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Bellosta-López P, Giner-Nicolás R, Molina-Molina A, Rubio-Peirotén A, Roche-Seruendo LE, Doménech-García V. Recovery of spatio-temporal gait and functional parameters following unilateral eccentric exercise-induced muscle damage in the hamstrings. J Sci Med Sport 2024; 27:387-393. [PMID: 38644066 DOI: 10.1016/j.jsams.2024.04.002] [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: 11/03/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES This study aimed to analyze how spatiotemporal gait parameters, active knee extension range of motion, muscle activity, and self-perceived function change over a seven-day period in healthy individuals after exercise-induced muscle damage (EIMD) in the hamstrings. DESIGN Longitudinal cohort study. METHODS Twenty-four healthy males participated in four sessions before and after EIMD (pre-EIMD, 48 h, 96 h, and 168 h post-EIMD). A single-leg deadlift exercise was performed to provoke EIMD in the hamstrings of the dominant leg. Lower limb function perception, spatiotemporal gait parameters, active knee extension range of motion, and electromyographic (EMG) activity of the semitendinosus and biceps femoris muscles during gait and maximal isometric contraction were assessed bilaterally. RESULTS At 48 h, the EIMD-side showed reduced step length, active knee extension range of motion, maximal strength and EMG activity compared to baseline (P < 0.042), while increased relative EMG activity in the biceps femoris during gait (P = 0.001). At 96 h, step length and EMG activity on the EIMD-side reached similar values to those at baseline, whereas lower limb function perception and active knee extension range of motion returned to baseline state at 168 h post-EIMD. No changes over time were observed on the control-side. CONCLUSIONS Recovery from EIMD requires a multimodal assessment since the different parameters affected by EIMD recover at different paces. Active range of motion appears to be the last variable to fully recover. Self-perceived function should not be considered in isolation as it does not represent complete functional recovery.
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Affiliation(s)
- Pablo Bellosta-López
- Universidad San Jorge, Autov A23 km 299, 50830 Villanueva de Gállego, Zaragoza, Spain
| | - Rafael Giner-Nicolás
- Universidad San Jorge, Autov A23 km 299, 50830 Villanueva de Gállego, Zaragoza, Spain
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Pfab F, Sieland J, Haser C, Banzer W, Kocher T. [Genetics in sports-muscle injuries]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:889-896. [PMID: 37773215 DOI: 10.1007/s00132-023-04439-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND The human genome is the complete set of genetic instructions encoded in an individual's DNA. Genetics plays an important role in the development and progression of muscle injuries. Many genes are involved in muscle development, growth, and repair, and variations in these genes can affect an athlete's susceptibility to muscle injury. SPECIFIC GENES Several genes have been linked to muscle injury, such as myostatin (MSTN), insulin-like growth factor 1 (IGF-1), and several collagen genes (COL). In addition to genes involved in muscle development, growth, and repair, genes involved in inflammation and pain signaling, such as tumor necrosis factor alpha (TNF-α), mu opioid receptor (OPRM1), and interleukin (IL) genes, may also play a role in the development and progression of muscle injury. GENETIC TESTS Genetic testing can be a helpful tool in the prevention of muscle injuries in athletes. Testing for variations in genes associated with muscle development, repair, and growth, as well as collagen formation, can provide valuable information about an athlete's susceptibility to muscle injury. It is important to note that while genetic testing can provide valuable information for injury prevention, it is only one piece of the puzzle. Other factors such as an individual's training history, general health, and lifestyle habits also play a role in injury risk. Therefore, all injury prevention strategies should be individualized and based on a comprehensive assessment of all relevant factors.
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Affiliation(s)
- Florian Pfab
- Technische Universität München, München, Deutschland.
- MedZentrum Residenz, Residenzstr. 9, 80333, München, Deutschland.
- Eintracht Frankfurt Fußball AG, Frankfurt am Main, Deutschland.
