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Couëpel B, Daneau C, Tremblay M, Javelot T, Abboud J, Pagé I, Descarreaux M. Effect of physical activity education on shoulder girdle pain and muscle strength in participants with fibromyalgia: a pilot experimental study. FRONTIERS IN PAIN RESEARCH 2024; 5:1328796. [PMID: 38751494 PMCID: PMC11094234 DOI: 10.3389/fpain.2024.1328796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
Background In patients with fibromyalgia, exercise and education are recommended to decrease pain level and improve pain management. The latest scientific evidence recommends to focus interventions on the upper limb. The aim of this pilot study was to compare the immediate effect of physical activity education vs. a control group on pain and muscle capacity in fibromyalgia patients. Method Fifty-six participants with fibromyalgia were randomized into an experimental group and a control group. The intervention consisted in watching a five-minute video that provided information about fibromyalgia, pain, kinesiophobia and physical activity. The control group watched a neutral five-minute video about beavers in Quebec. Following the video, participants performed a muscular fatigue task consisting of a repeated unilateral shoulder abduction task. At baseline and following the muscular fatigue task, maximal voluntary contraction (MVC) in shoulder abduction was assessed as well as pain level and pressure pain threshold (PPT) in the upper limb. Electromyographic activity was also assessed for upper trapezius and middle deltoid muscles. Two-way repeated measures analysis of variance was used to compare the MVC, PPT, and pain level before and after the muscular fatigue task between groups. Results The experimental group showed a significantly lower increase in pain than the control group in the middle deltoid muscle (p = 0.002) when assessed by verbal pain rating scale. No significant interaction or main effect of Group and Time were observed for the pain level at the upper trapezius and elbow extensor muscles nor for any of the PPT measures. According to electromyographic data, the median frequency values indicate that neither group experienced muscle fatigue during the repeated contraction task. Conclusions The preliminary results suggest that a short physical activity education video positively influenced middle deltoid pain following repeated abduction in participants with fibromyalgia. Electromyographic analysis showed no evidence of objective muscle fatigue, suggesting that there might be a partial disconnection between the perception of muscle fatigue and the physiological biomarkers associated with muscle fatigue.
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Affiliation(s)
- Bastien Couëpel
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Group on Neuromusculoskeletal Disorders (GRAN), Trois-Rivières, QC, Canada
| | - Catherine Daneau
- Research Group on Neuromusculoskeletal Disorders (GRAN), Trois-Rivières, QC, Canada
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Mathieu Tremblay
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Group on Neuromusculoskeletal Disorders (GRAN), Trois-Rivières, QC, Canada
| | - Thomas Javelot
- Research Group on Neuromusculoskeletal Disorders (GRAN), Trois-Rivières, QC, Canada
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Jacques Abboud
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Group on Neuromusculoskeletal Disorders (GRAN), Trois-Rivières, QC, Canada
| | - Isabelle Pagé
- Research Group on Neuromusculoskeletal Disorders (GRAN), Trois-Rivières, QC, Canada
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale (CIUSSS-CN), Quebec, QC, Canada
| | - Martin Descarreaux
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Augière T, Simoneau M, Brun C, Pinard AM, Blouin J, Mouchnino L, Mercier C. Behavioral and Electrocortical Response to a Sensorimotor Conflict in Individuals with Fibromyalgia. Brain Sci 2023; 13:931. [PMID: 37371409 DOI: 10.3390/brainsci13060931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
People with fibromyalgia have been shown to experience more somatosensory disturbances than pain-free controls during sensorimotor conflicts (i.e., incongruence between visual and somatosensory feedback). Sensorimotor conflicts are known to disturb the integration of sensory information. This study aimed to assess the cerebral response and motor performance during a sensorimotor conflict in people with fibromyalgia. Twenty participants with fibromyalgia and twenty-three pain-free controls performed a drawing task including visual feedback that was either congruent with actual movement (and thus with somatosensory information) or incongruent with actual movement (i.e., conflict). Motor performance was measured according to tracing error, and electrocortical activity was recorded using electroencephalography. Motor performance was degraded during conflict for all participants but did not differ between groups. Time-frequency analysis showed that the conflict was associated with an increase in theta power (4-8 Hz) at conflict onset over the left posterior parietal cortex in participants with fibromyalgia but not in controls. This increase in theta suggests a stronger detection of conflict in participants with fibromyalgia, which was not accompanied by differences in motor performance in comparison to controls. This points to dissociation in individuals with fibromyalgia between an altered perception of action and a seemingly unaltered control of action.
