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McAuliffe M, Pillay T, Jaber K, Sterling M, O'Leary S. Pre-operative pain pressure threshold association with patient satisfaction following Total Knee Arthroplasty. J Orthop 2024; 52:21-27. [PMID: 38404700 PMCID: PMC10881419 DOI: 10.1016/j.jor.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/09/2024] [Indexed: 02/27/2024] Open
Abstract
Background Total knee arthroplasty (TKA) is commonly performed for the treatment of knee osteoarthritis (KOA). Poor satisfaction continues to be seen after TKA. Whilst reasons for poor patient satisfaction are multifactorial, there is a strong correlation with persistent pain following TKA. Studies have shown an association between local and remote mechanical hypersensitivity, measured using pressure pain thresholds (PPTs), and severity of knee osteoarthritis and functional status. We aimed to determine if the pre-operative PPTs were associated with patient satisfaction following TKA. Methods A prospective longitudinal study of 77 individuals was undertaken. Regression modelling assessed the relationship between Patient Satisfaction using the Knee Society Score (satisfaction subscale) following TKA for KOA, and PPTs recorded pre-operatively locally and remote to the affected knee, while accounting for potentially confounding patient demographic and psychosocial factors. Results Lower PPTs (indicating increased mechanical hypersensitivity) locally and remote to the operative knee were modestly associated with lower patient satisfaction in the short-term (six weeks) following TKA (β 0.25-0.28, adjR2 = 0.14-0.15), independent of demographic or psychosocial influences. However, this relationship progressively diminished in the intermediate and long-term post TKA. Conclusion While pre-operative PPT measures may provide some foresight to patient satisfaction post TKA in the short term, these measures appear to provide little insight to patient satisfaction in the intermediate and longer term.
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Affiliation(s)
- Michael McAuliffe
- Ipswich General Hospital, Queensland Health, Ipswich, QLD, 4305, Australia
- The CJM Centre, Ipswich, QLD, 4305, Australia
- The Mater Private Hospital, Springfield Lakes, QLD, 4300, Australia
- St Andrew's Ipswich Private Hospital, Ipswich, QLD, 4305, Australia
| | - Tristan Pillay
- The CJM Centre, Ipswich, QLD, 4305, Australia
- The Mater Private Hospital, Springfield Lakes, QLD, 4300, Australia
- St Andrew's Ipswich Private Hospital, Ipswich, QLD, 4305, Australia
| | - Khalid Jaber
- Ipswich General Hospital, Queensland Health, Ipswich, QLD, 4305, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Michele Sterling
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Qld, Herston, 4006, Australia
| | - Shaun O'Leary
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD, 4029, Australia
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Kasahara K, Konrad A, Yoshida R, Murakami Y, Sato S, Koizumi R, Thomas E, Behm DG, Nakamura M. Comparison of acute and prolonged effects of short-term foam rolling and vibration foam rolling on the properties of knee extensors. Biol Sport 2024; 41:19-26. [PMID: 38524825 PMCID: PMC10955736 DOI: 10.5114/biolsport.2024.129488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/26/2023] [Accepted: 07/03/2023] [Indexed: 03/26/2024] Open
Abstract
Recently, Foam Rolling (FR) and Vibration Foam Rolling (VFR) have attracted attention in sports and rehabilitation fields. Previous studies have shown that FR and VFR acute interventions effectively increase the range of movement (ROM) and decrease tissue hardness. For application to sports and rehabilitation, it is necessary to compare the acute and prolonged effects of short duration FR and VFR. Therefore, this study aimed to compare and investigate the acute and prolonged (15 minutes) effects of short duration (30-s) FR and VFR interventions on knee extensors. The subjects were 14 male university students (22.4 ± 1.0 years old), in which the knee extensors of the dominant leg were tested. In a cross-over trial, 30-s of FR or VFR were performed with 2-s rolling of the anterior thigh (15 rolls). The frequency of VFR was 35 Hz. Measurements included knee flexion ROM, pain pressure threshold (PPT), tissue hardness, and countermovement jump height. The results of this study showed no interaction effects for all variables, but main time effects were observed for knee flexion ROM, PPT, and tissue hardness. Post-hoc tests showed that knee flexion ROM increased up to 10 minutes after the intervention. PPT significantly increased, and tissue hardness significantly decreased up to 15 minutes after intervention. This study showed that 30-s FR and VFR interventions effectively increased ROM, PPT, and decreased tissue hardness. The effects were prolonged up to 10-15 minutes after the intervention. The results of this study show no advantage of VFR over FR with acute short-term interventions.
