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Haenen V, Meeus M, Devoogdt N, Morlion B, Dams L, De Groote A, Foubert A, De Groef A. Concurrent validity of dynamic bedside quantitative sensory testing paradigms in breast cancer survivors with persistent pain. Scand J Pain 2024; 24:sjpain-2023-0093. [PMID: 38498596 DOI: 10.1515/sjpain-2023-0093] [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: 08/16/2023] [Accepted: 02/15/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Studies on the concurrent validity of clinically applicable testing protocols for conditioned pain modulation (CPM) and temporal summation of pain (TSP) in breast cancer survivors (BCS) with persistent pain are lacking. OBJECTIVES This study investigated the concurrent validity of two bedside protocols for CPM and TSP in comparison to a respective reference protocol. The participants' preferences for bedside CPM and TSP protocols were assessed. METHODS Thirty BCS experiencing persistent pain were included in this study. Each participant underwent a reference test along with two bedside alternatives for assessing both TSP and CPM. For CPM, a cold pressor test (CPT) and blood pressure cuff (BPC) were used as conditioning stimulus. The test stimulus was elicited in parallel by pressure pain threshold after 45 and 90 s of conditioning at the lower limb. The CPM reference test consisted of parallel heat stimuli at the forearms using a two-thermode system. TSP was elicited using a von Frey monofilament (256 mN) and an algometer (98 kPa) at the affected site and opposite lower limb. The TSP reference test consisted of heat stimuli at the affected site and opposite lower limb. Participants' testing preference was examined using a purpose-designed questionnaire. Spearman's rank test examined the correlation between protocols. RESULTS The two bedside CPM protocols were strongly correlated (r = 0.787-0.939, p < 0.005). A strong correlation was found between the BPC protocol and reference test using the relative effect magnitude (r = 0.541-0.555, p < 0.005). The bedside TSP protocols were moderately correlated with each other only at the lower limb using absolute change scores (r = 0.455, p = 0.012). No significant correlation was found between the bedside and reference TSP protocols. CONCLUSION The significantly moderate to very strong correlations between the bedside protocols validate their interchangeability. Researchers and clinicians should be able to choose which bedside protocol they utilize; however, participants favored the use of a BPC and algometer for the evaluation of CPM and TSP, respectively.
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Affiliation(s)
- Vincent Haenen
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Research Group Rehabilitation in Internal Disorders (GRID), Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Wilrijk, Belgium
| | - Mira Meeus
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Wilrijk, Belgium
| | - Nele Devoogdt
- Research Group Rehabilitation in Internal Disorders (GRID), Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium
- Centre for Lymphoedema, Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
- Lymphovenous Centre, Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Bart Morlion
- Department of Cardiovascular Sciences, Section Anesthesiology & Algology, KU Leuven, University of Leuven, Leuven, Belgium
- The Leuven Centre for Algology and Pain Management, University Hospitals Leuven, Leuven, Belgium
| | - Lore Dams
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Research Group Rehabilitation in Internal Disorders (GRID), Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium
- Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Amber De Groote
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Wilrijk, Belgium
| | - Anthe Foubert
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Wilrijk, Belgium
- Faculté des Sciences de la Motricité, Université Catholique de Louvain, Louvain-La-Neuve, Wilrijk, Belgium
| | - An De Groef
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
- Research Group Rehabilitation in Internal Disorders (GRID), Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium
- Pain in Motion International Research Group, www.paininmotion.be, Wilrijk, Belgium
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Naugle KM, Naugle KE, Teegardin M, Kaleth AS. Physical Activity to Prevent the Age-Related Decline of Endogenous Pain Modulation. Exerc Sport Sci Rev 2023; 51:169-175. [PMID: 37462564 DOI: 10.1249/jes.0000000000000325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
As humans age, the capacity of the central nervous system to endogenously modulate pain significantly deteriorates, thereby increasing the risk for the development of chronic pain. Older adults are the least physically active cohort of all age groups. We hypothesize that a sedentary lifestyle and decreased physical activity may contribute to the decline of endogenous pain modulation associated with aging.