- DNathlete AG, Schaan, Liechtenstein.
| | - Johanna Sieland
- Eintracht Frankfurt Fußball AG, Frankfurt am Main, Deutschland
| | - Christian Haser
- Eintracht Frankfurt Fußball AG, Frankfurt am Main, Deutschland
| | - Winfried Banzer
- Abteilung Präventiv- und Sportmedizin, Institut für Arbeits‑, Sozial- und Umweltmedizin, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Thomas Kocher
- EB House Austria, Research Program for Molecular Therapy of Genodermatoses, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, 5020, Salzburg, Österreich
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Simon CB, Bishop MD, Wallace MR, Staud R, DelRocco N, Wu SS, Dai Y, Borsa PA, Greenfield WH, Fillingim RB, George SZ. Circulating Inflammatory Biomarkers Predict Pain Change Following Exercise-Induced Shoulder Injury: Findings From the Biopsychosocial Influence on Shoulder Pain Preclinical Trial. THE JOURNAL OF PAIN 2023; 24:1465-1477. [PMID: 37178095 PMCID: PMC10523877 DOI: 10.1016/j.jpain.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/03/2023] [Accepted: 04/02/2023] [Indexed: 05/15/2023]
Abstract
Shoulder pain is a highly prevalent musculoskeletal condition that frequently leads to suboptimal clinical outcomes. This study tested the extent to which circulating inflammatory biomarkers are associated with reports of shoulder pain and upper-extremity disability for a high-risk genetic by psychological subgroup (catechol-O-methyltransferase [COMT] variation by pain catastrophizing [PCS]). Pain-free adults meeting high-risk COMT × PCS subgroup criteria completed an exercise-induced muscle injury protocol. Thirteen biomarkers were collected and analyzed from plasma 48 hours after muscle injury. Shoulder pain intensity and disability (Quick-DASH) were reported at 48 and 96 hours to calculate change scores. Using an extreme sampling technique, 88 participants were included in this analysis. After controlling for age, sex, and BMI, there were moderate positive associations between higher c-reactive protein (CRP; βˆ = .62; 95% confidence interval [CI] = -.03, 1.26), interleukin-6 (IL-6; βˆ = 3.13; CI = -.11, 6.38), and interleukin-10 (IL-10; βˆ = 2.51; CI = -.30, 5.32); and greater pain reduction from 48 to 96 hours post exercise muscle injury. Using an exploratory multivariable model to predict pain changes from 48 to 96 hours, we found participants with higher IL-10 were less likely to experience a high increase in pain (βˆ = -10.77; CI = -21.25, -2.69). Study findings suggest CRP, IL-6, and IL-10 are related to shoulder pain change for a preclinical high-risk COMT × PCS subgroup. Future studies will translate to clinical shoulder pain and decipher the complex and seemingly pleiotropic interplay between inflammatory biomarkers and shoulder pain change. PERSPECTIVE: In a preclinical high-risk COMT × PCS subgroup, 3 circulating inflammatory biomarkers (CRP, IL-6, and IL-10) were moderately associated with pain improvement following exercise-induced muscle injury.
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Affiliation(s)
- Corey B Simon
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
| | - Mark D Bishop
- Department of Physical Therapy, University of Florida, Gainesville, Florida
| | - Margaret R Wallace
- Department of Molecular Genetics and Microbiology, UF Genetics Institute, University of Florida, Gainesville, Florida
| | - Roland Staud
- Department of Medicine, University of Florida, Gainesville, Florida
| | - Natalie DelRocco
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Samuel S Wu
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Yunfeng Dai
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Paul A Borsa
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | | | - Roger B Fillingim
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida
| | - Steven Z George
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
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4
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George SZ, Bishop MD, Wu SS, Staud R, Borsa PA, Wallace MR, Greenfield WH, Dai Y, Fillingim RB. Biopsychosocial influence on shoulder pain: results from a randomized preclinical trial of exercise-induced muscle injury. Pain 2023; 164:305-315. [PMID: 35604152 PMCID: PMC9930191 DOI: 10.1097/j.pain.0000000000002700] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/18/2022] [Indexed: 02/06/2023]
Abstract
ABSTRACT Prior cohort studies validated that a subgroup defined by a specific COMT genotype and pain catastrophizing is at increased risk for heightened responses to exercise-induced or surgically induced shoulder pain. In this clinical trial, we used our preclinical model of exercise-induced muscle injury and pain to test the efficacy of interventions matched to characteristics of this high-risk subgroup (ie, personalized medicine approach). Potential participants provided informed consent to be screened for eligibility based on subgroup membership and then, as appropriate, were enrolled into the trial. Participants (n = 261) were randomized to 1 of 4 intervention groups comprised of pharmaceutical (propranolol or placebo) and informational (general education or psychologic intervention) combinations. After muscle injury was induced, participants received randomly assigned treatment and were followed for the primary outcome of shoulder pain intensity recovery over 4 consecutive days. Recovery rates were 56.4% (placebo and psychologic intervention), 55.4% (placebo and general education), 62.9% (propranolol and psychologic intervention), and 56.1% (propranolol and general education). No statistical differences were found between intervention groups in the primary analyses. Additional analyses found no differences between these intervention groups when shoulder pain duration was an outcome, and no differential treatment responses were detected based on sex, race, or level of pain catastrophizing. This trial indicates that these treatments were not efficacious for this high-risk subgroup when shoulder pain was induced by exercise-induced muscle injury. Accordingly, this phenotype should only be used for prognostic purposes until additional trials are completed in clinical populations.
