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1.
PeerJ ; 12: e17403, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38827299

RESUMO

Background: Effective rehabilitation of upper limb musculoskeletal disorders requires multimodal assessment to guide clinicians' decision-making. Furthermore, a comprehensive assessment must include reliable tests. Nevertheless, the interrelationship among various upper limb tests remains unclear. This study aimed to evaluate the reliability of easily applicable upper extremity assessments, including absolute values and asymmetries of muscle mechanical properties, pressure pain threshold, active range of motion, maximal isometric strength, and manual dexterity. A secondary aim was to explore correlations between different assessment procedures to determine their interrelationship. Methods: Thirty healthy subjects participated in two experimental sessions with 1 week between sessions. Measurements involved using a digital myotonometer, algometer, inclinometer, dynamometer, and the Nine-Hole Peg test. Intraclass correlation coefficients, standard error of the mean, and minimum detectable change were calculated as reliability indicators. Pearson's correlation was used to assess the interrelationship between tests. Results: For the absolute values of the dominant and nondominant sides, reliability was 'good' to 'excellent' for muscle mechanical properties, pressure pain thresholds, active range of motion, maximal isometric strength, and manual dexterity. Similarly, the reliability for asymmetries ranged from 'moderate' to 'excellent' across the same parameters. Faster performance in the second session was consistently found for the Nine-Hole Peg test. No systematic inter-session errors were identified for the values of the asymmetries. No significant correlations were found between tests, indicating test independence. Conclusion: These findings indicate that the sensorimotor battery of tests is reliable, while monitoring asymmetry changes may offer a more conservative approach to effectively tracking recovery of upper extremity injuries.


Assuntos
Antebraço , Mãos , Amplitude de Movimento Articular , Humanos , Masculino , Feminino , Reprodutibilidade dos Testes , Adulto , Amplitude de Movimento Articular/fisiologia , Mãos/fisiologia , Antebraço/fisiologia , Adulto Jovem , Voluntários Saudáveis , Músculo Esquelético/fisiologia , Limiar da Dor/fisiologia
2.
Chiropr Man Therap ; 32(1): 20, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822395

RESUMO

BACKGROUND: Clinical practice guidelines recommend spinal manipulation for patients with low back pain. However, the effects of spinal manipulation have contradictory findings compared to placebo intervention. Therefore, this study investigated the immediate effects of lumbar spinal manipulation on pressure pain threshold (PPT) and postural stability in people with chronic low back pain (cLBP). Second, we investigated the immediate effect of lumbar spinal manipulation on pain intensity and the interference of the participant beliefs about which treatment was received in the PPT, postural stability, and pain intensity. METHODS: A two-arm, randomised, placebo-controlled, double-blind trial was performed. Eighty participants with nonspecific cLPB and a minimum score of 3 on the Numeric Pain Rating Scale received one session of lumbar spinal manipulation (n = 40) or simulated lumbar spinal manipulation (n = 40). Primary outcomes were local and remote PPTs and postural stability. Secondary outcomes were pain intensity and participant's perceived treatment allocation. Between-group mean differences and their 95% confidence intervals (CIs) estimated the treatment effect. One-way analysis of covariance (ANCOVA) was performed to assess whether beliefs about which treatment was received influenced the outcomes. RESULTS: Participants had a mean (SD) age of 34.9 (10.5) years, and 50 (62.5%) were women. Right L5 [between-group mean difference = 0.55 (95%CI 0.19 to 0.90)], left L5 [between-group mean difference = 0.45 (95%CI 0.13 to 0.76)], right L1 [between-group mean difference = 0.41 (95%CI 0.05 to 0.78)], left L1 [between-group mean difference = 0.57 (95%CI 0.15 to 0.99)], left DT [between-group mean difference = 0.35 (95%CI 0.04 to 0.65)], and right LE [between-group mean difference = 0.34 (95%CI 0.08 to 0.60)] showed superior treatment effect in the spinal manipulation group than sham. Neither intervention altered postural stability. Self-reported pain intensity showed clinically significant decreases in both groups after the intervention. A higher proportion of participants in the spinal manipulation group achieved more than two points of pain relief (spinal manipulation = 90%; sham = 60%). The participants' perceived treatment allocation did not affect the outcomes. CONCLUSION: One spinal manipulation session reduces lumbar pain sensitivity but does not affect postural stability compared to a sham session in individuals with cLPB. Self-reported pain intensity lowered in both groups and a higher proportion of participants in the spinal manipulation group reached clinically significant pain relief. The participant's belief in receiving the manipulation did not appear to have influenced the outcomes since the adjusted model revealed similar findings.