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Affiliation(s)
- Kelly M Naugle
- Department of Kinesiology, School of Health and Human Sciences, Indiana University Purdue University Indianapolis (IUPUI), Indianapolis, IN
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Oono Y, Kono R, Kiyohara Y, Takagi S, Ide Y, Nagasaka H, Kohase H. Photobiomodulation enhanced endogenous pain modulation in healthy volunteers. Lasers Med Sci 2022; 38:16. [PMID: 36562828 PMCID: PMC9789003 DOI: 10.1007/s10103-022-03686-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/12/2022] [Indexed: 12/24/2022]
Abstract
To examine the effects of photobiomodulation (PBM) in healthy volunteers using photonic stimulation of acupuncture points on conditioned pain modulation (CPM), temporal summation of pain (TSP), and offset analgesia (OA), which reflect some aspects of endogenous pain modulation. We included 15 men and 15 women (age, 31.5 [27.3-37.0], body mass index, 25.7 [24.4-27.1], Fitzpatrick skin typing, II: 20, III: 8, IV: 2). CPM, TSP, and OA were evaluated after a sham procedure (control session) and after acupuncture point stimulation (LI4 and LI10 on the non-dominant forearm) using linear polarized near-infrared light irradiation (LPNILI; wavelengths peaked at approximately 1000 nm, output: 1.4 W/cm2, spot diameter: 10 mm, spot size: 1.02 cm2, maximum temperature: 40.5 °C, pulse width: 1 s, frequency: 0.2 Hz) (PBM session). Differences in CPM, TSP, and OA between the two sessions were evaluated by the paired t-test and Fisher's exact test (statistical significance: p < 0.05). Values indicate median [interquartile range]. LPNILI significantly increased CPM in all participants (control session: 12.1 [-4.5-37.4], PBM session: 23.9 [8.3-44.8], p < 0.05) and women (control session: 16.7 [-3.4-36.6], PBM session: 38.7 [24.6-52.1], p < 0.05). The CPM effect increment was significantly higher in women than in men (p = 0.0253). LPNILI decreased TSP in participants with higher TSP ratios (p = 0.0219) and increased OA in participants with lower OA scores (p = 0.0021). LPNILI enhanced endogenous pain modulation in healthy volunteers, particularly in women, as evaluated using CPM. CPM, TSP, and OA evaluations are potentially useful for discriminating PBM responders from non-responders.
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Affiliation(s)
- Yuka Oono
- Division of Dental Anesthesiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan.
| | - Ryoko Kono
- Division of Dental Anesthesiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Yuki Kiyohara
- Division of Dental Anesthesiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Saori Takagi
- Division of Dental Anesthesiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Yasuo Ide
- Department of Anesthesiology, Saitama Medical University Hospital, Saitama, Japan
| | - Hiroshi Nagasaka
- Department of Anesthesiology, Saitama Medical University Hospital, Saitama, Japan
| | - Hikaru Kohase
- Division of Dental Anesthesiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
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Perceived Pain in Athletes: A Comparison between Endurance Runners and Powerlifters through a Cold Experimental Stimulation and Two Sessions of Various Physical Activation. Sports (Basel) 2022; 10:sports10120211. [PMID: 36548508 PMCID: PMC9785022 DOI: 10.3390/sports10120211] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 12/10/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Few studies in the literature have illustrated cold hypoalgesia induced by strength training. Objectives of this contribution were to compare the ratings of perceived pain in endurance running (n = 22) and powerlifting (n = 22) male athletes and controls (n = 22) at baseline and after two bouts of 40 min aerobic/strength training respectively, using the Cold Pressor Test (CPT) and simultaneously monitoring changes in blood pressure (BP), heart rate (HR), and body temperature. A two-way repeated measures ANOVA was conducted to examine the effects of training sessions in endurance runners vs. powerlifting athletes vs. controls on the intensity of perceived pain at CPT. A statistically significant two-way interaction between the group and training resulted in p < 0.001, ηp2 = 0.513. A simple main effects analysis showed that as the participants went through the strength training session, pain perception at CPT was significantly lower in powerlifters compared to runners and controls. Considering the physiological parameters, powerlifters reported significantly higher values of BP and HR. This difference was present at baseline but after training as well, and before and after CPT, despite a slight hypotensive effect. The differences reported after CPT at baseline, but very significantly after the strength activation session in the powerlifters, provide interesting insights into the hypoalgesic effect of high-intensity strength training.
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Peterson JA, Lohman C, Larson RD, Bemben MG, Black CD. Lean Mass is Associated with, but Does Not Mediate Sex Differences in Pressure Pain Sensitivity in Healthy Adults. J Pain Res 2022; 15:3981-3994. [PMID: 36561645 PMCID: PMC9767032 DOI: 10.2147/jpr.s387635] [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: 09/10/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
Background Sex differences exist in pain sensitivity, however, the underlying mechanism(s) that explain these differences are not fully understood. Pain sensitivity has been shown to be influenced by body mass index, but limited data exist on the role of body composition on pain sensitivity. The purpose was to examine the influence of body composition on pain sensitivity in males and females. Methods This cross-sectional study design used pressure pain thresholds (PPT) of 87 participants (45 female) who were assessed in the vastus lateralis (leg PPT) and brachioradialis (arm PPT) using a pressure algometer. Fat and lean tissue were assessed via dual-energy X-ray absorptiometry (DXA). A two group by two limb, repeated measured ANOVA was used to assess differences between limbs and sex. Spearman correlations and hierarchical regression analyses were employed to determine the association between body composition and PPT. Results Males had higher PPTs then females (P<0.05) and had higher DXA assessed lean and lower levels fat mass (P<0.05). Total body and limb specific lean mass was associated with PPTs (r≥0.34; P<0.05). Hierarchical regression analysis revealed lean mass was a significant predictor of 8% of the variance in arm PPT (P<0.006) and 18% of the variance in leg PPT (P<0.001). However, lean mass was not found to statistically mediate the observed sex differences in PPT. Conclusion This finding suggests lean mass may play a previously unknown role in sex differences in pressure pain sensitivity. Future studies are needed to confirm this finding and a larger sample size is likely required to have sufficient power to perform the mediation analysis.