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Affiliation(s)
- Steven Z. George
- Duke Clinical Research Institute, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27715 USA
| | - Mark D. Bishop
- Department of Physical Therapy, University of Florida, Gainesville, FL 32610 USA
| | - Samuel S. Wu
- Department of Biostatistics, University of Florida, Gainesville, FL 32610 USA
| | - Roland Staud
- Department of Medicine, University of Florida, Gainesville, FL 32610 USA
| | - Paul A. Borsa
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611 USA
| | - Margaret R. Wallace
- Department of Molecular Genetics and Microbiology, UF Genetics Institute, University of Florida, Gainesville, FL 32610 USA
| | | | - Yunfeng Dai
- Department of Biostatistics, University of Florida, Gainesville, FL 32610 USA
| | - Roger B. Fillingim
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL 32610 USA
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Buhck M, Achenbach J, Wiese B, Tran AT, Stuhrmann M, Jaeger B, Bernateck M, Schneider N, Karst M. The interplay of chronic stress and genetic traits discriminates between patients suffering from multisomatoform disorder with pain as the leading symptom and matched controls. J Affect Disord 2022; 308:466-472. [PMID: 35460735 DOI: 10.1016/j.jad.2022.04.094] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Somatoform disorders and functional somatic syndromes (FSS) with symptoms that are not sufficiently explained by physical or technical examination are among the most challenging underlying causes. Many different somatoform disorders and FSS have overlapping symptoms, often with pain as the most prevalent one, leading to a high burden of disease. The concept of multisomatoform disorder (MSD) has been developed to acknowledge that fact. We analyzed a group of 151 patients and 149 matched controls to identify interactions of genetic and environmental factors with a possible influence on the development of MSD. DESIGN In a retrospective case-control study, we performed a statistical analysis on 151 patients and 149 matched controls using logistic regression and a Classification and Regression Tree (CART) analysis. RESULTS The logistic regression analysis of genes and environmental factors demonstrated significant differences in the results of the Trier Inventory of Chronic Stress (TICS) questionnaire, the single nucleotide polymorphism rs1800955 of the dopamine receptor D4 and the single nucleotide polymorphism rs4818 of the enzyme catechol-O-methyltransferase between patients with MSD and healthy controls. The resulting decision tree of the CART analysis determined that the TICS questionnaire was able to differentiate patients and controls most accurately, followed by certain genotypes of the 5-hydroxytryptamine receptor 2A and a single nucleotide polymorphism of the enzyme catechol-O-methyltransferase. CONCLUSIONS The results of the statistical analysis identified a gene-environmental interaction possibly leading to MSD. The resulting identifiers could be used as a reference to inform diagnostic algorithms to easier identify patients suffering from MSD.
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Affiliation(s)
- M Buhck
- Department of Child and Adolescent Psychiatry, Children's Hospital Auf der Bult Hannover, 30173 Hannover, Germany
| | - J Achenbach
- Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine, and Pain Medicine, Nordstadt Krankenhaus Hannover, 30167 Hannover, Germany.