Assuntos
Dor Crônica , Dor Lombar , Manipulação da Coluna , Medição da Dor , Limiar da Dor , Equilíbrio Postural , Humanos , Dor Lombar/terapia , Dor Lombar/fisiopatologia , Feminino , Manipulação da Coluna/métodos , Masculino , Adulto , Método Duplo-Cego , Pessoa de Meia-Idade , Dor Crônica/terapia , Dor Crônica/fisiopatologia , Resultado do Tratamento
3.
J Bodyw Mov Ther ; 39: 176-182, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876623

RESUMO

INTRODUCTION: Pain sensitivity is the main finding of central sensitization (CS) and can occur in patients with chronic shoulder pain. However, there is limited evidence concerning the distribution of pain sensitivity in shoulders, forearms, and legs in patients with CS associated with chronic shoulder pain. The present study aimed to determine the distribution of pain sensitivity in patients with CS associated with chronic subacromial pain syndrome (SPS). METHOD: This cross-sectional study included 58 patients with chronic SPS and CS (patient group) and 58 healthy participants (control group). The presence of CS was determined using the Central Sensitization Inventory (CSI). To determine the distribution of pain sensitivity, pressure pain threshold (PPT) measurements were performed from the shoulders, forearms, and legs. RESULTS: There was no significant difference between the two groups in terms of sociodemographic data (p > 0.05). The patient group had a significantly higher CSI score (p < 0.001) and lower PPTs in all regions (p < 0.05) than the control group. Unlike the control group, the patient group had lower PPTs on the affected side for the shoulder [mean difference (MD) 95% confidence interval (CI): 1.2 (-1.7 to -0.6)], forearm [MD 95% CI: 1.1 (-1.7 to -0.6)], and leg [MD 95% CI: 0.9 (-1.4 to -0.3)] compared with the contralateral side (p < 0.001). CONCLUSION: Pain sensitivity is more pronounced in the affected shoulder and the forearm and leg located on this side than in those on the contralateral side in patients with CS associated with chronic SPS.


Assuntos
Sensibilização do Sistema Nervoso Central , Dor Crônica , Limiar da Dor , Humanos , Estudos Transversais , Feminino , Masculino , Sensibilização do Sistema Nervoso Central/fisiologia , Pessoa de Meia-Idade , Adulto , Limiar da Dor/fisiologia , Dor Crônica/fisiopatologia , Dor de Ombro/fisiopatologia , Síndrome de Colisão do Ombro/fisiopatologia , Medição da Dor , Antebraço/fisiopatologia , Perna (Membro)/fisiopatologia
4.
J Bodyw Mov Ther ; 39: 32-37, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38876646

RESUMO

INTRODUCTION: This study aimed to investigate the effect of sex on regional and widespread pain sensitivity following acute bouts of stretching and to investigate the acute effect of stretching on regional and widespread pain sensitivity following stretching. METHODS: 73 healthy adults (36 females; mean age 25.6 ± 6.7 years) with an age range from 19 to 62 years were recruited for this experimental study. Regional and distant pain pressure pain thresholds, passive knee extension range of motion and passive resistive torque were measured before and 30 s after four bouts of 30-s static muscle stretching of the knee flexors with 20-s rest between bouts. RESULTS: No significant sex differences were found for pressure pain thresholds (p > 0.132), range of motion (p = 0.446) or passive resistive torque (p = 0.559) between pre-stretch and post-stretch measures. There were significant increases in pressure pain thresholds (p = 0.010), range of motion (p = 0.001) and passive resistive torque (p = 0.007) between pre-stretch and post-stretch measures. CONCLUSION: Muscle stretching significantly decreased regional and widespread pain sensitivity, indicating that central pain-modulating mechanisms are engaged during muscle stretching, resulting in stretch-induced hypoalgesia. Moreover, the results showed that the effect of stretching on regional and widespread pain sensitivity is not sex-specific.