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Affiliation(s)
- Kazuki Kasahara
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Riku Yoshida
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Yuta Murakami
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Shigeru Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryoma Koizumi
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishi Kyushu University, 4490-9 Ozaki, Kanzaki, Saga, 842-8585, Japan
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Sadeghnia M, Shadmehr A, Mir SM, Hadian Rasanani MR, Jalaei S, Fereydounnia S. The immediate effects of deep transverse friction massage, high- power pain threshold ultrasound and whole body vibration on active myofascial trigger points. J Bodyw Mov Ther 2023; 36:165-170. [PMID: 37949555 DOI: 10.1016/j.jbmt.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 06/08/2023] [Accepted: 07/04/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND The most important clinical problem in myofascial pain syndrome (MPS) is trigger points (TrPs). The aim of the present study was to investigate the comparison of immediate effect of deep transverse friction massage (DTFM), high-power pain threshold ultrasound (HPPTUS), and whole body vibration (WBV) on treatment of active myofascial trigger points (MTrPs). MATERIALS AND METHODS sixty six men with active TrPs of upper trapezius muscle were randomly divided into three equal groups: DTFM, HPPT US, and WBV. Pain intensity based on the Visual Analogue Scale (VAS), pressure pain threshold (PPT) and active contralateral lateral flexion range of motion (CLF ROM) of the neck were evaluated before and immediately after the interventions. RESULTS The VAS, PPT and the active CLF ROM were substantially improved after intervention in all groups (P < 0.01). When the three groups were compared regarding VAS, participants in the WBV group reported significantly more reduction in pain (P < 0.01). On comparing the interventions, there were no significant differences in PPT values (P > 0.05). The CLF ROM value in HPPTUS and WBV groups have significant increase in comparison to the DTFM group. CONCLUSION All three interventions can improve neck pain, PPT and ROM in participants with active TrPs in upper trapezius muscle, but due to the fact that the DTFM has more pressure on therapist fingers, and the HPPTUS technique requires proper interaction with the participants, WBV can be used as one of the effective intervention on active MTrPs of upper trapezius. CLINICAL TRIAL REGISTRATION NUMBER IRCT20200518047498N1.
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Affiliation(s)
- Mehrdad Sadeghnia
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Shadmehr
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Seyed Mohsen Mir
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shohreh Jalaei
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Fereydounnia
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Çelik Ö, Şencan S. Bracing or kinesio taping in the management of lateral elbow tendinopathy: A prospective, randomized single-blinded trial. J Bodyw Mov Ther 2023; 36:235-243. [PMID: 37949566 DOI: 10.1016/j.jbmt.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 06/01/2023] [Accepted: 07/04/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE The aim of the study was to compare the effects of forearm counter force brace (FCB) and kinesio taping (KT) on pain severity, grip strength and functionality of patients with lateral elbow tendinopathy (LET). METHODS The study was planned as a prospective, randomized and assessor-blinded study with 1-month follow-up period. Seventy-two patients, diagnosed as LET were randomly assigned to FCB (n = 41) or KT (n = 31) groups. In the FCB group, the patients were informed and instructed to wear the brace for three weeks continuously. In the KT group, tape was applied once a week for four weeks with muscle inhibition and fascia correction techniques. The outcome measures were pain pressure threshold (PPT), maximal pain-free hand grip strength measurement and patient-rated tennis elbow evaluation questionnaire (PRTEE). The assessments were performed at the baseline, immediately after treatment and one month later after treatment. RESULTS PPT and grip strength were significantly increased over time in both groups. Pain, function and total scores of PRTEE were significantly decreased in both FCB and KT groups. The effect size of the improvement in PRTEE function score was within acceptable clinical significance in the KT group. However, there was no significant difference between groups. CONCLUSIONS Pain severity, grip strength and functionality of patients with LET improved over time in both FCB and KT groups. However, neither was superior in the management of LET.
