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1.
J Sports Sci ; 41(12): 1207-1217, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37789670

RESUMO

This study compared the effects of supervised versus unsupervised resistance training (RT) on measures of muscle strength and hypertrophy in resistance-trained individuals. Thirty-six young men and women were randomly assigned to one of two experimental, parallel groups to complete an 8-week RT programme: One group received direct supervision for their RT sessions (SUP); the other group performed the same RT programme in an unsupervised manner (UNSUP). Programme variables were kept constant between groups. We obtained pre- and post-study assessments of body composition via multi-frequency bioelectrical impedance analysis (MF-BIA), muscle thickness of the upper and lower limbs via ultrasound, 1 repetition maximum (RM) in the back squat and bench press, isometric knee extension strength, and countermovement jump (CMJ) height. Results showed the SUP group generally achieved larger increases in muscle thickness for the triceps brachii, all sites of the rectus femoris, and the proximal region of the vastus lateralis. MF-BIA indicated increases in lean mass favoured SUP. Squat 1RM was greater for SUP; bench press 1RM and isometric knee extension were similar between conditions. CMJ increases modestly favoured UNSUP. In conclusion, our findings suggest that supervised RT promotes greater muscular adaptations and enhances exercise adherence in young, resistance-trained individuals.


Assuntos
Treinamento Resistido , Masculino , Humanos , Feminino , Treinamento Resistido/métodos , Músculo Quadríceps/fisiologia , Músculo Esquelético/fisiologia , Extremidade Inferior , Braço , Força Muscular/fisiologia , Adaptação Fisiológica
2.
Hum Brain Mapp ; 42(3): 713-723, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33079467

RESUMO

Head motion is a major confounding factor impairing the quality of functional magnetic resonance imaging (fMRI) data. In particular, head motion can reduce analytical efficiency, and its effects are still present even after preprocessing. To examine the validity of motion removal and to evaluate the remaining effects of motion on the quality of the preprocessed fMRI data, a new metric of group quality control (QC), dissimilarity of functional connectivity, is introduced. Here, we investigate the association between head motion, represented by mean framewise displacement, and dissimilarity of functional connectivity by applying four preprocessing methods in two independent resting-state fMRI datasets: one consisting of healthy participants (N = 167) scanned in a 3T GE-Discovery 750 with longer TR (2.5 s), and the other of chronic back pain patients (N = 143) in a 3T Siemens Magnetom Prisma scanner with shorter TR (0.555 s). We found that dissimilarity of functional connectivity uncovers the influence of participant's motion, and this relationship is independent of population, scanner, and preprocessing method. The association between motion and dissimilarity of functional connectivity, and how the removal of high-motion participants affects this association, is a new strategy for group-level QC following preprocessing.


Assuntos
Dor nas Costas/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Dor Crônica/diagnóstico por imagem , Conectoma , Movimentos da Cabeça , Imageamento por Ressonância Magnética , Adulto , Dor nas Costas/fisiopatologia , Encéfalo/fisiologia , Dor Crônica/fisiopatologia , Conectoma/normas , Feminino , Humanos , Imageamento por Ressonância Magnética/normas , Masculino , Pessoa de Meia-Idade
3.
J Strength Cond Res ; 35(6): 1724-1731, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-30741868

RESUMO

ABSTRACT: Iacono, AD, Vigotsky, AD, Laver, L, and Halperin, I. Beneficial effects of small-sided games as a conclusive part of warm-up routines in young elite handball players. J Strength Cond Res 35(6): 1724-1731, 2021-The aim of this study was to compare the effects of small-sided games (SSGs) and traditional warm-up strategies on the mechanical, physiological, and perceptional responses of handball players. Using a randomized and counterbalanced design, 12 elite male handball players completed a general 8-minute warm-up, which was concluded with an 8-minute section of either specific handball shooting drills or 3 × 2 minutes of 3 vs. 3 SSG with a passive recovery of 1 minute between bouts. Countermovement jumps (CMJs) and plyometric press-ups (PPs) were assessed before and immediately after the warm-up regimens using a force plate. Heart rate (HR) was assessed during the warm-up regimens, and rating of perceived exertion (RPE) was assessed after the regimens. Meaningful differences favoring SSG were observed in most of the kinetic variables in the CMJs and PPs (|Hedges g| = 0.26-1.42). Conversely, no meaningful differences were found between warm-up regimens in RPE or HR responses (z-scores = 0.45 and 1.88, respectively). These results indicate that concluding warm-ups with SSGs offer greater benefits compared with a more traditional warm-up routine, despite similar HR and RPE responses even when matched for duration among elite-level handball players.