Assuntos
Exercícios de Alongamento Muscular , Limiar da Dor , Amplitude de Movimento Articular , Humanos , Adulto , Masculino , Feminino , Limiar da Dor/fisiologia , Exercícios de Alongamento Muscular/fisiologia , Amplitude de Movimento Articular/fisiologia , Adulto Jovem , Fatores Sexuais , Pessoa de Meia-Idade , Torque , Músculo Esquelético/fisiologia , Músculo Esquelético/fisiopatologia , Articulação do Joelho/fisiologia , Articulação do Joelho/fisiopatologia
5.
Gen Hosp Psychiatry ; 89: 84-92, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38838608

RESUMO

OBJECTIVE: This study aimed to investigate the effects of opioid-free anesthesia (OFA) in laparoscopic gastrectomy and identify the psychological factors that could influence the efficacy of OFA. METHOD: 120 patients undergoing laparoscopic gastrectomy were allocated to either the opioid-based anesthesia group (OA) (n = 60) or the OFA (n = 60) group. Remifentanil was administered to the OA group intraoperatively, whereas dexmedetomidine and lidocaine were administered to the OFA group. The interaction effect of the psychological factors on OFA was analyzed using the aligned rank transform for nonparametric factorial analyses. RESULTS: The opioid requirement for 24 h after surgery was lower in the OFA group than in the OA group (fentanyl equivalent dose 727 vs. 650 µg, p = 0.036). The effect of OFA was influenced by the pain catastrophizing scale (p = 0.041), temporal pain summation (p = 0.046), and pressure pain tolerance (p = 0.034). This indicates that patients with pain catastrophizing or high pain sensitivity significantly benefited from OFA, whereas patients without these characteristics did not. CONCLUSIONS: This study demonstrated that OFA with dexmedetomidine and lidocaine effectively reduced the postoperative 24-h opioid requirements following laparoscopic gastrectomy, which was modified by baseline pain catastrophizing and pain sensitivity. CLINICAL TRIAL REGISTRY: The study protocol was approved by the Institutional Review Board of Yonsei University Health System Gangnam Severance Hospital (#3-2021-0295) and registered at ClinicalTrials.gov (NCT05076903).


Assuntos
Analgésicos Opioides , Dexmedetomidina , Gastrectomia , Lidocaína , Dor Pós-Operatória , Remifentanil , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Analgésicos Opioides/administração & dosagem , Idoso , Dexmedetomidina/administração & dosagem , Dexmedetomidina/farmacologia , Lidocaína/administração & dosagem , Lidocaína/farmacologia , Dor Pós-Operatória/tratamento farmacológico , Remifentanil/administração & dosagem , Remifentanil/farmacologia , Laparoscopia , Catastrofização , Adulto , Limiar da Dor/efeitos dos fármacos , Anestésicos Locais/administração & dosagem , Anestésicos Locais/farmacologia
6.
J Orthop Surg Res ; 19(1): 357, 2024 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-38880910

RESUMO

BACKGROUND: This study aimed to validate alterations in the gene expression of DNA methylation-related enzymes and global methylation in the peripheral blood mononuclear cell (PBMC) and synovial tissues of animal hip osteoarthritis (OA) models. METHODS: Animals were assigned to the control (no treatment), sham (25 µL of sterile saline), and OA (25 µL of sterile saline and 2 mg of monoiodoacetate) groups. Microcomputed tomography scan, histopathological assessment and pain threshold measurement were performed after induction. The mRNA expression of the DNA methylation machinery genes and global DNA methylation in the PBMC and hip synovial tissue were evaluated. RESULTS: The OA group presented with hip joint OA histopathologically and radiologically and decreased pain threshold. The mRNA expression of DNA methyltransferase (Dnmt 3a), ten-eleven translocation (Tet) 1 and Tet 3 in the synovial tissue of the OA group was significantly upregulated. Global DNA methylation in the synovial tissue of the OA group was significantly higher than that of the control and sham groups. CONCLUSIONS: The intra-articular administration of monoiodoacetate induced hip joint OA and decreased pain threshold. The DNA methylation machinery in the synovial tissues of hip OA was altered.