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Affiliation(s)
- Öznur Çelik
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkiye.
| | - Süreyya Şencan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkiye
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Sagerer E, Wirner C, Schoser B, Wenninger S. Nociceptive pain in adult patients with 5q-spinal muscular atrophy type 3: a cross-sectional clinical study. J Neurol 2023; 270:250-261. [PMID: 36036285 PMCID: PMC9813071 DOI: 10.1007/s00415-022-11351-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder caused by mutations in the SMN gene, leading to progressive muscular weakness, atrophy and so far neglected musculoskeletal pain. This study is the first to characterize nociceptive pain in patients living with SMA type 3 by assessing whether muscle pain is associated with alterations in muscle strength, function, stiffness, frequency, decrement, relaxation, or creep. METHODS We performed a cross-sectional pilot study on 20 SMA3 patients. We evaluated motor function and muscle strength (dynamometry, quick motor function test and 6-min-walk test), nociceptive pain (pressure algometer evaluating muscular pressure pain threshold (PPT)) and non-invasive measurement of muscle stiffness, frequency, decrement, relaxation, or creep (myotonometry with the MyotonPro®). For statistical analysis, we used t tests, Mann-Whitney U tests and linear regression. RESULTS Significantly more women than men reported musculoskeletal pain (p = 0.003). A lower score in dynamometry was associated with lower scores in PPT in all extremities reflecting a higher sensitivity of these muscles to pressure. We did not find significant correlations between the PPT values and the MyotonPro values in the corresponding muscles. Assessments of PPT before and after the 6-min walk test did not show clinical meaningful changes. Besides nociceptive pain, fatigue was prevalent in 50% and pain in 55% of the patients. CONCLUSIONS Muscle pain in SMA3 is associated with muscular weakness in the arms and legs, but not with changes in muscular stiffness, frequency, decrement, relaxation, or creep. This shows that muscle pain in SMA3 is mainly caused by changes in the dysbalanced musculoskeletal system due to muscle weakness.
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Affiliation(s)
- Elena Sagerer
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians University Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Corinna Wirner
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians University Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Benedikt Schoser
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians University Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Stephan Wenninger
- Department of Neurology, Friedrich-Baur-Institute, Ludwig-Maximilians University Munich, Ziemssenstr. 1, 80336, Munich, Germany.
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Tomschi F, Lieverkus D, Hilberg T. Exercise-induced hypoalgesia (EIH) in response to different exercise intensities. Eur J Appl Physiol 2022. [PMID: 35809091 DOI: 10.1007/s00421-022-04997-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/17/2022] [Indexed: 11/25/2022]
Abstract
Purpose Acute physical activity leads to exercise-induced hypoalgesia (EIH). The aim of this study was to investigate the effects of four different exercise intensities on EIH. Methods 25 male (age: 24.7 ± 3.0) subjects underwent four different exercise sessions on a bicycle ergometer for 30 min each at 60, 80, 100, and 110% of the individual anaerobic threshold on separate days in a randomized crossover design. Before, as well as 5- and 45-min post-exercise, pain sensitivity was measured employing pain pressure thresholds (PPT) at the elbow, knee, and ankle joints as well as the sternum and forehead. Besides, conditioned pain modulation (CPM) was conducted using thermal test- and conditioned stimuli before, 5-, and 45-min post-exercise. Results A main time effect was observed regarding PPT at all landmarks except for the forehead with higher values observed 5 and 45 min post-exercise compared to the pre-values. Yet, no interaction effects occurred. CPM did not change in response to any of the intensities used. Conclusion EIH occurs 5 and 45 min after exercise regardless of the intensity used at the joints and sternum which might be explained by local pain-inhibiting pathways and probably to a limited degree by central mechanisms, as no hypoalgesia was observed at the forehead and no changes in CPM occurred. Supplementary Information The online version contains supplementary material available at 10.1007/s00421-022-04997-1.