Assuntos
Desempenho Atlético , Exercício de Aquecimento , Frequência Cardíaca , Humanos , Masculino , Esportes
4.
Scand J Med Sci Sports ; 29(1): 44-54, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30230052

RESUMO

Different stance widths are commonly utilized when completing the barbell back squat during athletic general preparedness training. Width manipulation is thought to influence sagittal plane stimuli to the hip and knee extensors, the primary extensor musculature in the squat. However, how width manipulation affects frontal plane stimuli is less understood. Knowledge of hip and knee net joint moments (NJM) could improve exercise selection when aiming to improve sport-specific performance and prevent injuries. Fourteen adult amateur rugby athletes were recruited for this study. After a familiarization period, participants performed wide- (WIDE, 1.5× greater trochanter width) and narrow-stance (NARROW, 1× greater trochanter width) barbell back squats to femur parallel depth, using relative loads of 70% and 85% of one-repetition maximum. Sagittal and frontal plane hip and knee kinetics and kinematics were compared between widths. A Bonferroni-corrected alpha of 0.01 was employed as the threshold for statistical significance. Knee flexion angle was statistically greater in NARROW than WIDE (P < 0.0001, d = 2.56-2.86); no statistical differences were observed for hip flexion angle between conditions (P = 0.049-0.109, d = 0.33-0.38). Hip-to-knee extension NJM ratios and knee adduction NJMs were statistically greater in WIDE than NARROW (P < 0.007, d = 0.51-1.41). At femur parallel, stance width manipulation in the barbell back squat may provide substantial differences in biomechanical stimulus in both the sagittal plane and the frontal plane. In certain contexts, these differences may have clinically relevant longitudinal implications, from both a performance and a injury prevention standpoint, which are discussed.


Assuntos
Quadril/fisiologia , Joelho/fisiologia , Postura , Amplitude de Movimento Articular , Adulto , Atletas , Fenômenos Biomecânicos , Estudos Transversais , Feminino , Humanos , Masculino , Músculo Esquelético , Suporte de Carga , Adulto Jovem
5.
J Strength Cond Res ; 33 Suppl 1: S26-S35, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29489722

RESUMO

Vigotsky, AD, Bryanton, MA, Nuckols, G, Beardsley, C, Contreras, B, Evans, J, and Schoenfeld, BJ. Biomechanical, anthropometric, and psychological determinants of barbell back squat strength. J Strength Cond Res 33(7S): S26-S35, 2019-Previous investigations of strength have only focused on biomechanical or psychological determinants, while ignoring the potential interplay and relative contributions of these variables. The purpose of this study was to investigate the relative contributions of biomechanical, anthropometric, and psychological variables to the prediction of maximum parallel barbell back squat strength. Twenty-one college-aged participants (male = 14; female = 7; age = 23 ± 3 years) reported to the laboratory for 2 visits. The first visit consisted of anthropometric, psychometric, and parallel barbell back squat 1 repetition maximum (1RM) testing. On the second visit, participants performed isometric dynamometry testing for the knee, hip, and spinal extensors in a sticking point position-specific manner. Multiple linear regression and correlations were used to investigate the combined and individual relationships between biomechanical, anthropometric, and psychological variables and squat 1RM. Multiple regression revealed only 1 statistically predictive determinant: fat-free mass normalized to height (standardized estimate ± SE = 0.6 ± 0.3; t(16) = 2.28; p = 0.037). Correlation coefficients for individual variables and squat 1RM ranged from r = -0.79 to 0.83, with biomechanical, anthropometric, experiential, and sex predictors showing the strongest relationships, and psychological variables displaying the weakest relationships. These data suggest that back squat strength in a heterogeneous population is multifactorial and more related to physical rather than psychological variables.


