male Athletes in High-Level Judo and Brazilian Jiu-Jitsu Championships: Psychological Factors Associated With the Probability of Success

ABSTRACT

Brandt, R, Bevilacqua, GG, Crocetta, TB, Monteiro, CBdM, Guarnieri, R, Hobold, E, Flores, LJF, Miarka, B, and Andrade, A. Comparisons of mood states associated with outcomes achieved by female and male athletes in high-level judo and Brazilian jiu-jitsu championships: psychological factors associated with the probability of success. J Strength Cond Res 35(9): 2518-2524, 2019-Moods can be used to predict the performance of athletes in various sports; accordingly, we selected the Brunel Mood Scale (BRUMS) to evaluate mood states of high-level judo and Brazilian jiu-jitsu (BJJ) athletes. The aims of this study were (a) to compare the mood states of high-level female and male athletes in BJJ and judo championships in relation to their performance outcomes and (b) to verify associations between psychological factors and performance in estimating their probability of success. The subjects were 173 grappling athletes (judo, n = 85 and BJJ, n = 88), separated into male (n = 129, 40 winners and 89 nonwinners) and female (n = 44, 23 winners and 21 nonwinners) groups. Each subject's mood state was assessed 60 minutes before the first match using the BRUMS (tension, depression, anger, vigor, fatigue, and mental confusion dimensions). Descriptive and inferential statistics (including logistic regression and variance analysis) were used to evaluate relations between mood states and performance (i.e., winning/losing), with p ≤ 0.05. Analysis showed significant differences between male and female athletes in vigor and fatigue, and differences between male judo and male BJJ athletes in tension, vigor, confusion, and fatigue. Female judo and female BJJ athletes showed significant differences in depression and vigor. Logistic regression revealed that higher levels of anger and tension increased athletes' chances of performing well in a match by 23 and 13%, respectively. In addition, lower levels of depression increased athletes' chances of better performance by up to 32%. Overall, we observed a significant relationship between mood state and sports performance. Thus, coaching staff and athletes should monitor athletes' mood states before competitions to ensure that they are in optimal condition to perform and use psychological interventions to support judo and BJJ preparation.

Association between Polymorphism rs1799732 of DRD2 Dopamine Receptor Gene and Personality Traits among MMA Athletes

Four factors—namely, harm avoidance, novelty seeking, reward addiction and persistence—represent the nature of temperament that is not genetically determined in itself. It was shown in earlier studies that a strong propensity to look for novelty or a tendency to engage in risky behavior is correlated with genetic variants in the area of the genes encoding dopamine receptors. Therefore, the aim of this study is to determine whether there is a relationship between personality traits and genetic variants in the area of the DRD2 dopamine receptor gene in MMA athletes. The participants consisted of 85 mixed martial arts (MMA) athletes and 284 healthy, non-MMA male participants. Their personality traits were measured using the Revised Temperament and Character Inventory. Blood was collected for genetic assays and all samples were genotyped using the real-time PCR method. We observed a statistically significant effect of a complex factor of the DRD2 rs1799732 genotype on MMA participants’ control and reward dependence. Engaging in high-risk sport may be associated with several personality characteristics. The DRD2 rs1799732 polymorphism may be associated with reduced harm avoidance in martial arts athletes, thereby modulating athletes’ predisposition to participate in high-risk sport.

Can Injuries Have a Lasting Effect on the Perception of Pain in Young, Healthy Women and Men?

BACKGROUND

Pain is a characteristic, unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain is a subjective sensation, modulated by many factors such as age, sex, emotional state, national origin, or physical activity. Moreover, it is closely associated with intense physical activity, injuries, and traumas, which can significantly modulate pain tolerance.

HYPOTHESIS

We postulate that there are correlations between past injuries, physical activity, and intensity of pain perception (pain threshold and pain tolerance) in a population of healthy men and women.

STUDY DESIGN

Retrospective cohort study.

LEVEL OF EVIDENCE

Level 4.

METHODS

A total of 302 participants aged 18 to 32 years were included. The participants were divided into 2 groups (active and inactive individuals), in accordance with the scope of physical activity they had indicated. The test of pressure pain threshold and pressure pain tolerance was performed using an algometer.

RESULTS

Active women achieved significantly higher pain threshold and pain tolerance values in all measurements on the upper limb (except for the pain threshold on the left hand) compared with inactive women. In mediation analysis, the effect of injury remained significant only for the pressure pain tolerance in the dominant arm and the left hand in the female group. In the case of men, there were no significant differences in all measurements in view of the threshold and tolerance for pain between the groups of active and inactive and between men with injuries and without injuries.

CONCLUSION

Intense, regular physical activity is a factor modulating the perception of pain. This was demonstrated as lowered sensitivity to pain stimuli in a population of healthy women.

CLINICAL RELEVANCE

Injuries should be treated as an important factor modulating the perception of pain. We recommend detailed monitoring of injuries during treatment and control of pain sensation.

Pain Is Inevitable But Suffering Is Optional: Relationship of Pain Coping Strategies to Performance in Multistage Ultramarathon Runners

INTRODUCTION

Ultramarathon runners commonly endure musculoskeletal pain during endurance events. However, the effect of pain coping skills on performance has not been examined.