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Pinto Fiamengui LMS, Furquim BD, De la Torre Canales G, Fonseca Carvalho Soares F, Poluha RL, Palanch Repeke CE, Bonjardim LR, Garlet GP, Rodrigues Conti PC. Role of inflammatory and pain genes polymorphisms in temporomandibular disorder and pressure pain sensitivity. Arch Oral Biol 2020; 118:104854. [PMID: 32763472 DOI: 10.1016/j.archoralbio.2020.104854] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to assess the correlation of inflammatory and pain genes polymorphisms with the presence of temporomandibular disorder (TMD) patients and with pressure pain sensitivity. DESIGN Data was collected from 268 consecutive subjects at Bauru School of Dentistry. Subjects aged younger than 20 years, with dental and neuropathic pain, sinusitis, cognitive and neurologic disorder were excluded. Included subjects were evaluated using the Research Diagnostic Criteria for Temporomandibular disorders and divided into two groups: TMD cases and healthy controls. Groups were submitted to pressure pain threshold (PPT) test for the temporomandibular joint, anterior temporalis and masseter muscles and genotyped for Val158Met, IL6-174, IL-1β-3954 and TNFA-308. Student's t-test and Pearson chi-square test were used to comparisons between groups. A linear multiple regression was used to evaluate the influence of genetics variables on the PPT and a bivariate analysis was used to assesses the influence of genetics variables on pain sensitivity below the PPT cut off of the structures in TMD group. RESULTS TMD group showed significantly lower PPT values for all structures when compared with control group (p < 0.001). SNP IL6-174 predicted higher pain sensitivity in the temporomandibular joint (p < 0.005) and in anterior temporalis muscle (p < 0.044) and SNP Val158Met in the masseter muscle (p < 0.038); when TMD group was divided according to PPT cut-off values the SNP Val158Met influenced increase pain sensibility in the masseter muscle. CONCLUSION TNFA-308 was associated with TMD and SNP IL6-174 and SNP Val158Met influenced pain sensitivity of patients with TMD.
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Affiliation(s)
| | - Bruno D'Aurea Furquim
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | - Giancarlo De la Torre Canales
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Sao Paulo, Brazil.
| | - Flávia Fonseca Carvalho Soares
- Bauru Orofacial Pain Group, Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | - Rodrigo Lorenzi Poluha
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | | | - Leonardo Rigoldi Bonjardim
- Bauru Orofacial Pain Group, Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | | | - Paulo César Rodrigues Conti
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Sao Paulo, Brazil
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Petersson M, Abbott A. Lumbar interspinous pressure pain threshold values for healthy young men and women and the effect of prolonged fully flexed lumbar sitting posture: An observational study. World J Orthop 2020; 11:158-166. [PMID: 32280605 PMCID: PMC7138865 DOI: 10.5312/wjo.v11.i3.158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/26/2020] [Accepted: 03/05/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is a common condition with large burden worldwide. Exposure to prolonged sitting with a flexed lumbar posture has been suggested in the literature to be a potential risk factor for self-reported LBP. No study has previously investigated whether exposure to prolonged flexed sitting posture provokes discomfort/pain and decreased interspinous pressure pain thresholds for healthy young men and women without back pain, despite this being a suggested risk factor for LBP.
AIM To investigate whether sitting in a prolonged flexed lumbar posture provokes discomfort and lowers interspinous pressure pain thresholds in the lumbar spine for healthy young men and women without previous LBP.
METHODS This is a an observational before and after study of 26 participants (13 men, 13 women) between 20-35 years old. Algometry was used to examine the pain threshold for pressure applied between spinous processes of the lumbar spine L1-L5. Pressure algometer measures were performed in prone before and after participants were instructed to sit in a fully flexed posture for a maximum of 15 min or until discomfort was experienced in the low back (Borg CR10 = 7/10). Wilcoxon signed-rank test was used for analyze values from the before and after test conditions. Mann-Whitney U test was used to investigate potential gender difference.
RESULTS Fully flexed lumbar spine sitting posture up to 15 min provoked temporary discomfort but the proportion of participants experiencing discomfort 7/10 in the low back was 62%. For all pain pressure threshold locations tested, there was a significant difference for the study population with moderate-large decreased (r = -0.56) pressure pain threshold after exposure to prolonged flexed sitting posture (P < 0.01). Comparisons between gender did not show any significant difference.
CONCLUSION The result showed that exposure to fully flexed lumbar sitting posture for up to 15 min produced temporary discomfort in the low back in young healthy adults with no previous history of LBP and significantly reduced lumbar interspinous pressure pain thresholds. No gender-based differences were observed.
