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Vesal M, Roohafza H, Feizi A, Asgari K, Shahoon H, Ani A, Adibi P. Pressure algometry in the general adult population: Age and sex differences. Medicine (Baltimore) 2024; 103:e39418. [PMID: 39183389 DOI: 10.1097/md.0000000000039418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
Experimental pain studies have revealed inter-individual variations in pain perception that are influenced by age, sex, and country of origin. This study aimed to explore the age and sex differences in pressure pain thresholds within the Iranian general population. To assess the pressure pain thresholds, a handheld pressure algometer was applied bilaterally to the middle fingers of both hands. The participants also completed the short form of the McGill Pain Questionnaire to provide a clinical pain rating. This cross-sectional study included 1610 adult subjects (54.96% female, mean age 40.13 ± 10.18 years). The findings indicated that females generally exhibited lower pain thresholds than males when assessing pain detection and tolerance parameters (P < .001). Females also demonstrated a significant lower pressure thresholds and clinical pain ratings compared with men (P < .001). Additionally, significant differences were observed between age groups in terms of pain detection and tolerance thresholds (P = .02 and P = .03, respectively). However, the interaction between sex and age was not significant. No significant differences in pain detection thresholds were observed between the right and left hand (P = .11). This study underscores the potential utility of algometry as a valuable tool for objectifying pain in the Iranian population.
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Affiliation(s)
- Mina Vesal
- Department of Psychology, University of Isfahan, Isfahan, Iran
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Epidemiology and Biostatistics Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Karim Asgari
- Department of Psychology, University of Isfahan, Isfahan, Iran
| | - Hassan Shahoon
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Ani
- Department of Bioinformatics, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Nogueira Carrer HC, Haik MN, Espósito G, Vasilceac FA, Melo CDS, Pedroso MG, Gramani Say K. What Predicts a Longer Period of Pain in Patients Referred to an Interdisciplinary Center for Pain Care? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:845. [PMID: 39063422 PMCID: PMC11276389 DOI: 10.3390/ijerph21070845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/07/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024]
Abstract
Chronic musculoskeletal pain (CMP) is a global health condition that affects thousands of people. CMP can substantially affect the functional capacity and quality of life of the people impacted, resulting in high costs for health care and social security systems. Sociodemographic factors may play a significant role in pain chronification prevention and control programs. Thus, current risk factors for CMP must be seriously considered as part of an interdisciplinary management strategy. The purpose of the study was to identify the primary sociodemographic characteristics of CMP patients at a multidisciplinary and specialized center for chronic pain. This is a retrospective investigation based on a review of medical records. Age, gender, income, and the time of onset of pain symptoms were among the variables included in the analyzed data. To analyze variables related to the duration of discomfort, a multiple regression model was utilized. Sociodemographic factors explained 37.94% of experiencing prolonged pain, according to the study's findings. Being female and having a family income above the minimum wage were variables that were directly proportional to discomfort duration. Age was not associated with a prolonged duration of pain perception.
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Affiliation(s)
- Helen Cristina Nogueira Carrer
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (M.N.H.); (C.d.S.M.); (M.G.P.)
| | - Melina Nevoeiro Haik
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (M.N.H.); (C.d.S.M.); (M.G.P.)
| | - Gabriela Espósito
- Department of Gerontology, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (G.E.); (F.A.V.)
| | - Fernando Augusto Vasilceac
- Department of Gerontology, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (G.E.); (F.A.V.)
| | - Cristiane de Sousa Melo
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (M.N.H.); (C.d.S.M.); (M.G.P.)
| | - Maria Gabriela Pedroso
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (M.N.H.); (C.d.S.M.); (M.G.P.)
| | - Karina Gramani Say
- Department of Gerontology, Federal University of São Carlos (UFSCar), Interdisciplinary Center for Pain Care at UFSCar, São Carlos 13565-905, Brazil; (G.E.); (F.A.V.)
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Puto G, Repka I, Gniadek A. Gender differences in the quantitative and qualitative assessment of chronic pain among older people. Front Public Health 2024; 12:1344381. [PMID: 38915749 PMCID: PMC11194344 DOI: 10.3389/fpubh.2024.1344381] [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: 11/25/2023] [Accepted: 05/28/2024] [Indexed: 06/26/2024] Open
Abstract
Background Pain, regardless of its causes, is a subjective and multidimensional experience that consists of sensory, emotional and cognitive factors that cannot be adequately captured by a single number on a pain scale. The aim of the study was to understand gender differences in the assessment of quantitative and qualitative chronic pain among older people. Methods The study used a questionnaire that included questions about demographic and social characteristics as well as the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Depression Scale (GDS-15), McGill Pain Questionnaire (MPQ). Results The pain rating index based on rank values of adjectives was higher among women than men (18.36 ± 7.81 vs. 17.17 ± 9.69, p = 0.04). The analysis of the frequency of selection of individual adjectives describing the sensory aspects of pain showed that men described the pain as "stabbing" more often than women (26.1% vs. 14.3%, p < 0.05). Women chose adjectives from the emotional category more often than men (59.8% vs. 75.4%, p < 0.05), describing the pain as "disgusting" (8.9% vs. 1.4%, p < 0.05), "unbearable" (19.6 vs. 4.3, p < 0.05). In the subjective category, there was a difference between women and men in terms of describing pain as "terrible" (23.2% vs. 7.2%, p < 0.05) and as "unpleasant" (11.6% vs. 23.3%, p < 0 0.05). Conclusion When referring to pain, women tend to employ more detailed and factual language, indicative of heightened emotional sensitivity. Men tend to use fewer words and focus on the sensory aspects of pain. Subjective aspects of pain were demonstrated by both women and men.