Assuntos
Antropometria , Força Muscular , Músculo Esquelético/fisiologia , Levantamento de Peso/psicologia , Adiposidade , Adulto , Fenômenos Biomecânicos , Estatura , Feminino , Humanos , Masculino , Adulto Jovem
6.
J Strength Cond Res ; 31(9): 2599-2608, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28486337

RESUMO

Schoenfeld, BJ, Ogborn, DI, Vigotsky, AD, Franchi, MV, and Krieger, JW. Hypertrophic effects of concentric vs. eccentric muscle actions: A systematic review and meta-analysis. J Strength Cond Res 31(9): 2599-2608, 2017-Controversy exists as to whether different dynamic muscle actions produce divergent hypertrophic responses. The purpose of this paper was to conduct a systematic review and meta-analysis of randomized controlled trials comparing the hypertrophic effects of concentric vs. eccentric training in healthy adults after regimented resistance training (RT). Studies were deemed eligible for inclusion if they met the following criteria: (a) were an experimental trial published in an English-language refereed journal; (b) directly compared concentric and eccentric actions without the use of external implements (i.e., blood pressure cuffs) and all other RT variables equivalent; (c) measured morphologic changes using biopsy, imaging (magnetic resonance imaging, computerized tomography, or ultrasound), bioelectrical impedance, and/or densitometry; (d) had a minimum duration of 6 weeks; and (e) used human participants without musculoskeletal injury or any health condition that could directly, or through the medications associated with the management of said condition, be expected to impact the hypertrophic response to resistance exercise. A systematic literature search determined that 15 studies met inclusion criteria. Results showed that eccentric muscle actions resulted in a greater effect size (ES) compared with concentric actions, but results did not reach statistical significance (ES difference = 0.25 ± 0.13; 95% confidence interval: -0.03 to 0.52; p = 0.076). The mean percent change in muscle growth across studies favored eccentric compared with concentric actions (10.0% vs. 6.8, respectively). The findings indicate the importance of including eccentric and concentric actions in a hypertrophy-oriented RT program, as both have shown to be effective in increasing muscle hypertrophy.


Assuntos
Músculo Esquelético/fisiologia , Treinamento Resistido/métodos , Adulto , Biópsia , Impedância Elétrica , Exercício Físico/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Músculo Esquelético/diagnóstico por imagem , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
J Strength Cond Res ; 31(4): 999-1008, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27253835

RESUMO

Contreras, B, Vigotsky, AD, Schoenfeld, BJ, Beardsley, C, McMaster, DT, Reyneke, JHT, and Cronin, JB. Effects of a six-week hip thrust vs. front squat resistance training program on performance in adolescent males: A randomized controlled trial. J Strength Cond Res 31(4): 999-1008, 2017-The barbell hip thrust may be an effective exercise for increasing horizontal force production and may thereby enhance performance in athletic movements requiring a horizontal force vector, such as horizontal jumping and sprint running. The ergogenic ability of the squat is well known. The purpose of this study was to compare the effects of 6-week front squat and hip thrust programs in adolescent male athletes. Vertical jump height, horizontal jump distance, 10- and 20-m sprint times, and isometric midthigh pull peak force were among the measured performance variables, in addition to front squat and hip thrust 3 repetition maximum (3RM) strength. Magnitude-based effect sizes revealed potentially beneficial effects for the front squat in both front squat 3RM strength and vertical jump height when compared with the hip thrust. No clear benefit for one intervention was observed for horizontal jump performance. Potentially beneficial effects were observed for the hip thrust compared with the front squat in 10- and 20-m sprint times. The hip thrust was likely superior for improving normalized isometric midthigh pull strength and very likely superior for improving hip thrust 3RM and isometric midthigh pull strength. These results support the force vector theory.