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Affiliation(s)
- Jessica A Peterson
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA,Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA,Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Cameron Lohman
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Rebecca D Larson
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Michael G Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Christopher D Black
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA,Correspondence: Christopher D Black, Department of Health and Exercise Science, University of Oklahoma, Norman, OK, 73069, USA, Tel +1 706-255-3750, Email
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Yücel FN, Duruöz MT. Central Sensıtızatıon ın Axıal Spondyloarthrıtıs: An Exploratıve Study wıth Quantıtatıve Sensory Testıng and Clınıcal Scales. Mod Rheumatol 2021; 32:1137-1145. [PMID: 34865130 DOI: 10.1093/mr/roab110] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/02/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the central sensitization (CS) and the related parameters in patients with axial spondyloarthritis (axSpA). METHODS Quantitative sensory testing (QST) which consists of pressure pain threshold (PPT), temporal summation (TS), and conditioned pain modulation (CPM) were applied to the participants. Disease activity, functional status, sleep quality, pain, depression, and fatigue were assessed. Patients were divided as the ones with and without CS according to the central sensitization inventory (CSI) and the results were compared. RESULTS One hundred patients and fifty controls were recruited. Sixty axSpA patients had CS. When QST results were compared between the patient and control groups, all PPT scores were found lower (p<0.05) in patients. Regarding the comparison of the patients with and without CS, sacroiliac, and trapezius PPT scores were found lower in the patients with CS (p<0.05). On the other hand, there was no significant difference in the mean TS scores (p>0.05) between patients and controls, and in patients with and without CS. All investigated comorbidities were found to be significantly more frequent (p<0.001) in the patients with CS. In regression analysis female gender, morning stiffness duration, CPM, depression, and fatigue were detected as related parameters with CSI scores. CONCLUSION CS and related comorbidities were found to be increased in axSpA patients. This increase should be taken into consideration in the management of these patients.
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Affiliation(s)
- Feyza Nur Yücel
- PMR Department, Marmara University School of Medicine, Istanbul, Turkey
| | - Mehmet Tuncay Duruöz
- PMR Department, Rheumatology Division, Marmara University School of Medicine, Istanbul, Turkey
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Vincenot M, Coulombe-Lévêque A, Sean M, Camirand Lemyre F, Gendron L, Marchand S, Léonard G. Development and Validation of a Predictive Model of Pain Modulation Profile to Guide Chronic Pain Treatment: A Study Protocol. FRONTIERS IN PAIN RESEARCH 2021; 2:606422. [PMID: 35295452 PMCID: PMC8915565 DOI: 10.3389/fpain.2021.606422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/13/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction: Quantitative sensory testing is frequently used in research to assess endogenous pain modulation mechanisms, such as Temporal Summation (TS) and Conditioned Pain Modulation (CPM), reflecting excitatory and inhibitory mechanisms, respectively. Numerous studies found that a dysregulation of these mechanisms is associated with chronic pain conditions. In turn, such a patient's “profile” (increased TS and/or weakened CPM) could be used to recommend different pharmacological treatments. However, the procedure to evaluate these mechanisms is time-consuming and requires expensive equipment that is not available in the clinical setting. In this study, we aim to identify psychological, physiological and socio-demographic markers that could serve as proxies to allow healthcare professionals to identify these pain phenotypes in clinic, and consequently optimize pharmacological treatments. Method: We aim to recruit a healthy participant cohort (n = 360) and a chronic pain patient cohort (n = 108). Independent variables will include psychological questionnaires, pain measurements, physiological measures and sociodemographic characteristics. Dependent variables will include TS and CPM, which will be measured using quantitative sensory testing in a single session. We will evaluate one prediction model and two validation models (for healthy and chronic pain participants) using multiple regression analysis between TS/CPM and our independent variables. The significance thresholds will be set at p = 0.05, respectively. Perspectives: This study will allow us to develop a predictive model to compute the pain modulation profile of individual patients based on their biopsychosocial characteristics. The development of the predictive model is the first step toward the overarching goal of providing clinicians with a set of quick and cheap tests, easily applicable in clinical practice to orient pharmacological treatments.
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Affiliation(s)
- Matthieu Vincenot
- Research Center on Aging, Université de Sherbrooke, Sherbrooke, QC, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Alexia Coulombe-Lévêque
- Research Center on Aging, Université de Sherbrooke, Sherbrooke, QC, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Monica Sean
- Research Center on Aging, Université de Sherbrooke, Sherbrooke, QC, Canada
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Félix Camirand Lemyre
- Centre de Recherche du Centre Hospitaliser Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- Département de Mathématiques, Faculté des Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Louis Gendron
- Department of Pharmacology-Physiology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre Hospitaliser Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Serge Marchand
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Guillaume Léonard
- Research Center on Aging, Université de Sherbrooke, Sherbrooke, QC, Canada
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
- *Correspondence: Guillaume Léonard
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