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Affiliation(s)
- Grażyna Puto
- Faculty of Health Sciences, Institute of Nursing and Midwifery, Jagiellonian University Medical College, Cracow, Poland
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Renda E, Lamanuzzi S, Dal Maso F, Côté JN. The effects of hand dominance, fatigue, and sex on muscle activation during a repetitive overhead fatiguing task. Hum Mov Sci 2023; 92:103149. [PMID: 37741198 DOI: 10.1016/j.humov.2023.103149] [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: 04/24/2023] [Revised: 08/08/2023] [Accepted: 09/15/2023] [Indexed: 09/25/2023]
Abstract
Previous studies have shown that the dominant arm is generally stronger and more resistant to fatigue. However, whether there are side differences in shoulder muscle activation during a fatiguing upper limb task, and whether this varies according to sex, is unknown. Thirty right-handed adults (15 females) were recruited to complete two sessions of an overhead repetitive fatiguing task (shoulder flexion between 90 and 135° at 1 Hz), performed in two separate sessions with their dominant arm (DA) and non-dominant arm (NDA) until exhaustion. Electromyographic (EMG) data was collected from 11 shoulder muscles of the moving arm, and their activation amplitude (RMS) and activation variability (SD) were assessed. Results show that time to exhaustion was not affected by arm or by sex. There were some main arm effects on EMG activity amplitude, with higher activity on the DA's pectoralis major (p < 0.001), and on the NDA's middle (p = 0.009) and posterior deltoid (p = 0.001) and infraspinatus (p < 0.001). The pectoralis major was affected by arm and fatigue mostly in males. Their DA's pectoralis major activity amplitude was higher, and the amplitude variability was lower, compared to the NDA, with both parameters showing fatigue-dependent decreases at the NDA only (arm x sex x fatigue: RMS: p = 0.007; SD: p = 0.001). As for females, the DA variability of their lower trapezius was smaller, and that of their subscapularis was higher, compared to the NDA (sex x arm, p = 0.028, p = 0.05). There was also more EMG variability on the supraspinatus' dominant side, and on the posterior deltoid and infraspinatus ND side. Results show an overhead shoulder flexion task dependency on pectoralis major control in males, and on lower trapezius and shoulder girdle stabilizers in females, which could be related to both sex- and gender-based factors. This knowledge can help identify side-specific injury risk factors due to overhead work in males and females, and help determine the appropriateness of implementing sex-specific workplace protocols, including alternating arms as fatigue compensatory and recovery strategies.
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Affiliation(s)
- Erika Renda
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada; Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec H7V 1R2, Canada.
| | - Samuel Lamanuzzi
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada; Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec H7V 1R2, Canada
| | - Fabien Dal Maso
- School of Kinesiology and Physical Education, University of Montreal, Montreal, Quebec H3T 1J4, Canada
| | - Julie N Côté
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada; Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec H7V 1R2, Canada
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Parto DN, Wong AY, Macedo L. Prevalence of musculoskeletal disorders and associated risk factors in canadian university students. BMC Musculoskelet Disord 2023; 24:501. [PMID: 37337246 DOI: 10.1186/s12891-023-06630-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Musculoskeletal disorders (MSKDs) present a significant burden to health care systems worldwide. Evidence suggests that university students may have unique risk factors for developing MSKDs; however, research on the corresponding prevalence and risk factors of MSKDs in Canadian students is limited. METHODS Using a multi-year cross-sectional survey, we aimed to understand the prevalence and risk factors of MSKDs in students at McMaster University. A survey on the prevalence of MSKD as well as potential risk factors was conducted online in the years 2018-2022. Our outcomes were the prevalence of MSKDs over the last 7 days and the last 12 months, as well as presence of lower body, upper body, and spine MSKDs. We investigated risk factors using negative binomial regression analysis, including a sex-stratified analysis. RESULTS There were a total of 289 respondents in 2018 with a decrease in the number of participants in the subsequent years (n2019 = 173, n2020 = 131, n2021 = 76). Participants reported a median of 2-3 pain sites in the last year and 1-2 pain sites in the last week in all four years. The most prevalent sources of self-reported pain were the lower back and neck. Depending on the year and outcome studied, 59-67% of participants reported neck/lower back pain in the last year, and 43-49% reported it in the last week. Although risk factors were different depending on the year and sex, overall, poorer mental health, being in health care studies, regular sports participation (males only), older age, and less hours of sleep were significantly associated with higher prevalence of MSKDs. CONCLUSIONS This study identified that MSKDs are a prevalent source of pain in university students. While some risk factors, such as mental health, are known to play a role in developing MSKDs, sports activity and academic pressure are risk factors that are unique to students. Our study also suggests that there may be differences in risk factors between sexes.