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Affiliation(s)
- Tania Augière
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC G1M 2S8, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Martin Simoneau
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC G1M 2S8, Canada
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Clémentine Brun
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC G1M 2S8, Canada
| | - Anne Marie Pinard
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC G1M 2S8, Canada
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
| | - Jean Blouin
- Laboratoire de Neurosciences Cognitives, Aix-Marseille University, National Center for Scientific Research (CNRS), 13331 Marseille, France
| | - Laurence Mouchnino
- Laboratoire de Neurosciences Cognitives, Aix-Marseille University, National Center for Scientific Research (CNRS), 13331 Marseille, France
- Institut Universitaire de France, 75005 Paris, France
| | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Quebec City, QC G1M 2S8, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
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Interoceptive accuracy and bias in somatic symptom disorder, illness anxiety disorder, and functional syndromes: A systematic review and meta-analysis. PLoS One 2022; 17:e0271717. [PMID: 35980959 PMCID: PMC9387777 DOI: 10.1371/journal.pone.0271717] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/06/2022] [Indexed: 12/03/2022] Open
Abstract
Somatic symptom disorder, illness anxiety disorder, and functional syndromes are characterized by burdensome preoccupation with somatic symptoms. Etiological models propose either increased interoceptive accuracy through hypervigilance to the body, or decreased and biased interoception through top-down predictions about sensory events. This systematic review and meta-analysis summarizes findings of 68 studies examining interoceptive accuracy and 8 studies examining response biases in clinical or non-clinical groups. Analyses yielded a medium population effect size for decreased interoceptive accuracy in functional syndromes, but no observable effect in somatic symptom disorder and illness anxiety disorder. The overall effect size was highly heterogeneous. Regarding response bias, there was a small significant effect in somatic symptom disorder and illness anxiety disorder. Our findings strengthen the notion of top-down factors that result in biased rather than accurate perception of body signals in somatic symptom disorder and illness anxiety disorder.
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Vittersø AD, Halicka M, Buckingham G, Proulx MJ, Bultitude JH. The sensorimotor theory of pathological pain revisited. Neurosci Biobehav Rev 2022; 139:104735. [PMID: 35705110 DOI: 10.1016/j.neubiorev.2022.104735] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/13/2022] [Accepted: 06/07/2022] [Indexed: 01/31/2023]
Abstract
Harris (1999) proposed that pain can arise in the absence of tissue damage because changes in the cortical representation of the painful body part lead to incongruences between motor intention and sensory feedback. This idea, subsequently termed the sensorimotor theory of pain, has formed the basis for novel treatments for pathological pain. Here we review the evidence that people with pathological pain have changes to processes contributing to sensorimotor function: motor function, sensory feedback, cognitive representations of the body and its surrounding space, multisensory processing, and sensorimotor integration. Changes to sensorimotor processing are most evident in the form of motor deficits, sensory changes, and body representations distortions, and for Complex Regional Pain Syndrome (CRPS), fibromyalgia, and low back pain. Many sensorimotor changes are related to cortical processing, pain, and other clinical characteristics. However, there is very limited evidence that changes in sensorimotor processing actually lead to pain. We therefore propose that the theory is more appropriate for understanding why pain persists rather than how it arises.
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Affiliation(s)
- Axel D Vittersø
- Centre for Pain Research, University of Bath, Bath, Somerset, United Kingdom; Department of Psychology, University of Bath, Bath, Somerset, United Kingdom; Department of Sport & Health Sciences, University of Exeter, Exeter, Devon, United Kingdom; Department of Psychology, Oslo New University College, Oslo, Norway.