Assuntos
Atletas , Desempenho Atlético/fisiologia , Força Muscular/fisiologia , Treinamento Resistido/métodos , Adolescente , Teste de Esforço , Quadril/fisiologia , Humanos , Contração Isométrica/fisiologia , Masculino , Corrida/fisiologia , Coxa da Perna/fisiologia
8.
Eur J Appl Physiol ; 116(4): 863-4, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26896956

RESUMO

The results of Calatayud et al. (Eur J Appl Physiol, 2015. doi: 10.1007/s00421-015-3305-7 ) indicate that focusing on the pectoralis major and triceps brachii muscles during bench press exercise selectively enhanced their activation, and thus suggest a training strategy. However, the authors did not discuss the well-established negative effects that focusing on specific muscle groups has on exercise performance. For proper perspective of the results and their practical utility, it is helpful to note the interplay between negative and positive effects of different focus conditions.


Assuntos
Músculo Esquelético , Treinamento Resistido , Diafragma , Exercício Físico , Humanos , Força Muscular , Músculos Peitorais
9.
Eur J Appl Physiol ; 116(3): 657-8, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26705245

RESUMO

The study by Jenkins et al. attempted to elucidate the mechanisms behind the findings of Mitchell et al. (J Appl Physiol 113(1):71-77, 2012). However, we believe the work of Jenkins et al. contains methodological issues, does not meet electromyographic reporting standards, and deduces conclusions beyond which can be interpreted from the data provided.


Assuntos
Exercício Físico/fisiologia , Fadiga Muscular/fisiologia , Músculo Esquelético/fisiologia , Treinamento Resistido , Feminino , Humanos , Masculino
11.
J Appl Biomech ; 32(1): 16-22, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26252837

RESUMO

Front, full, and parallel squats are some of the most popular squat variations. The purpose of this investigation was to compare mean and peak electromyography (EMG) amplitude of the upper gluteus maximus, lower gluteus maximus, biceps femoris, and vastus lateralis of front, full, and parallel squats. Thirteen healthy women (age = 28.9 ± 5.1 y; height = 164 ± 6.3 cm; body mass = 58.2 ± 6.4 kg) performed 10 repetitions of their estimated 10-repetition maximum of each respective variation. There were no statistical (P ≤ .05) differences between full, front, and parallel squats in any of the tested muscles. Given these findings, it can be concluded that the front, full, or parallel squat can be performed for similar EMG amplitudes. However, given the results of previous research, it is recommended that individuals use a full range of motion when squatting, assuming full range can be safely achieved, to promote more favorable training adaptations. Furthermore, despite requiring lighter loads, the front squat may provide a similar training stimulus to the back squat.


Assuntos
Eletromiografia , Perna (Membro)/fisiologia , Contração Muscular/fisiologia , Músculo Esquelético/fisiologia , Treinamento Resistido/métodos , Adulto , Fenômenos Biomecânicos/fisiologia , Feminino , Músculos Isquiossurais/fisiologia , Humanos , Amplitude de Movimento Articular/fisiologia
12.
J Appl Biomech ; 32(3): 254-60, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26695353

RESUMO

Bridging exercise variations are well researched and commonly employed for both rehabilitation and sport performance. However, resisted bridge exercise variations have not yet been compared in a controlled experimental study. Therefore, the purpose of this study was to compare the differences in upper and lower gluteus maximus, biceps femoris, and vastus lateralis electromyography (EMG) amplitude for the barbell, band, and American hip thrust variations. Thirteen healthy female subjects (age = 28.9 y; height = 164.3 cm; body mass = 58.2 kg) familiar with the hip thrust performed 10 repetitions of their 10-repetition maximum of each variation in a counterbalanced and randomized order. The barbell hip thrust variation elicited statistically greater mean gluteus maximus EMG amplitude than the American and band hip thrusts, and statistically greater peak gluteus maximus EMG amplitude than the band hip thrust (P ≤ .05), but no other statistical differences were observed. It is recommended that resisted bridging exercise be prescribed according to the individual's preferences and desired outcomes.