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Affiliation(s)
- Dorsa Nouri Parto
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | - Arnold Yl Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Luciana Macedo
- School of Rehabilitation Sciences, McMaster University, 1400 Main St West IAHS 441, Hamilton, ON, Canada.
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Smith RW, Housh TJ, Arnett JE, Anders JPV, Neltner TJ, Ortega DG, Schmidt RJ, Johnson GO. Utilizing the RPE-Clamp model to examine interactions among factors associated with perceived fatigability and performance fatigability in women and men. Eur J Appl Physiol 2023; 123:1397-1409. [PMID: 36856798 DOI: 10.1007/s00421-023-05163-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/17/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE The purpose of the present study was to examine the interactions between perceived fatigability and performance fatigability in women and men by utilizing the RPE-Clamp model to assess the fatigue-induced effects of a sustained, isometric forearm flexion task anchored to RPE = 8 on time to task failure (TTF), torque, and neuromuscular responses. METHODS Twenty adults (10 men and 10 women) performed two, 3 s forearm flexion maximal voluntary isometric contractions (MVICs) followed by a sustained, isometric forearm flexion task anchored to RPE = 8 using the OMNI-RES (0-10) scale at an elbow joint angle of 100°. Electromyographic amplitude (EMG AMP) was recorded from the biceps brachii. Torque and EMG AMP values resulting from the sustained task were normalized to the pretest MVIC. Neuromuscular efficiency was defined as NME = normalized torque/normalized EMG AMP. Mixed factorial ANOVAs and Bonferroni corrected dependent t tests and independent t tests were used to examine differences across time and between sex for torque and neuromuscular parameters. RESULTS There were no differences between the women and men for the fatigue-induced decreases in torque, EMG AMP, or NME, and the mean decreases (collapsed across sex) were 50.3 ± 8.6 to 2.8 ± 2.9% MVIC, 54.7 ± 12.0 to 19.6 ± 5.3% MVIC, and 0.94 ± 0.19 to 0.34 ± 0.16, respectively. Furthermore, there were no differences between the women and men for TTF (251.8 ± 74.1 vs. 258.7 ± 77.9 s). CONCLUSION The results suggested that the voluntary reductions in torque to maintain RPE and the decreases in NME were likely due to group III/IV afferent feedback from peripheral fatigue that resulted in excitation-contraction coupling failure.
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Affiliation(s)
- Robert W Smith
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA.
- , 840 N 14th Street, Lincoln, NE, 68508, USA.
| | - Terry J Housh
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
| | - Jocelyn E Arnett
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
| | - John Paul V Anders
- The Exercise Science Program, Department of Human Sciences, The Ohio State University, Columbus, OH, 43017, USA
| | - Tyler J Neltner
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
| | - Dolores G Ortega
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
| | - Richard J Schmidt
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
| | - Glen O Johnson
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
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de la Garanderie MP, Courtay A, Féral-Basin C, Rainville P, Gaveau J, Pageaux B. Perception of effort and the allocation of physical resources: A generalization to upper-limb motor tasks. Front Psychol 2023; 13:974172. [PMID: 36760904 PMCID: PMC9904170 DOI: 10.3389/fpsyg.2022.974172] [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: 06/20/2022] [Accepted: 11/28/2022] [Indexed: 01/26/2023] Open
Abstract
Purpose The perception of effort (PE) is widely used to prescribe and monitor exercise during locomotor and resistance tasks. The present study examines the validity of PE to prescribe and monitor exercise during upper-limb motor tasks under various loads and speed requirements. Methods Forty participants volunteered in two experiments. In experiment 1, we used four PE intensities to prescribe exercise on a modified version of the box and block test (BBT) and a pointing task. We investigated the possibility of monitoring the exercise intensity by tracking changes in PE rating in response to three different tempos or additional weights. Experiment 2 replicated the possibility of prescribing the exercise with the PE intensity during the BBT and explored the impact of additional weights on performance and PE during the standardized version of the BBT. Muscle activation, heart rate, and respiratory frequencies were recorded. Results In experiment 1, increasing the PE intensity to prescribe exercise induced an increased performance between each intensity. Increasing task difficulty with faster movement tempo and adding weight on the forearm increased the rating of PE. Experiment 2 replicated the possibility to use PE intensity for exercise prescription during the BBT. When completing the BBT with an additional weight on the forearm, participants maintained performance at the cost of a higher PE. In both experiments, changes in PE were associated with changes in muscle activation. Conclusion Our results suggest that PE is a valid tool to prescribe and monitor exercise during upper-limb motor tasks.