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Affiliation(s)
- Martin Petersson
- Department of Physiotherapy Gripen, Värmland Country Council, Karlstad SE-65224, Sweden
- Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping SE-58183, Sweden
| | - Allan Abbott
- Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Health Sciences, Linköping University, Linköping SE-58183, Sweden
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Hirata RP, Skou ST, Simonsen O, Rasmussen S, Laursen M, Graven-Nielsen T. Increased postural stiffness during challenging postural tasks in patients with knee osteoarthritis with high pain sensitization. Clin Biomech (Bristol, Avon) 2019; 61:129-135. [PMID: 30553079 DOI: 10.1016/j.clinbiomech.2018.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 11/12/2018] [Accepted: 12/04/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Postural stability is affected in knee osteoarthritis patients who present with pain but the link to pain sensitization is unclear. METHODS Patients with knee osteoarthritis completed the Knee Injury and Osteoarthritis Outcome Score and pressure pain thresholds were assessed bilaterally at the knee, lower leg and forearm prior to standing quietly (1 min) on a force platform in four conditions: Firm surface with open eyes, firm surface with closed eyes, soft surface with open eyes, and soft surface with closed eyes. Pain intensity during standing was assessed via numerical rating scale. Postural stability was assessed by the range, velocity, and standard deviation of the Center of Pressure (CoP) extracted from the force platform. The means of three repeated measures per standing condition were analysed. High-sensitization and low-sensitization groups were defined based on bilateral pressure pain thresholds from leg and arm. FINDINGS Fifty-six patients were included. Compared with the low-sensitization group, the high-sensitization group demonstrated 1) smaller pressure pain thresholds at the knee (P < 0.05) although the Knee Injury and Osteoarthritis Outcome Score and pain intensity were not significantly different between groups, and 2) smaller range of the CoP in the anterior-posterior direction during the soft surface with closed eyes condition (P < 0.05). INTERPRETATION Smaller CoP range suggest that patients with more widespread pain sensitivity have increased postural stiffness compared with the low-sensitization group. The greater stiffness found in high-sensitization patients under sensory restrictions (closed eyes and reduced proprioception) might relate to restricted integration of sensory information due to widespread pain sensitization.
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Affiliation(s)
| | - S T Skou
- SMI, Aalborg University, Denmark; Orthopedic Surgery Research Unit, Aalborg University Hospital, Aalborg, Denmark; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark
| | - O Simonsen
- SMI, Aalborg University, Denmark; Orthopedic Surgery Research Unit, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - S Rasmussen
- SMI, Aalborg University, Denmark; Orthopedic Surgery Research Unit, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - M Laursen
- SMI, Aalborg University, Denmark; Orthopedic Surgery Research Unit, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - T Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Aalborg University, Denmark
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10
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Gordon CM, Lindner SM, Birbaumer N, Montoya P, Ankney RL, Andrasik F. Self-Myofascial Vibro-Shearing: a Randomized Controlled Trial of Biomechanical and Related Changes in Male Breakdancers. Sports Med Open 2018; 4:13. [PMID: 29582181 PMCID: PMC5876229 DOI: 10.1186/s40798-018-0128-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/13/2018] [Indexed: 11/23/2022]
Abstract
Background This randomized controlled trial explored the practicality and effectiveness of a novel tool-assisted self-help device, one that combines vibrational oscillation, leverage, and the shearing effect from the edges, for promoting meaningful changes in key biomechanical tissue indices and related parameters. Methods One hundred and thirteen male breakdancers were randomized to an intervention or control group. Individuals assigned to the intervention group performed the self-help treatment on the quadriceps and the iliotibial band of their right thighs for 8 min, while individuals assigned to the control condition merely sat quietly during this period. Various primary outcome measures (e.g., elasticity, stiffness, range of motion, pain pressure threshold sensitization, and blood flow) were assessed before and after the intervention for each participant, with position and posture being standardized throughout. Subjective sensations and a measure selected to assess for potential experimental demand effects, serving as secondary measures, were also administered pre- to post-treatment. Results Stiffness was significantly reduced for both structures (p < 0.001), elasticity and flexibility of the quadriceps were increased significantly (p < 0.001 for each), sensitization was significantly lessened (p < 0.001), and local temperatures increased to a significant degree as well (p < 0.001) when comparing change scores following application of the self-help tool on the treated thighs to those on the untreated thighs. Participants using the self-help tool reported their treated leg as being more relaxed, light, and stable. Conclusions The vibro-shearing manipulation with a muscle-fascia tool resulted in significant improvements in various objective mechanical tissue properties, range of motion, and pain desensitization in healthy, well-conditioned dancers. These promising effects for a new tool-assisted self-treatment indicate further basic investigations are warranted, as are pilot investigations with patient populations. Electronic supplementary material The online version of this article (10.1186/s40798-018-0128-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Niels Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Pedro Montoya