| | - B Wiese
- Institute for General Practice and Palliative Care, Hannover Medical School, 30625 Hannover, Germany
| | - A T Tran
- Department of Neurology und Neurophysiology, Hannover Medical School, 30625 Hannover, Germany
| | - M Stuhrmann
- Institute of Human Genetics, Hannover Medical School, 30625 Hannover, Germany
| | - B Jaeger
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany
| | - M Bernateck
- Center for Pain Medicine Hannover, 30159 Hannover, Germany
| | - N Schneider
- Institute for General Practice and Palliative Care, Hannover Medical School, 30625 Hannover, Germany
| | - M Karst
- Department of Anesthesiology and Intensive Care Medicine, Pain Clinic, Hannover Medical School, 30625 Hannover, Germany
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Kristensen NS, Hertel E, Skadhauge CH, Kronborg SH, Petersen KK, McPhee ME. Psychophysical predictors of experimental muscle pain intensity following fatiguing calf exercise. PLoS One 2021; 16:e0253945. [PMID: 34329324 PMCID: PMC8323909 DOI: 10.1371/journal.pone.0253945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/15/2021] [Indexed: 01/11/2023] Open
Abstract
Musculoskeletal pain affects approximately 20% of the population worldwide and represents one of the leading causes of global disability. As yet, precise mechanisms underlying the development of musculoskeletal pain and transition to chronicity remain unclear, though individual factors such as sleep quality, physical activity, affective state, pain catastrophizing and psychophysical pain sensitivity have all been suggested to be involved. This study aimed to investigate whether factors at baseline could predict musculoskeletal pain intensity to an experimental delayed onset of muscle soreness (DOMS) pain model. Demographics, physical activity, pain catastrophizing, affective state, sleep quality, isometric force production, temporal summation of pain, and psychophysical pain sensitivity using handheld and cuff algometry were assessed at baseline (Day-0) and two days after (Day-2) in 28 healthy participants. DOMS was induced on Day-0 by completing eccentric calf raises on the non-dominant leg to fatigue. On Day-2, participants rated pain on muscle contraction (visual analogue scale, VAS, 0-10cm) and function (Likert scale, 0–6). DOMS resulted in non-dominant calf pain at Day-2 (3.0±2.3cm), with significantly reduced isometric force production (P<0.043) and handheld pressure pain thresholds (P<0.010) at Day-2 compared to Day-0. Linear regression models using backward selection predicted from 39.3% (P<0.003) of VAS to 57.7% (P<0.001) of Likert score variation in DOMS pain intensity and consistently included cuff pressure pain tolerance threshold (P<0.01), temporal summation of pain (P<0.04), and age (P<0.02) as independent predictive factors. The findings indicate that age, psychological and central pain mechanistic factors are consistently associated with pain following acute muscle injury.
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Affiliation(s)
| | - Emma Hertel
- Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | | | | | - Kristian Kjær Petersen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Megan E. McPhee
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- * E-mail:
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Barratt DT, Sia AT, Tan EC, Somogyi AA. Innate Immune and Neuronal Genetic Markers are Highly Predictive of Postoperative Pain and Morphine Patient-Controlled Analgesia requirements in Indian but not Chinese or Malay hysterectomy patients. PAIN MEDICINE 2021; 22:2648-2660. [PMID: 34015137 DOI: 10.1093/pm/pnab172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/11/2021] [Accepted: 05/18/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Pain severity and opioid requirements in the postoperative period show substantial and clinically significant inter-patient variation due mainly to factors such as age, surgery type and duration. Genetic factors have not been adequately assessed except for the neuronal OPRM1 rs1799971 and COMT rs4680, whereas the contribution of innate immune signalling pathway genetics was seldom investigated. SETTING Hospital surgical ward. SUBJECTS 107 Indian, 184 Malay and 750 Han Chinese women undergoing total hysterectomy surgery. METHODS Morphine consumption, pre- and post-operative pain were evaluated in relation to genetic variability comprising 19 SNPs in 14 genes involved in glial activation, inflammatory signalling and neuronal regulation plus OPRM1 (1 SNP) and COMT (3 SNPs). RESULTS Pre- and post-operative pain and age were associated with increased and decreased morphine consumption, respectively. In Chinese patients, only 8% of the variability in consumption could be explained by these nongenetic and genetic (BDNF, IL1B, IL6R, CRP, OPRM1, COMT, MYD88) factors. However, in Indian patients, 41% of morphine consumption variability could be explained by age (explaining <3%) and variants in OPRM1 rs1799971, CRP rs2794521, TLR4 rs4986790, IL2 rs2069762, COMT rs4818, TGFB1 rs1800469 and IL6R rs8192284 when not controlling for postoperative pain. CONCLUSIONS This is the highest known value reported for genetic contributions (38%) to morphine use in the acute postoperative pain setting. Our findings highlight the need to incorporate both genetic and non-genetic factors and, consider ethnicity-dependent and non-additive genotypic models, when assessing factors that contribute to variability in opioid use.