Assuntos
Músculos Isquiossurais/fisiologia , Músculo Esquelético/fisiologia , Desempenho Psicomotor/fisiologia , Músculo Quadríceps/fisiologia , Treinamento Resistido/métodos , Adulto , Nádegas , Eletromiografia , Feminino , Humanos
13.
J Sports Sci Med ; 15(4): 715-722, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27928218

RESUMO

The purpose of the present study was to evaluate muscular adaptations between heavy- and moderate-load resistance training (RT) with all other variables controlled between conditions. Nineteen resistance-trained men were randomly assigned to either a strength-type RT routine (HEAVY) that trained in a loading range of 2-4 repetitions per set (n = 10) or a hypertrophy-type RT routine (MODERATE) that trained in a loading range of 8-12 repetitions per set (n = 9). Training was carried out 3 days a week for 8 weeks. Both groups performed 3 sets of 7 exercises for the major muscle groups of the upper and lower body. Subjects were tested pre- and post-study for: 1 repetition maximum (RM) strength in the bench press and squat, upper body muscle endurance, and muscle thickness of the elbow flexors, elbow extensors, and lateral thigh. Results showed statistically greater increases in 1RM squat strength favoring HEAVY compared to MODERATE. Alternatively, statistically greater increases in lateral thigh muscle thickness were noted for MODERATE versus HEAVY. These findings indicate that heavy load training is superior for maximal strength goals while moderate load training is more suited to hypertrophy-related goals when an equal number of sets are performed between conditions.

14.
J Appl Biomech ; 31(6): 452-8, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26214739

RESUMO

The back squat and barbell hip thrust are both popular exercises used to target the lower body musculature; however, these exercises have yet to be compared. Therefore, the purpose of this study was to compare the surface electromyographic (EMG) activity of the upper and lower gluteus maximus, biceps femoris, and vastus lateralis between the back squat and barbell hip thrust. Thirteen trained women (n = 13; age = 28.9 years; height = 164 cm; mass = 58.2 kg) performed estimated 10-repetition maximums (RM) in the back squat and barbell hip thrust. The barbell hip thrust elicited significantly greater mean (69.5% vs 29.4%) and peak (172% vs 84.9%) upper gluteus maximus, mean (86.8% vs 45.4%) and peak (216% vs 130%) lower gluteus maximus, and mean (40.8% vs 14.9%) and peak (86.9% vs 37.5%) biceps femoris EMG activity than the back squat. There were no significant differences in mean (99.5% vs 110%) or peak (216% vs 244%) vastus lateralis EMG activity. The barbell hip thrust activates the gluteus maximus and biceps femoris to a greater degree than the back squat when using estimated 10RM loads. Longitudinal training studies are needed to determine if this enhanced activation correlates with increased strength, hypertrophy, and performance.


Assuntos
Eletromiografia/métodos , Exercício Físico/fisiologia , Contração Muscular/fisiologia , Músculo Esquelético/fisiologia , Equilíbrio Postural/fisiologia , Levantamento de Peso/fisiologia , Adulto , Feminino , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
15.
Sports Med ; 2024 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-38909350

RESUMO

Effort and the perception of effort (PE) have been extensively studied across disciplines, resulting in multiple definitions. These inconsistencies block scientific progress by impeding effective communication between and within fields. Here, we present an integrated perspective of effort and PE that is applicable to both physical and cognitive activities. We define effort as the energy utilized to perform an action. This definition can be applied to biological entities performing various voluntary or involuntary activities, irrespective of whether the effort contributes to goal achievement. Then, we define PE as the instantaneous experience of utilizing energy to perform an action. This definition builds on that of effort without conflating it with other subjective experiences. We explore the nature of effort and PE as constructs and variables and highlight key considerations in their measurement. Our integrated perspective aims to facilitate a deeper understanding of these constructs, refine research methodologies, and promote interdisciplinary collaborations.