Assuntos
Metilação de DNA , Modelos Animais de Doenças , Osteoartrite do Quadril , Animais , Osteoartrite do Quadril/genética , Osteoartrite do Quadril/metabolismo , Osteoartrite do Quadril/patologia , Masculino , Ratos , Ácido Iodoacético , Membrana Sinovial/metabolismo , Membrana Sinovial/patologia , Leucócitos Mononucleares/metabolismo , Ratos Sprague-Dawley , DNA Metiltransferase 3A/genética , DNA Metiltransferase 3A/metabolismo , Limiar da Dor
7.
J Sports Sci ; 42(7): 574-588, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38726662

RESUMO

Exercise-Induced Hypoalgesia (EIH) refers to an acute reduced pain perception after exercise. This systematic review and meta-analysis investigated the effect of a single aerobic exercise session on local and remote EIH in healthy individuals, examining the role of exercise duration, intensity, and modality. Pressure pain thresholds (PPT) are used as the main measure, applying the Cochrane risk of bias tool and GRADE approach for certainty of evidence assessment. Mean differences (MD; Newton/cm²) for EIH effects were analysed. Thirteen studies with 23 exercises and 14 control interventions are included (498 participants). Most studies used bicycling, with only two including running/walking and one including rowing. EIH occurred both locally (MD = 3.1) and remotely (MD = 1.8), with high-intensity exercise having the largest effect (local: MD = 7.5; remote: MD = 3.0) followed by moderate intensity (local: MD = 3.1; remote: MD = 3.0). Low-intensity exercise had minimal impact. Neither long nor short exercise duration induced EIH. Bicycling was found to be effective in eliciting EIH, in contrast to the limited research observed in other modalities. The overall evidence quality was moderate with many studies showing unclear risk biases.


Assuntos
Exercício Físico , Percepção da Dor , Limiar da Dor , Humanos , Exercício Físico/fisiologia , Limiar da Dor/fisiologia , Percepção da Dor/fisiologia , Ciclismo/fisiologia , Corrida/fisiologia , Fatores de Tempo
8.
Behav Brain Res ; 469: 115047, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38759799

RESUMO

Hyperalgesia occurs in the orofacial region of rats when estrogen levels are low, although the specific mechanism needs to be investigated further. Furthermore, oxidative stress plays an important role in the transmission of pain signals. This study aimed to explore the role of oxidative stress in orofacial hyperalgesia under low estrogen conditions. We firstly found an imbalance between oxidative and antioxidant capacity within the spinal trigeminal subnucleus caudalis (SP5C) of rats after ovariectomy (OVX), resulting in oxidative stress and then a decrease in the orofacial pain threshold. To investigate the mechanism by which oxidative stress occurs, we used virus as a tool to silence or overexpress the excitatory amino acid transporter 3 (EAAT3) gene. Further investigation revealed that the regulation of glutathione (GSH) and reactive oxygen species (ROS) can be achieved by regulating EAAT3, which in turn impacts the occurrence of oxidative stress. In summary, our findings suggest that reduced expression of EAAT3 within the SP5C of rats in the low estrogen state may decrease GSH content and increase ROS levels, resulting in oxidative stress and ultimately lead to orofacial hyperalgesia. This suggests that antioxidants could be a potential therapeutic direction for orofacial hyperalgesia under low estrogen conditions, though more research is needed to understand its mechanism.