| | - Monika Halicka
- Centre for Pain Research, University of Bath, Bath, Somerset, United Kingdom; Department of Psychology, University of Bath, Bath, Somerset, United Kingdom
| | - Gavin Buckingham
- Department of Sport & Health Sciences, University of Exeter, Exeter, Devon, United Kingdom
| | - Michael J Proulx
- Department of Psychology, University of Bath, Bath, Somerset, United Kingdom; Centre for Real and Virtual Environments Augmentation Labs, Department of Computer Science, University of Bath, Bath, Somerset, United Kingdom
| | - Janet H Bultitude
- Centre for Pain Research, University of Bath, Bath, Somerset, United Kingdom; Department of Psychology, University of Bath, Bath, Somerset, United Kingdom
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Lower regulatory frequency for postural control in patients with fibromyalgia and chronic fatigue syndrome. PLoS One 2018; 13:e0195111. [PMID: 29617424 PMCID: PMC5884530 DOI: 10.1371/journal.pone.0195111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 03/16/2018] [Indexed: 11/20/2022] Open
Abstract
As many similar symptoms are reported in fibromyalgia (FM) and chronic fatigue syndrome (CFS), underlying defcits may potentially also be similar. Postural disequilibrium reported in both conditions may thus be explained by similar deviations in postural control strategies. 75 females (25/group FM, CFS and control, age 19-49 years) performed 60 s of quiet standing on a force platform in each of three conditions: 1) firm surface with vision, 2) firm surface without vision and, 3) compliant surface with vision. Migration of center of pressure was decomposed into a slow and a fast component denoting postural sway and lateral forces controlling postural sway, analyzed in the time and frequency domains. Main effects of group for the antero-posterior (AP) and medio-lateral (ML) directions showed that patients displayed larger amplitudes (AP, p = 0.002; ML, p = 0.021) and lower frequencies (AP, p < 0.001; ML, p < 0.001) for the slow component, as well as for the fast component (amplitudes: AP, p = 0.010; ML, p = 0.001 and frequencies: AP, p = 0.001; ML, p = 0.029) compared to controls. Post hoc analyses showed no significant differences between patient groups. In conclusion, both the CFS- and the FM-group differed from the control group. Larger postural sway and insufficient control was found in patients compared to controls, with no significant differences between the two patient groups.
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Bardal EM, Roeleveld K, Ihlen E, Mork PJ. Micro movements of the upper limb in fibromyalgia: The relation to proprioceptive accuracy and visual feedback. J Electromyogr Kinesiol 2015; 26:1-7. [PMID: 26790141 DOI: 10.1016/j.jelekin.2015.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 12/17/2015] [Accepted: 12/17/2015] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to explore the role of visual and proprioceptive feedback in upper limb posture control in fibromyalgia (FM) and to assess the coherence between acceleration measurements of upper limb micro movements and surface electromyography (sEMG) of shoulder muscle activity (upper trapezius and deltoid). Twenty-five female FM patients and 25 age- and sex-matched healthy controls (HCs) performed three precision motor tasks: (1) maintain a steady shoulder abduction angle of 45° while receiving visual feedback about upper arm position and supporting external loads (0.5, 1, or 2kg), (2) maintain the same shoulder abduction angle without visual feedback (eyes closed) and no external loading, and (3) a joint position sense test (i.e., assessment of proprioceptive accuracy). Patients had more extensive increase in movement variance than HCs when visual feedback was removed (P<0.03). Proprioceptive accuracy was related to movement variance in HCs (R⩾0.59, P⩽0.002), but not in patients (R⩽0.25, P⩾0.24). There was no difference between patients and HCs in coherence between sEMG and acceleration data. These results may indicate that FM patients are more dependent on visual feedback and less reliant on proprioceptive information for upper limb posture control compared to HCs.
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Affiliation(s)
- Ellen Marie Bardal
- Department of Neuroscience, Norwegian University of Science and Technology, N-7491 Trondheim, Norway.
| | - Karin Roeleveld
- Department of Neuroscience, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
| | - Espen Ihlen
- Department of Neuroscience, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and General Practice, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
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Inada E, Saitoh I, Yu Y, Tomiyama D, Murakami D, Takemoto Y, Morizono K, Iwasaki T, Iwase Y, Yamasaki Y. Quantitative evaluation of toothbrush and arm-joint motion during tooth brushing. Clin Oral Investig 2014; 19:1451-62. [PMID: 25467235 PMCID: PMC4478439 DOI: 10.1007/s00784-014-1367-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 11/13/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES It is very difficult for dental professionals to objectively assess tooth brushing skill of patients, because an obvious index to assess the brushing motion of patients has not been established. The purpose of this study was to quantitatively evaluate toothbrush and arm-joint motion during tooth brushing. MATERIALS AND METHODS Tooth brushing motion, performed by dental hygienists for 15 s, was captured using a motion-capture system that continuously calculates the three-dimensional coordinates of object's motion relative to the floor. The dental hygienists performed the tooth brushing on the buccal and palatal sides of their right and left upper molars. The frequencies and power spectra of toothbrush motion and joint angles of the shoulder, elbow, and wrist were calculated and analyzed statistically. RESULTS The frequency of toothbrush motion was higher on the left side (both buccal and palatal areas) than on the right side. There were no significant differences among joint angle frequencies within each brushing area. The inter- and intra-individual variations of the power spectrum of the elbow flexion angle when brushing were smaller than for any of the other angles. CONCLUSIONS This study quantitatively confirmed that dental hygienists have individual distinctive rhythms during tooth brushing. All arm joints moved synchronously during brushing, and tooth brushing motion was controlled by coordinated movement of the joints. The elbow generated an individual's frequency through a stabilizing movement. CLINICAL RELEVANCE The shoulder and wrist control the hand motion, and the elbow generates the cyclic rhythm during tooth brushing.