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Affiliation(s)
- Daniel T Barratt
- Discipline of Pharmacology, Adelaide Medical School, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, 5005, Australia
| | - Alex T Sia
- SingHealth-Duke-NUS Academic Clinical Programme, Singapore.,Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore
| | - Ene-Choo Tan
- SingHealth-Duke-NUS Academic Clinical Programme, Singapore.,KK Research Centre, KK Women's and Children's Hospital, Singapore, Singapore
| | - Andrew A Somogyi
- Discipline of Pharmacology, Adelaide Medical School, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, 5005, Australia.,Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, 5001, Australia
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Li JL, Liu CZ, Zhang N, Yan CQ, Tu JF, Wang LQ, Qi YS, Liu JH, Wang X. Neurological and psychological mechanisms of the specific and nonspecific effects of acupuncture on knee osteoarthritis: study protocol for a randomized, controlled, crossover trial. Trials 2020; 21:989. [PMID: 33256796 PMCID: PMC7706223 DOI: 10.1186/s13063-020-04908-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 11/16/2020] [Indexed: 12/31/2022] Open
Abstract
Background Acupuncture, as one of the promising non-pharmacological interventions, has been proved to be beneficial for patients. However, the magnitude of acupuncture’s specific and nonspecific effects, as well as their neurological and psychological determinants, remains unclear. Therefore, this study is designed to examine the acupuncture efficacy, investigate whether the brain mechanisms between the specific and nonspecific effects of acupuncture are different, and to evaluate how psychological factors affect the acupuncture effects. Methods This is a randomized, controlled, crossover clinical trial. A total of 60 patients with knee osteoarthritis will receive 4 weeks of acupuncture treatment and 4 weeks of sham acupuncture treatment in a random order separated by a washout period of 2 weeks. The changes in clinical characteristics based on pain-related scales will be assessed to investigate the clinical efficacy of acupuncture. Resting state functional magnetic resonance imaging (fMRI) scans will be used to identify the brain activity changes related to the specific and nonspecific effects of acupuncture. The questionnaires of psychological factors will be used to evaluate patients’ psychological properties. Correlation and mediation analyses will be conducted among psychological factors, brain activity changes, and symptoms improvement to explore the neurological and psychological correlates of the acupuncture effects. Discussion This study will concentrate on distinguishing and clarifying the specific and nonspecific effects of acupuncture. The results of this study may contribute to rationally optimize the acupuncture therapies by flexible application of the specific and nonspecific effects of acupuncture. Trial registration Chinese Clinical Trial Registry ChiCTR1900025807. Registered on 9 September 2019 Supplementary information The online version contains supplementary material available at 10.1186/s13063-020-04908-9.
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Affiliation(s)
- Jin-Ling Li
- Acupuncture Research Center, School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Cun-Zhi Liu
- Acupuncture Research Center, School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Na Zhang
- Acupuncture Research Center, School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Chao-Qun Yan
- Acupuncture Research Center, School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Jian-Feng Tu
- Acupuncture Research Center, School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Li-Qiong Wang
- Acupuncture Research Center, School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - You-Sheng Qi
- Nanyuan Community Health Service Center, Fengtai District, Beijing, 100076, China
| | - Jun-Hong Liu
- Nanyuan Community Health Service Center, Fengtai District, Beijing, 100076, China
| | - Xu Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 100029, China.
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Unpredictable stress delays recovery from exercise-induced muscle pain: contribution of the sympathoadrenal axis. Pain Rep 2019; 4:e782. [PMID: 31875187 PMCID: PMC6882572 DOI: 10.1097/pr9.0000000000000782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/16/2019] [Accepted: 08/01/2019] [Indexed: 11/26/2022] Open
Abstract
Introduction Although stress is a well-establish risk factor for the development of chronic musculoskeletal pain, the underlying mechanisms, specifically the contribution of neuroendocrine stress axes, remain poorly understood. Objective To evaluate the hypothesis that psychological stress-induced activation of the sympathoadrenal stress axis prolongs the muscle pain observed after strenuous exercise. Methods Adult male Sprague-Dawley rats were exposed to unpredictable sound stress and eccentric exercise. The involvement of the sympathoadrenal stress axis was evaluated by means of surgical interventions, systemic administration of epinephrine, and intrathecal β2-adrenergic receptor antisense. Results Although sound stress alone did not modify nociceptive threshold, it prolonged eccentric exercise-induced mechanical hyperalgesia. Adrenal medullectomy (ADMdX) attenuated, and administration of stress levels of epinephrine to ADMdX rats mimicked this effect of sound stress. Knockdown of β2-adrenergic receptors by intrathecal antisense also attenuated sound stress-induced prolongation of eccentric exercise-induced hyperalgesia. Conclusion Together, these results indicate that sympathoadrenal activation, by unpredictable sound stress, disrupts the capacity of nociceptors to sense recovery from eccentric exercise, leading to the prolongation of muscle hyperalgesia. This prolonged recovery from ergonomic pain is due, at least in part, to the activation of β2-adrenergic receptors on muscle nociceptors.
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