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Affiliation(s)
- Marie Payen de la Garanderie
- École de Kinésiologie et des Sciences de l’Activité Physique (EKSAP), Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
| | - Aymeric Courtay
- École de Kinésiologie et des Sciences de l’Activité Physique (EKSAP), Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France
| | - Camille Féral-Basin
- École de Kinésiologie et des Sciences de l’Activité Physique (EKSAP), Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
| | - Pierre Rainville
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
- Département de Stomatologie, Faculté de Médecine Dentaire, Université de Montréal, Montreal, QC, Canada
| | - Jérémie Gaveau
- INSERM UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, Dijon, France
- Espace d’Etude du Mouvement—Etienne Jules MAREY, Université Bourgogne Franche-Comte, UFR des Sciences du Sport, Dijon, France
| | - Benjamin Pageaux
- École de Kinésiologie et des Sciences de l’Activité Physique (EKSAP), Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montreal, QC, Canada
- Centre Interdisciplinaire de Recherche sur le Cerveau et l’Apprentissage (CIRCA), Montreal, QC, Canada
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Renda E, Yang C, Côté JN. Sex-specific myoelectric manifestations of localized fatigue during a multi-joint repetitive task. J Electromyogr Kinesiol 2022; 67:102717. [PMID: 36334403 DOI: 10.1016/j.jelekin.2022.102717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
We have previously demonstrated that fatigue at different locations impacts joint angles, angular variability, and coordination variability differently. However, the neuromuscular control aspects underlying these kinematic changes have never been demonstrated. Seventeen young adults (8 males) were recruited. Electromyographic electrodes were placed on: upper trapezius, pectoralis major, anterior and middle deltoid, biceps and triceps brachii, and left and right erector spinae. Subjects performed the repetitive pointing task (RPT) at 1 Hz for 30 s before and after localized fatigue tasks, which consisted of one shoulder, one elbow and one lower back isometric fatiguing protocols until exhaustion in randomized order. Electromyographic amplitude (RMS), variability (SD) and mean power frequency (MnPF) were calculated for each of the pre-fatigue and post-fatigue RPT trials. There were sex × fatigue location interaction effects on upper trapezius RMS (p = 0.038) with males' values increasing the most after shoulder fatigue. Females' triceps brachii RMS was greater compared to males after shoulder, elbow, and trunk fatigue (p = 0.003, p = 0.001 and p = 0.007 respectively). There were sex × fatigue location effects on left erector spinae MnPF (p = 0.011) with males and females' values decreasing the most after trunk fatigue, but more so in males. Results demonstrate that males and females compensate differently during a repetitive pointing task when their elbows, shoulders and trunks are locally fatigued, which could have implications on sex-specific workplace injury risks. See Table 1 for acronyms.
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Affiliation(s)
- Erika Renda
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada; Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec H7V 1R2, Canada.
| | - Chen Yang
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada; Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec H7V 1R2, Canada
| | - Julie N Côté
- Department of Kinesiology and Physical Education, McGill University, 475 Pine Avenue West, Montreal, Quebec H2W 1S4, Canada; Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec H7V 1R2, Canada
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Suzuki H, Tahara S, Mitsuda M, Izumi H, Ikeda S, Seki K, Nishida N, Funaba M, Imajo Y, Yukata K, Sakai T. Current Concept of Quantitative Sensory Testing and Pressure Pain Threshold in Neck/Shoulder and Low Back Pain. Healthcare (Basel) 2022; 10:healthcare10081485. [PMID: 36011141 PMCID: PMC9408781 DOI: 10.3390/healthcare10081485] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022] Open
Abstract
In recent years, several published articles have shown that quantitative sensory testing (QST) and pressure pain threshold (PPT) are useful in the analysis of neck/shoulder and low back pain. A valid reference for normal PPT values might be helpful for the clinical diagnosis of abnormal tenderness or muscle pain. However, there have been no reliable references for PPT values of neck/shoulder and back pain because the data vary depending on the devices used, the measurement units, and the area examined. In this article, we review previously published PPT articles on neck/shoulder and low back pain, discuss the measurement properties of PPT, and summarize the current data on PPT values in patients with chronic pain and healthy volunteers. We also reveal previous issues related to PPT evaluation and discuss the future of PPT assessment for widespread use in general clinics. We outline QST and PPT measurements and what kinds of perceptions can be quantified with the PPT. Ninety-seven articles were selected in the present review, in which we focused on the normative values and abnormal values in volunteers/patients with neck/shoulder and low back pain. We conducted our search of articles using PubMed and Medline, a medical database. We used a combination of “Pressure pain threshold” and “Neck shoulder pain” or “Back pain” as search terms and searched articles from 1 January 2000 to 1 June 2022. From the data extracted, we revealed the PPT values in healthy control subjects and patients with neck/shoulder and low back pain. This database could serve as a benchmark for future research with pressure algometers for the wide use of PPT assessment in clinics.