METHODS

A prospective observational study during three 250 km (155 mi), 6 stage ultramarathons was conducted. Finish line surveys were completed after each of the four 40 km (25 mi) and one 80 km (50 mi) stages of racing. Variables gathered included pain intensity, pain coping strategy use, pain interference, finishing position (quintile), and successful race completion.

RESULTS

A total of 204 participants (age 41.4±10.3 y; 73% male) reported average pain intensity of 3.9 (±2.0 SD) and worst pain intensity of 5.3 (±2.3) on a 0 to 10 scale. They used greater adaptive pain coping strategies (3.0±1.3) relative to maladaptive strategies (1.3±1.1). Worst pain and pain interference increased over each stage of the race for all runners (P<0.001), with worst pain being significantly different by finishing status (P=0.02). Although all runners endured increased pain and interference, the nonfinishers (28 [14%]) had significantly greater differences in changes in pain intensity (P<0.01) and pain interference (P<0.001). Maladaptive pain coping strategies were more common in nonfinishers; with each 1-point increase (0-6 scale), there was a 3 times increase in odds of not finishing the race.

CONCLUSIONS

Although increased pain intensity and pain interference was found in all multistage ultramarathon runners, successful event completion was significantly associated with less maladaptive pain coping. Training in coping with pain may be a beneficial part of ultramarathon preparation.

Evaluation of Anterior-Posterior Spine Curvatures and Incidence of Sagittal Defects in Children and Adolescents Practicing Traditional Karate

Background and Study Aim

To evaluate anterior-posterior spine curvatures and incidence of sagittal defects in children and adolescents practicing traditional Karate.

Material and Methods

152 people aged 6-16 yrs, mean age 10.5±3.03. The study group (SG), subjects attending traditional Karate classes for min one year, 60 minutes twice a week (76 people). The control group (CG) randomly selected on 1:1 basis to match SG. The anterior-posterior curvatures were measured with a gravitational inclinometer. Sauder's norms were used to assess postural defects. Body mass, height, and BMI were measured. Mann-Whitney U-test/Student's t-test for independent variables, χ² test, and Cramer V test were used in statistical analysis.

Results

Significant differences were observed between the groups in lumbosacral inclination ALPHA1 p<0.001; karateka had significantly lower ALPHA 1 and greater thoracic inclination (GAMMA TH/L) p=0.23. In study group, lumbosacral angle flattening (ALPHA 2) (81.6%) was greater than in CG (56.6%). ALPHA 2 (43.4%) was more frequently within the norm in CG. Increased ALPHA 2 was reported only among SG (2.6%). Differences were statistically significant (χ² (2) = 15.23 p<0.001) and of moderate power (Cramer V=0.31). Regarding thoracic kyphosis and lumbar lordosis, there were no statistically significant differences between the groups.

Conclusions

Traditional Karate affects pelvic tilt leading to posterior tilt; it correlates with somatic parameters: height, mass, and BMI in terms of spine curvatures. The size of the lumbar lordosis and thoracic kyphosis in karatekas is comparable to that of those not practicing sport. Frequent incidence of reduced pelvic tilt in karatekas requires implementing exercises activating anterior tilt during training session.

Mild iron deficiency may affect female endurance and behavior

The function of central nervous system (CNS) processes is highly dependent on iron containing enzymes and proteins. Therefore, even mild iron deficiency (ID) may result in decreased endurance, increased irritability and withdrawal behavior among women. The current study was designed to assess the effects of iron status on perceived energy level along with its electroencephalographical (EEG) correlates and cognitive capacity of young women, since this group is at particular risk of experiencing depleted iron stores and iron deficiency anemia. The study group consisted of 23 non-anemic women of reproductive age (20-32 years) during their follicular phase of menstrual cycle. All participants were moderately physically active with a mean weekly energy expenditure of 1110 ± 450 Metabolic Equivalent of Task per minute-(MET/min). The group's electroencephalographic (EEG) alpha asymmetry and psychometric data - intelligence, anxiety level and temperamental traits (activity, briskness, sensory sensitivity, emotional reactivity, perseveration and endurance) were assessed and compared between iron deficient (serum ferritin <12 μg/l) and iron sufficient (serum ferritin ≥12 μg/l) females. Participants with depleted iron stores reported lower levels of activity (p = .004; partial η² = 0.34) and endurance (p = .038, partial η² = 0.25), temperamental traits, and presented increased relative left EEG alpha activity in prefrontal regions (p = .004; partial η² = 0.63), which is a characteristic EEG pattern for withdrawal tendencies. Iron-depleted females did not differ in anxiety and general intelligence scores from those which were iron sufficient, however needed more time (median difference: 3 min, p = .004; partial η² = 0.53) to complete an administered intelligence test, which may reflect lowered endurance during a cognitive-demanding task. These data provide proof that that even mild iron deficiency may be connected with CNS function and lead to decreased endurance, or at least cognitive endurance, which may be a risk-factor for mood disorders. Therefore, more attention should be paid to preventing even mild iron deficiency, particularly among young women.