16.
Trends Cogn Sci ; 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38991876

RESUMO

Decoding mental and perceptual states using fMRI has become increasingly popular over the past two decades, with numerous highly-cited studies published in high-profile journals. Nevertheless, what have we learned from these decoders? In this opinion, we argue that fMRI-based decoders are not neurophysiologically informative and are not, and likely cannot be, applicable to real-world decision-making. The former point stems from the fact that decoding models cannot disentangle neural mechanisms from their epiphenomena. The latter point stems from both logical and ethical constraints. Constructing decoders requires precious time and resources that should instead be directed toward scientific endeavors more likely to yield meaningful scientific progress.

17.
J Neurol ; 271(3): 1256-1266, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37947856

RESUMO

OBJECTIVE: Few effective treatments improve upper extremity (UE) function after stroke. Immersive virtual reality (imVR) is a novel and promising strategy for stroke UE recovery. We assessed the extent to which imVR-based UE rehabilitation can augment conventional treatment and explored changes in brain functional connectivity (FC) that were related to the rehabilitation. METHODS: An assessor-blinded, parallel-group randomized controlled trial was performed with 40 subjects randomly assigned to either imVR or Control group (1:1 allocation), each receiving rehabilitation 5 times per week for 3 weeks. Subjects in the imVR received both imVR and conventional rehabilitation, while those in the Control received conventional rehabilitation only. Our primary and secondary outcomes were the Fugl-Meyer assessment's upper extremity subscale (FMA-UE) and the Barthel Index (BI), respectively. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed to assess the effectiveness of the trial. For both the FMA-UE/BI, a one-way analysis of covariance (ANCOVA) model was used, with the FMA-UE/BI at post-intervention or at follow-up, respectively, as the dependent variable, the two groups as the independent variable, baseline FMA-UE/BI, age, sex, site, time since onset, hypertension and diabetes as covariates. RESULTS: Both ITT and PP analyses demonstrated the effectiveness of imVR-based rehabilitation. The FMA-UE score was greater in the imVR compared with the Control at the post-intervention (mean difference: 9.1 (95% CI 1.6, 16.6); P = 0.019) and follow-up (mean difference:11.5 (95% CI 1.9, 21.0); P = 0.020). The results were consistent for BI scores. Moreover, brain FC analysis found that the motor function improvements were associated with a change in degree in ipsilesional premotor cortex and ipsilesional dorsolateral prefrontal cortex immediately following the intervention and in ipsilesional visual region and ipsilesional middle frontal gyrus after the 12-week follow-up. CONCLUSIONS: ImVR-based rehabilitation is an effective tool that can improve the recovery of UE functional capabilities of subacute stroke patients when added to standard care. These improvements were associated with distinctive brain changes at two post-stroke timepoints. The study results will benefit future patients with stroke and provide evidence for a promising new method of stroke rehabilitation. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03086889.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Realidade Virtual , Humanos , Encéfalo , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/métodos , Resultado do Tratamento , Extremidade Superior , Masculino , Feminino
18.
Eur J Pain ; 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38850090