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Affiliation(s)
- Hidenori Suzuki
- Department of Orthopaedics Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi 755-8505, Japan
- Pain Management Research Institute, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
- Correspondence: ; Tel.: +81-836-22-2268
| | - Shu Tahara
- Pain Management Research Institute, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
- Department of Rehabilitation, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
| | - Mao Mitsuda
- Pain Management Research Institute, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
- Department of Rehabilitation, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
| | - Hironori Izumi
- Pain Management Research Institute, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
- Department of Rehabilitation, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
| | - Satoshi Ikeda
- Pain Management Research Institute, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
- Department of Rehabilitation, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
| | - Kazushige Seki
- Department of Orthopaedics Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi 755-8505, Japan
- Department of Rehabilitation, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
| | - Norihiro Nishida
- Department of Orthopaedics Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi 755-8505, Japan
- Department of Rehabilitation, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
| | - Masahiro Funaba
- Department of Orthopaedics Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi 755-8505, Japan
| | - Yasuaki Imajo
- Department of Orthopaedics Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi 755-8505, Japan
| | - Kiminori Yukata
- Department of Orthopaedics Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi 755-8505, Japan
- Department of Rehabilitation, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
| | - Takashi Sakai
- Department of Orthopaedics Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi 755-8505, Japan
- Pain Management Research Institute, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
- Department of Rehabilitation, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan
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Dispositional pain catastrophising in non-clinical sample: The role of depression, perceived stress and social support. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00956-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Yoon S, Bailey CA, Côté JN. Sex-specific muscle activation and oxygenation kinetics during a repetitive forward pointing task. Appl Physiol Nutr Metab 2022; 47:502-516. [PMID: 35050824 DOI: 10.1139/apnm-2021-0664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We compared the minute-by-minute muscle activity and oxygenation responses to a repetitive arm motion-induced fatiguing task between the sexes in order to address the literature gap on these time-dependent fatigue responses. Twenty-six (13 females) healthy adults performed a repetitive pointing task (RPT) with the arm moving forward/backward at shoulder height until reaching 8/10 (Borg CR10) for neck/shoulder perceived exertion (RPE). Neck/shoulder RPE, oxygenation and electromyography were recorded every minute and compared between first and second half of the task and between the sexes. Greater changes in oxygen supply and activation amplitude occurred during the second half of the task. Despite similar time to fatigue-terminal (p > 0.05), females showed greater anterior deltoid activation amplitude at all time points than males, and only the males showed increases in anterior and posterior deltoid activation amplitudes. In females, middle (ρ = -0.34, p = 0.04) and posterior (ρ = -0.44, p = 0.01) deltoid amplitudes were negatively correlated with perceived exertion during the first half of the task. Results suggest that reduced modulation of anterior deltoid activation amplitude in females may reflect a sub-optimal fatigue-mitigation mechanism compared with males and may help explain their greater susceptibility to neck/shoulder musculoskeletal disorders. Novelty: Despite similar fatigability and trapezius oxygenation, females showed greater deltoid activation throughout the task. Deltoid activation increased in males but not in females. The results support the important role of the deltoid in sex-specific neck/shoulder injury mechanisms.
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Affiliation(s)
- SangHoon Yoon
- Department of Kinesiology and Physical Education, McGill University, Montréal, QC H2W 1S4, Canada.,Department of Kinesiology and Physical Education, McGill University, Montréal, QC H2W 1S4, Canada
| | - Christopher A Bailey
- Department of Kinesiology and Physical Education, McGill University, Montréal, QC H2W 1S4, Canada.,Department of Kinesiology and Physical Education, McGill University, Montréal, QC H2W 1S4, Canada
| | - Julie N Côté
- Department of Kinesiology and Physical Education, McGill University, Montréal, QC H2W 1S4, Canada.,Department of Kinesiology and Physical Education, McGill University, Montréal, QC H2W 1S4, Canada
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12
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Lenert ME, Avona A, Garner KM, Barron LR, Burton MD. Sensory Neurons, Neuroimmunity, and Pain Modulation by Sex Hormones. Endocrinology 2021; 162:bqab109. [PMID: 34049389 PMCID: PMC8237991 DOI: 10.1210/endocr/bqab109] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Indexed: 12/16/2022]
Abstract
The inclusion of women in preclinical pain studies has become more commonplace in the last decade as the National Institutes of Health (NIH) released its "Sex as a Biological Variable" mandate. Presumably, basic researchers have not had a comprehensive understanding about neuroimmune interactions in half of the population and how hormones play a role in this. To date, we have learned that sex hormones contribute to sexual differentiation of the nervous system and sex differences in behavior throughout the lifespan; however, the cycling of sex hormones does not always explain these differences. Here, we highlight recent advances in our understanding of sex differences and how hormones and immune interactions influence sensory neuron activity to contribute to physiology and pain. Neuroimmune mechanisms may be mediated by different cell types in each sex, as the actions of immune cells are sexually dimorphic. Unfortunately, the majority of studies assessing neuronal contributions to immune function have been limited to males, so it is unclear if the mechanisms are similar in females. Finally, pathways that control cellular metabolism, like nuclear receptors, have been shown to play a regulatory role both in pain and inflammation. Overall, communication between the neuroimmune and endocrine systems modulate pain signaling in a sex-dependent manner, but more research is needed to reveal nuances of these mechanisms.