- Research Institute on Health Sciences (IUNICS), University of Balearic Islands, Palma, Spain
| | - Rachel L Ankney
- Department of Psychology, University of Memphis, Memphis, TN, USA
| | - Frank Andrasik
- Department of Psychology, University of Memphis, Memphis, TN, USA
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Giudice AL, Brewer I, Leonardi R, Roberts N, Bagnato G. Pain threshold and temporomandibular function in systemic sclerosis: comparison with psoriatic arthritis. Clin Rheumatol 2018; 37:1861-1867. [PMID: 29445986 DOI: 10.1007/s10067-018-4028-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/26/2018] [Accepted: 02/06/2018] [Indexed: 01/20/2023]
Abstract
The aim of the study was to evaluate whether a reduced pain threshold is associated with increased temporomandibular dysfunction in systemic sclerosis (SSc) compared to psoriatic arthritis (PsA) and healthy controls. Ninety subjects participated in the study (30 SSc, 30 PsA, and 30 healthy controls). The Helkimo index was used to evaluate temporomandibular dysfunction. Digital palpation was performed at the temporomandibular joint (TMJ) surface and at the superficial masseter muscle (SMM) and pain intensity was recorded on a visual analog scale (VAS), while pain pressure threshold (PPT) was measured at the same sites through a pressure algometer. PPT scores were lower in SSc patients compared to PsA patients and controls. In addition, the average Helkimo index score, measuring the degree of TMJ dysfunction, was higher in SSc compared to PsA and controls. A significant inverse correlation was observed between every PPT score, and both Helkimo index and VAS palpation in SSc and PsA. Both the range of motion and all the other pain-related subdomains of the Helkimo index score (pain on movement, pain palpation TMJ and pain palpation muscle) were significantly worse in SSc compared to PsA, while no significant differences were observed in the TMJ function subdomain. In SSc patients, the skin score was directly associated with the range of motion subdomain of the Helkimo index. Our results confirm that TMJ function is impaired in SSc; further longitudinal studies are needed to assess the role of pain threshold in the assessment of limitations in TMJ function and to identify an objective marker of therapeutic response.
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Affiliation(s)
- Antonino Lo Giudice
- Department of Medical-Surgical Specialties, Department of Orthodontics, Policlinico Universitario "Vittorio Emanuele", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy. .,Department of Biomedical and Dental Sciences and Morphofunctional Imaging - Section of Orthodontics, School of Dentistry, Policlinico Universitario "G. Martino", University of Messina, Via Consolare Valeria, 98123, Messina, Italy.
| | - Idona Brewer
- Department of Medicine, Division of Rheumatology, University of Louisville School of Medicine, 401 E. Chestnut St. Suite 690, Louisville, KY, 40202, USA
| | - Rosalia Leonardi
- Department of Medical-Surgical Specialties, Department of Orthodontics, Policlinico Universitario "Vittorio Emanuele", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Neal Roberts
- Department of Medicine, Division of Rheumatology, University of Louisville School of Medicine, 401 E. Chestnut St. Suite 690, Louisville, KY, 40202, USA
| | - Gianluca Bagnato
- Division of Rheumatology, Department of Clinical and Experimental Medicine, Policlinico Universitario "G. Martino", University of Messina, Via Consolare Valeria, 98125, Messina, Italy
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Alfieri FM, Lima ARS, Oliveira NC, Portes LA. The influence of physical fitness on pressure pain threshold of elderly women. J Bodyw Mov Ther 2017; 21:599-604. [PMID: 28750971 DOI: 10.1016/j.jbmt.2016.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/05/2016] [Accepted: 09/05/2016] [Indexed: 11/23/2022]
Abstract
Several factors may influence pressure pain threshold (PPT), including physical fitness. However, only a few authors have studied this relationship. The aim of this study was to investigate the relationships between muscle strength, functional capacity (ability to perform physical work and activities of daily living) and PPT in elderly women. This observational cross-sectional study involved 75 healthy women aged between 60 and 75 years. Volunteers underwent an evaluation consisting of anthropometry, functional capacity, muscle strength and PPT assessment by algometry in the following muscles: biceps brachii, flexor carpi ulnaris, flexor carpi radialis, vastus medialis, vastus lateralis and gluteus maximus. Mean age of the 75 volunteers was 66.8 ± 4.6 years old. No significant correlations were found between handgrip or elbow flexion strength and PPT in the upper limb muscles evaluated. The same was observed regarding functional capacity, lower limbs strength and PPT in lower limb muscles. Functional capacity and muscle strength did not correlate with PPT in healthy elderly women.
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