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Affiliation(s)
- Emi Inada
- Department of Pediatric Dentistry, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
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Bardal EM, Olsen TV, Ettema G, Mork PJ. Metabolic rate, cardiac response, and aerobic capacity in fibromyalgia: a case-control study. Scand J Rheumatol 2013; 42:417-20. [PMID: 23527918 DOI: 10.3109/03009742.2013.767372] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Several studies report reduced aerobic capacity in patients with fibromyalgia (FM). The purpose of our study was to investigate whether a reduction in aerobic capacity in these patients is accompanied by alterations in metabolic rate and heart rate (HR) response. METHOD Twelve women with FM and 12 healthy controls (HCs) matched on sex and age, and with similar leisure time physical activity, participated in the study. All subjects performed an incremental submaximal cycle ergometer test to anaerobic threshold [AT; i.e. blood lactate concentration (bLa) ≥ 4 mmol/L], followed by a stepwise test to exhaustion to estimate maximal oxygen consumption (VO(2max)). RESULTS Oxygen consumption and workload were lower among patients than HCs both at AT and at termination of the VO(2max) test (p < 0.011 for all comparisons). Two patients (18%) and nine HCs (75%) reached VO(2max) criteria. The relationship between metabolic rate and workload did not differ between groups at exercise below AT. At exercise above AT, the metabolic rate increased disproportionally to workload in the patients. Although the patients had a higher anaerobic contribution to the total metabolic rate at the end of the submaximal test, the anaerobic contribution at the end of the maximal test did not differ between groups. HR responses were largely similar between groups. CONCLUSIONS The current study indicates that patients with FM have similar metabolic and cardiovascular responses to submaximal exercise as HCs. However, these patients have reduced ability to reach VO(2max) and a possible deficit in the metabolic system when exercising above the AT.
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Affiliation(s)
- E M Bardal
- Department of Human Movement Science, Norwegian University of Science and Technology , Trondheim , Norway
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Pérez-de-Heredia-Torres M, Martínez-Piédrola RM, Cigarán-Méndez M, Ortega-Santiago R, Fernández-de-Las-Peñas C. Bilateral deficits in fine motor control ability and manual dexterity in women with fibromyalgia syndrome. Exp Brain Res 2013; 226:137-43. [PMID: 23354668 DOI: 10.1007/s00221-013-3417-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 01/10/2013] [Indexed: 10/27/2022]
Abstract
The aim of the current study was to investigate fine motor control ability and manual dexterity women with fibromyalgia syndrome (FMS) without symptoms in the upper extremity compared to healthy women. Subtests of the Purdue Pegboard Test (one-hand, bilateral and assembly) and of the Jebsen-Taylor hand-function test (writing, turning cards, picking up small, light and large heavy objects, simulated feeding and stacking checkers) were evaluated bilaterally in 20 women with FMS (aged 35-55 years) without symptoms in the upper limb and 20 age- and hand dominance-matched healthy women. Differences between sides and groups were analysed with several analysis of variance (ANOVA). The ANOVA revealed significant differences between groups (P < 0.001) and sides (P = 0.007) for one-hand pin placement subtest: women with FMS showed bilateral worse scores than controls. Patients also exhibited significantly lower scores in bilateral pin placement and assembly subtests when compared to healthy controls (P < 0.001). The ANOVA also revealed significant differences between groups for writing, turning over cards, picking up small objects, stacking checkers, picking up large light objects and picking up large heavy objects (all, P < 0.001): women with FMS needed more time for these subtests than healthy women with both hands. No difference for simulated feeding was found between groups. Our findings revealed bilateral deficits in fine motor control ability and manual dexterity in patients with FMS without symptoms in the upper extremity. These deficits are not related to the clinical features of the symptoms supporting an underlying central mechanism of altered motor control.
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Affiliation(s)
- Marta Pérez-de-Heredia-Torres
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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