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Affiliation(s)
- Melissa E Lenert
- Neuroimmunology and Behavior Laboratory, Center for Advanced Pain Studies (CAPS), Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080, USA
| | - Amanda Avona
- Neuroimmunology and Behavior Laboratory, Center for Advanced Pain Studies (CAPS), Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080, USA
| | - Katherine M Garner
- Neuroimmunology and Behavior Laboratory, Center for Advanced Pain Studies (CAPS), Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080, USA
| | - Luz R Barron
- Neuroimmunology and Behavior Laboratory, Center for Advanced Pain Studies (CAPS), Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080, USA
| | - Michael D Burton
- Neuroimmunology and Behavior Laboratory, Center for Advanced Pain Studies (CAPS), Department of Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas 75080, USA
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13
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Murray I, Bhanot G, Bhargava A. Neuron-Glia-Immune Triad and Cortico-Limbic System in Pathology of Pain. Cells 2021; 10:cells10061553. [PMID: 34205372 PMCID: PMC8234386 DOI: 10.3390/cells10061553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/07/2021] [Accepted: 06/15/2021] [Indexed: 01/02/2023] Open
Abstract
Pain is an unpleasant sensation that alerts one to the presence of obnoxious stimuli or sensations. These stimuli are transferred by sensory neurons to the dorsal root ganglia-spinal cord and finally to the brain. Glial cells in the peripheral nervous system, astrocytes in the brain, dorsal root ganglia, and immune cells all contribute to the development, maintenance, and resolution of pain. Both innate and adaptive immune responses modulate pain perception and behavior. Neutrophils, microglial, and T cell activation, essential components of the innate and adaptive immune responses, can play both excitatory and inhibitory roles and are involved in the transition from acute to chronic pain. Immune responses may also exacerbate pain perception by modulating the function of the cortical-limbic brain regions involved in behavioral and emotional responses. The link between an emotional state and pain perception is larger than what is widely acknowledged. In positive psychological states, perception of pain along with other somatic symptoms decreases, whereas in negative psychological states, these symptoms may worsen. Sex differences in mechanisms of pain perception are not well studied. In this review, we highlight what is known, controversies, and the gaps in this field.
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Affiliation(s)
- Isabella Murray
- Department of Obstetrics and Gynecology, Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA; (I.M.); (G.B.)
| | - Gayatri Bhanot
- Department of Obstetrics and Gynecology, Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA; (I.M.); (G.B.)
- Eleanor Roosevelt College, University of California San Diego, San Diego, CA 92122, USA
| | - Aditi Bhargava
- Department of Obstetrics and Gynecology, Center for Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA; (I.M.); (G.B.)
- Correspondence: ; Tel.: +1-415-502-8453
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14
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Sala E, Lopomo NF, Tomasi C, Romagnoli F, Morotti A, Apostoli P, De Palma G. Importance of Work-Related Psychosocial Factors in Exertion Perception Using the Borg Scale Among Workers Subjected to Heavy Physical Work. Front Public Health 2021; 9:678827. [PMID: 33996736 PMCID: PMC8116491 DOI: 10.3389/fpubh.2021.678827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/31/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: This study aimed to analyse the role of several environmental and time variables, as well as individual and psychosocial factors, on the perception of exertion, expressed by using the Borg scale, on logistics workers performing heavy manual tasks. Materials and Methods: We enrolled 56 subjects working in logistics sector that were interviewed on the perceived exertion required to execute a task of manual lifting of heavy loads, by using the Borg scale. The interviews were carried out during different shifts, at different times during the shifts and during several different months of the year. We also assessed the workers' anthropometric characteristics, length of service, any musculoskeletal diseases, and physical activity outside work. Workers were also interviewed using the structured OREGE questionnaire, in order to evaluate the main symptoms of stress and work-related psychosocial risk factors. Results: Overall, the subjective perception of the strength exerted by the workers exposed to a high risk of manual handling of loads was moderate. The rating attributed using the Borg scale showed no correlation with any of the investigated variables. 100% of the workers denied to suffer from symptoms of stress, whereas in terms of psychosocial factors, the workload was globally perceived as positive. Conclusion: The study results support the hypothesis that optimal work conditions-from a psychosocial point of view-reduce the subjective perception of exertion by workers even if exposed to a high risk of biomechanical overload.
