RESUMO
OBJECTIVE: Given the complex and unclear etiology of neck pain, it is important to understand the differences in central sensitization as well as psychosocial factors in individuals with chronic neck pain and healthy controls. The purpose of this study was to benchmark differences in central sensitization, psychosocial factors, and range of motion between people with nonspecific chronic neck pain and healthy controls and to analyze the correlation between pain intensity, neck disability, and psychosocial factors in people with chronic neck pain. METHODS: Thirty individuals with chronic neck pain and 30 healthy controls were included in this case-control study. Outcome measures were as follows: central sensitization (pressure pain threshold, temporal summation, and conditioned pain modulation), psychosocial factors (depressive symptoms, pain catastrophizing, and quality of life), and active cervical range of motion. RESULTS: People with neck pain had lower local pressure pain threshold, a decrease in conditioned pain modulation, more depressive symptoms, greater pain catastrophizing, lower quality of life, and reduced range of motion for neck rotation when compared with healthy controls. In people with neck pain, moderate correlations were observed between pain intensity and quality of life (ρ = -0.479), disability and pain catastrophizing (ρ = 0.379), and disability and quality of life (ρ = -0.456). CONCLUSIONS: People with neck pain have local hyperalgesia, impaired conditioning pain modulation, depressive symptoms, pain catastrophizing, low quality of life, and reduced active range of motion during neck rotation, which should be taken into account during assessment and treatment. IMPACT: This study shows that important outcomes, such as central sensitization and psychosocial factors, should be considered during assessment and treatment of individuals with nonspecific chronic neck pain. In addition, pain intensity and neck disability are correlated with psychosocial factors.
RESUMO
A produção de força muscular pode estar comprometida em pacientes portadores de miopatias. Estas representam um grupo heterogêneo de doenças com distintas características clínicas e morfológicas. Supõe-se que achados de desempenho funcional estejam relacionados com o tipo predominante de fibra expresso no músculo em análise. OBJETIVO: Correlacionar a proporção das fibras tipo 2 (FT2) do músculo bíceps braquial de sujeitos com hipótese clínica de miopatia (HCM) com picos de torque isométrico e isocinético de flexão do cotovelo. MATERIAIS E MÉTODOS: Participaram deste estudo sete sujeitos com HCM: quatro do sexo feminino com média de idade de 37 anos (dp= 9), peso de 73kg (dp= 26) e altura de 155cm (dp= 6); e três do sexo masculino com média de idade de 39 anos (dp= 1), peso de 88kg (dp= 5) e altura de 172cm (dp= 4). Pela técnica histoquímica de mATPase, foi realizada análise de proporção das fibras musculares. Após um mês da realização das biópsias, os sujeitos realizaram teste de força isométrica e isocinética concêntrica de flexão e extensão do cotovelo em dinamômetro isocinético. Avaliou-se o pico de torque (PT) isométrico a 90ºs-Õ e 180ºs-Õ e calculou-se o torque relativo 90 (TR90) e 180 (TR180). Para análise estatística, utilizou-se correlação de Spearman (r). RESULTADOS: A proporção de FT2 se correlacionou positivamente com TR180 (r= 0,89, p= 0,01). Uma moderada correlação foi encontrada entre FT2 e TR90 (r= 0,75, p= 0,05). CONCLUSÕES: Os resultados sugerem que o comportamento contrátil das FT2 não foi modificado nestes sujeitos. O dinamômetro isocinético mostrou ser um instrumento que pode avaliar, de forma não invasiva, a predominância do tipo de fibra muscular.
Muscular strength production may be impaired in myopathic patients. Myopathies represent a heterogeneous group of diseases with distinct clinical and morphological characteristics. It has been hypothesized that functional performance findings may be related to the predominant fiber type expressed in the muscle analyzed. OBJECTIVE: To correlate the proportion of type 2 fibers in the biceps brachii muscles of subjects with a clinical hypothesis of myopathy with their peak isometric and isokinetic torque during elbow flexion. METHOD: Seven subjects with a clinical hypothesis of myopathy participated in this study: four females of mean age 37 years (sd = 9), weight 73kg (sd= 26) and height 155cm (sd= 6); and three males of mean age 39 years (sd= 1), weight 88kg (sd= 5) and height 172cm (sd= 4). The muscle fiber proportion was analyzed using the mATPase technique. One month after taking biopsies, the subjects performed concentric isometric and isokinetic strength tests for elbow flexion and extension using an isokinetic dynamometer. The isometric and isokinetic peak torques at 90ºs-Õ and 180ºs-Õ were evaluated and the relative 90º (RT90) and 180º (RT180) torques were calculated. Spearman's correlation (r) was used for statistical analyses. RESULTS: The proportion of type 2 fibers correlated positively with RT180 (r= 0.89, p= 0.01), and there was a moderate correlation with RT90 (r= 0.75, p= 0.05). CONCLUSIONS: The results suggest that the contractile behavior of type 2 fibers was not modified in these subjects. The isokinetic dynamometer was shown to be an instrument capable of noninvasively evaluating muscle fiber type predominance.