RESUMO

BACKGROUND: Total knee replacement (TKR) is the gold standard treatment for end-stage chronic osteoarthritis pain, yet many patients report chronic postoperative pain after TKR. The search for preoperative predictors for chronic postoperative pain following TKR has been studied with inconsistent findings. METHODS: This study investigates the predictive value of quantitative sensory testing (QST) and PainDETECT for postoperative pain 3, 6 and 12 months post-TKR. We assessed preoperative and postoperative (3 and 6 months) QST measures in 77 patients with knee OA (KOA) and 41 healthy controls, along with neuropathic pain scores in patients (PainDETECT). QST parameters included pressure pain pressure threshold (PPT), pain tolerance threshold (PTT), conditioned pain modulation (CPM) and temporal summation (TS) using cuff algometry, alongside mechanical hyperalgesia and temporal summation to repeated pinprick stimulation. RESULTS: Compared to healthy controls, KOA patients at baseline demonstrated hyperalgesia to pinprick stimulation at the medial knee undergoing TKR, and cuff pressure at the calf. Lower cuff algometry PTT and mechanical pinprick hyperalgesia were associated with preoperative KOA pain intensity. Moreover, preoperative pinprick pain hyperalgesia explained 25% of variance in pain intensity 12 months post-TKR and preoperative neuropathic pain scores also captured 30% and 20% of the variance in postoperative pain at 6 and 12 months respectively. A decrease in mechanical pinprick hyperalgesia from before surgery to 3 months after TKR was associated with lower postoperative pain at the 12 months post-TKR follow-up. CONCLUSION: Our findings suggest that preoperative pinprick hyperalgesia and neuropathic-like pain symptoms show predictive value for the development of chronic post-TKR pain. SIGNIFICANCE STATEMENT: This study's findings hold significant implications for chronic pain management in knee osteoarthritis patients, particularly those undergoing total knee replacement surgery (TKR). Mechanical hyperalgesia and neuropathic pain-like characteristics predict postoperative pain 1 year after TKR, emphasizing the importance of understanding pain phenotypes in OA for selecting appropriate pain management strategies. The normalization of hyperalgesia after surgery correlates with better long-term outcomes, further highlighting the therapeutic potential of addressing abnormal pain processing mechanisms pre- and post-TKR.

19.
medRxiv ; 2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38293074

RESUMO

Total knee replacement (TKR) is the gold-standard treatment for end-stage chronic osteoarthritis pain, yet many patients report chronic postoperative pain after TKR. The search for preoperative predictors for chronic postoperative pain following TKR has been studied with inconsistent findings. This study investigates the predictive value of quantitative sensory testing (QST) and PainDETECT for postoperative pain 3, 6, and 12 months post-TKR. We assessed baseline and postoperative (3- and 6-months) QST measures in 77 patients with knee OA (KOA) and 41 healthy controls, along with neuropathic pain scores in patients (PainDETECT). QST parameters included pressure pain pressure threshold (PPT), pain tolerance threshold (PTT), conditioned pain modulation (CPM), and temporal summation (TS) using cuff algometry, alongside mechanical hyperalgesia, and mechanical temporal summation to repeated pinprick stimulation. Compared to healthy controls, KOA patients at baseline demonstrated hyperalgesia to pinprick stimulation at the medial OA-affected knee and cuff pressure on the ipsilateral calf. Lower cuff algometry PTT and mechanical pinprick hyperalgesia were associated with baseline KOA pain intensity. Moreover, baseline pinprick pain hyperalgesia explained 25% of variance in pain intensity 12 months post-TKR and preoperative neuropathic pain scores also captured 30% and 20% of the variance in postoperative pain at 6- and 12-months, respectively. A decrease in mechanical pinprick hyperalgesia from before surgery to 3 months after TKR was associated with lower postoperative pain at the 12 months post-TKR follow-up, and vice-versa. Our findings suggest that preoperative pinprick hyperalgesia and PainDETECT neuropathic-like pain symptoms show predictive value for the development of chronic post-TKR pain.

20.
medRxiv ; 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38370783

RESUMO

Chronic pain is commonly treated with long-term opioids, but the neuropsychological outcomes associated with stable long-duration opioid use remain unclear. Here, we contrasted the psychological profiles, brain activity, and brain structure of 70 chronic back pain patients on opioids (CBP+O, average opioid exposure 6.2 years) with 70 patients managing their pain without opioids. CBP+O exhibited moderately worse psychological profiles and small differences in brain morphology. However, CBP+O had starkly different spontaneous brain activity, dominated by increased mesocorticolimbic and decreased dorsolateral-prefrontal activity, even after controlling for pain intensity and duration. These differences strongly reflected cortical opioid and serotonin receptor densities and mapped to two antagonistic resting-state circuits. The circuits' dynamics were explained by mesocorticolimbic activity and reflected negative affect. We reassessed a sub-group of CBP+O after they briefly abstained from taking opioids. Network dynamics, but not spontaneous activity, reflected exacerbated signs of withdrawal. Our results have implications for the management and tapering of opioids in chronic pain.

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