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Affiliation(s)
- Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Occupational Prevention, University Hospital Spedali Civili, Brescia, Italy
| | | | - Cesare Tomasi
- Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Francesco Romagnoli
- Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Alberto Morotti
- Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Pietro Apostoli
- Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppe De Palma
- Unit of Occupational Health, Hygiene, Toxicology and Occupational Prevention, University Hospital Spedali Civili, Brescia, Italy.,Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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15
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Lima TM, Coelho DA. Gender differences in associating musculoskeletal complaints, housework, electronic device usage and physical exercise for administrative workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1189-1197. [PMID: 33468020 DOI: 10.1080/10803548.2021.1878695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives. This study assessed musculoskeletal complaints (MSCs) in administrative workers, associating MSCs with non-paid housework, home use of electronic devices and physical exercise, while keeping a distinctive gender approach. This may promote the development of more effective preventive measures, by meeting the specific strengths and weaknesses of each gender. Methods. Ninety-six administrative workers (58 women and 38 men) who used computers more than 50% of their working time participated in a cross-sectional study. A questionnaire concerning individual socio-demographic data, habits and lifestyle, and including the Nordic musculoskeletal questionnaire (NMQ), was deployed. Gender-based odds ratios for MSCs in body areas over the previous 12 months and correlation coefficients between habits and lifestyle variables and NMQ variables were computed. Results. Women did not incur a higher risk of MSCs than men. Analysis of the association did not yield meaningful associations for either gender. Results suggest giving future consideration to development of gender-specific preventive measures. Conclusion. Computerized work performed concomitantly with physical exposures outside the workplace showed mixed associations with MSCs, according to gender and depending on the kind of exposure. Results are indicative of the need for development of gender-specific preventive measures.
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Affiliation(s)
- Tânia M Lima
- C-MAST - Centre for Mechanical and Aerospace Science and Technologies, Department of Electromechanical Engineering, University of Beira Interior, Covilhã, Portugal
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16
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Kranz C, Lee K, Jadhav P, Vestlin L, Barker M, Jacques A, Falkmer T, Netto J, Netto K. Kinematic and perceptual responses in heavy lifting and pulling: Are there differences between males and females? APPLIED ERGONOMICS 2021; 90:103274. [PMID: 32979817 DOI: 10.1016/j.apergo.2020.103274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
This study investigated kinematic and perceptual differences between the sexes in a heavy lifting and pulling task. A 20 kg box was lifted from floor to chest height, and a 70 kg mannequin pulled across 20m. The effect of height, mass and average grip strength on kinematics and perceived workload was examined in 42 (19 females, 23 males) healthy individuals. A univariate linear regression analysis found females lifted with greater lumbar extension compared to males (p < 0.001), and adopted more hip (p = 0.006) and knee flexion (p = 0.036) in the pulling task. Females reported a greater perceived workload in both tasks (p < 0.001). After the multivariable analysis, only grip strength remained significant for perceived workload in the lift (p = 0.04), and height for knee flexion in the pull (p = 0.009). This highlights that height and strength are important factors driving kinematics and perceived workload. Clinicians may consider these factors in heavy manual tasks, more so than sex.
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Affiliation(s)
- Courtney Kranz
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Kellyn Lee
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Parnashree Jadhav
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Linda Vestlin
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Mike Barker
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Angela Jacques
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Torbjörn Falkmer
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Julie Netto
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Kevin Netto
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
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17
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Bouffard J, Weber Z, Pearsall L, Emery K, Côté JN. Similar effects of fatigue induced by a repetitive pointing task on local and remote light touch and pain perception in men and women. PLoS One 2020; 15:e0244321. [PMID: 33338075 PMCID: PMC7748284 DOI: 10.1371/journal.pone.0244321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/07/2020] [Indexed: 01/21/2023] Open
Abstract
Background Women involved in repetitive, fatiguing, jobs develop more neck and/or shoulder musculoskeletal disorders than men. Sex differences in the pain response to exercise could contribute to the higher prevalence of neck/shoulder musculoskeletal disorders in women. The objective of this study was to assess sex differences in pain sensitivity following a fatiguing upper limb task. Relationships between measures of fatigue and of the sensitivity to nociceptive and to non-nociceptive stimulations were also explored. Methods Thirty healthy adults (15 women) performed a fatiguing repetitive pointing task with their dominant arm. Upper limb electromyography was recorded from the dominant upper trapezius, anterior deltoid and bicep brachii and from the contralateral tibialis anterior. Before and immediately after the repetitive pointing task, pressure pain and light touch sensitivity thresholds were measured over the same muscles. Results Electromyographic signs of fatigue were observed only in the anterior deltoid and biceps brachii muscles. Pressure pain thresholds over both muscles increased slightly (effect size ≤ 0.34), but no changes occurred over the upper trapezius and the tibialis anterior. Light touch thresholds increased moderately to importantly after the repetitive pointing task over all four muscles (effect sizes = 0.58 to 0.87). No sex differences were observed in any sensory variable. Moreover, no or weak correlations (r = -0.27 to 0.39) were observed between electromyographical signs of fatigue, light touch threshold and pressure pain threshold variables. Conclusions We observed sex-independent effects of a repetitive upper limb task on the sensitivity to painful and to nonpainful stimuli. Moreover, the hypoalgesia induced by the repetitive pointing task was weak and localized, and did not directly correlate with the induced muscle fatigue. Results suggest that fatigue-related changes in the sensitivity to noxious and innocuous stimuli could not explain women’s greater prevalence of neck/shoulder musculoskeletal disorders.
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Affiliation(s)
- Jason Bouffard
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
- Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec, Canada
- * E-mail:
| | - Zachary Weber
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
- Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec, Canada
| | - Lyndsey Pearsall
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
- Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec, Canada
| | - Kim Emery
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
- Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec, Canada
| | - Julie N. Côté
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
- Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec, Canada
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Ford B, Halaki M, Diong J, Ginn KA. Acute experimentally-induced pain replicates the distribution but not the quality or behaviour of clinical appendicular musculoskeletal pain. A systematic review. Scand J Pain 2020; 21:217-237. [PMID: 34387953 DOI: 10.1515/sjpain-2020-0076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/16/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Experimental pain is a commonly used method to draw conclusions about the motor response to clinical musculoskeletal pain. A systematic review was performed to determine if current models of acute experimental pain validly replicate the clinical experience of appendicular musculoskeletal pain with respect to the distribution and quality of pain and the pain response to provocation testing. METHODS A structured search of Medline, Scopus and Embase databases was conducted from database inception to August 2020 using the following key terms: "experimental muscle pain" OR "experimental pain" OR "pain induced" OR "induced pain" OR "muscle hyperalgesia" OR ("Pain model" AND "muscle"). Studies in English were included if investigators induced experimental musculoskeletal pain into a limb (including the sacroiliac joint) in humans, and if they measured and reported the distribution of pain, quality of pain or response to a provocation manoeuvre performed passively or actively. Studies were excluded if they involved prolonged or delayed experimental pain, if temporomandibular, orofacial, lumbar, thoracic or cervical spine pain were investigated, if a full text of the study was not available or if they were systematic reviews. Two investigators independently screened each title and abstract and each full text paper to determine inclusion in the review. Disagreements were resolved by consensus with a third investigator. RESULTS Data from 57 experimental pain studies were included in this review. Forty-six of these studies reported pain distribution, 41 reported pain quality and six detailed the pain response to provocation testing. Hypertonic saline injection was the most common mechanism used to induce pain with 43 studies employing this method. The next most common methods were capsaicin injection (5 studies) and electrical stimulation, injection of acidic solution and ischaemia with three studies each. The distribution of experimental pain was similar to the area of pain reported in clinical appendicular musculoskeletal conditions. The quality of appendicular musculoskeletal pain was not replicated with the affective component of the McGill Pain Questionnaire consistently lower than that typically reported by musculoskeletal pain patients. The response to provocation testing was rarely investigated following experimental pain induction. Based on the limited available data, the increase in pain experienced in clinical populations during provocative maneuvers was not consistently replicated. CONCLUSIONS Current acute experimental pain models replicate the distribution but not the quality of chronic clinical appendicular musculoskeletal pain. Limited evidence also indicates that experimentally induced acute pain does not consistently increase with tests known to provoke pain in patients with appendicular musculoskeletal pain. The results of this review question the validity of conclusions drawn from acute experimental pain studies regarding changes in muscle behaviour in response to pain in the clinical setting.
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Affiliation(s)
- Brendon Ford
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW Australia
| | - Mark Halaki
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, NSWAustralia
| | - Joanna Diong
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW Australia
| | - Karen A Ginn
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW Australia
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Is sex a proxy for mechanical variables during an upper limb repetitive movement task? An investigation of the effects of sex and of anthropometric load on muscle fatigue. Biol Sex Differ 2020; 11:60. [PMID: 33126920 PMCID: PMC7596960 DOI: 10.1186/s13293-020-00336-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women report more work-related pain and neck/shoulder musculoskeletal disorders than men. For the same absolute workload, due to lower strength, females generally work at a higher relative intensity, which could induce more fatigue. However, the arm's anthropometric load (AL) of men is higher. Therefore, simply lifting their arm could be more fatiguing. Sex as a variable is formed of many constructs, and analyses can become muddied by their differing responses to fatigue. No studies have considered AL, when comparing how fatigue affects men and women. The purpose was to determine if including the arm's AL in the statistical analysis would impact findings of sex-specific effects of shoulder fatigue on muscle EMG. METHODS Fifty-five (29m/26f) participants completed a repetitive pointing task (RPT) at shoulder height until they reported fatigue of 8+ on the BORG CR-10 scale. Muscle activities were measured using surface electrodes placed over the anterior deltoid (AD) and upper trapezius (UT) muscles. Muscle activity amplitude was quantified using root mean square (RMS). First- and last-minute data were used to assess change from no-fatigue (NF) to fatigue-terminal (FT) conditions. AL was calculated using sex-specific body parameter equations. General estimating equations (GEE) were used to determine the effects of sex and fatigue on RMS values, while including AL in the GEE. RESULTS There was no sex difference in time to reach fatigue. A significant main effect of sex on RMS was observed (χ2(1) = 4.17, p = 0.04) when including AL as a covariate. Females displayed a significantly higher percentage change in AD RMS from NF to FT, compared to males (p = 0.03), when AL was included in the GEE. No sex differences in UT were observed. CONCLUSIONS This sex difference emerged when AL was included as a covariate, suggesting that sex-associated anthropometric differences may contribute to sex differences in the fatigue response. Differences in the impact of AL on AD compared to UT could be explained by differences in their respective mechanical roles or muscle fiber content. Anthropometrics may be useful to include as covariates in future research to separate individual anthropometric differences from sex differences.
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