Assuntos
Estrogênios , Transportador 3 de Aminoácido Excitatório , Dor Facial , Glutationa , Hiperalgesia , Ovariectomia , Estresse Oxidativo , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio , Animais , Hiperalgesia/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/fisiologia , Feminino , Estrogênios/metabolismo , Estrogênios/farmacologia , Dor Facial/metabolismo , Glutationa/metabolismo , Ratos , Espécies Reativas de Oxigênio/metabolismo , Transportador 3 de Aminoácido Excitatório/metabolismo , Limiar da Dor/efeitos dos fármacos , Limiar da Dor/fisiologia , Núcleo Inferior Caudal do Nervo Trigêmeo/metabolismo , Núcleo Inferior Caudal do Nervo Trigêmeo/efeitos dos fármacos , Antioxidantes/farmacologia , Antioxidantes/metabolismo
9.
Sci Rep ; 14(1): 10197, 2024 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-38702506

RESUMO

Fibromyalgia is a heterogenous chronic pain disorder diagnosed by symptom-based criteria. The aim of this study was to clarify different pathophysiological characteristics between subgroups of patients with fibromyalgia. We identified subgroups with distinct pain thresholds: those with a low pressure pain threshold (PL; 16 patients) and those with a normal pressure pain threshold (PN; 15 patients). Both groups experienced severe pain. We performed resting-state functional MRI analysis and detected 11 functional connectivity pairs among all 164 ROIs with distinct difference between the two groups (p < 0.001). The most distinctive one was that the PN group had significantly higher functional connectivity between the secondary somatosensory area and the dorsal attention network (p < 0.0001). Then, we investigated the transmission pathway of pain stimuli. Functional connectivity of the thalamus to the insular cortex was significantly higher in the PL group (p < 0.01 - 0.05). These results suggest that endogenous pain driven by top-down signals via the dorsal attention network may contribute to pain sensation in a subgroup of fibromyalgia patients with a normal pain threshold. Besides, external pain driven by bottom-up signals via the spinothalamic tract may contribute to pain sensations in another group of patients with a low pain threshold. Trial registration: UMIN000037712.


Assuntos
Fibromialgia , Imageamento por Ressonância Magnética , Limiar da Dor , Humanos , Fibromialgia/fisiopatologia , Fibromialgia/diagnóstico por imagem , Feminino , Estudos de Casos e Controles , Limiar da Dor/fisiologia , Adulto , Pessoa de Meia-Idade , Masculino , Atenção/fisiologia , Rede Nervosa/fisiopatologia , Rede Nervosa/diagnóstico por imagem
10.
J Bodyw Mov Ther ; 38: 73-80, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38763618

RESUMO

INTRODUCTION: Myofascial trigger point therapy (MTrP) is a widely used therapeutic approach, although the underlying mechanisms remain unclear. Mechanisms discussed include peripheral involvement of muscles as well as central pain modulating processes such as the conditioned pain modulation (CPM). The aim of this study was to investigate whether the analgesic response of MTrP and the analgesic response of CPM correlate in asymptomatic participants in order to identify shared underlying mechanisms of MTrP and CPM. METHOD: Both, CPM and MTrP protocols consisted of heat-based test stimuli (heat pain thresholds before and after the intervention) and pressure-based (conditioning) stimuli. Asymptomatic participants (n = 94) were randomly assigned to receive either mild, intense or no pressure stimuli (between-group design) to both the fingernail and the MTrP of the infraspinatus muscle (within-group design). Pressure stimuli at both locations (fingernail, MTrP) were applied with a pressure algometer for 120 s and continuously adjusted to maintain a constant pain intensity of mild or intense pain. All thermal stimuli were applied on the lower leg with a thermal stimulator. RESULTS: A significant correlation was shown between the analgesic effect of CPM and MTrP therapy for mild (r = 0.53, p = 0.002) and intensive stimuli (r = 0.73, p < 0.001). 17.3% of the variance of the MTrP effect were explained by CPM after mild stimulation, and 47.1% after intense stimulation. Pain-related characteristics did not explain the variance within the analgesic response using a regression analysis. CONCLUSIONS: Between the analgesic responses following MTrP and CPM paradigms, a moderate to strong correlation was observed, suggesting shared underlying mechanisms.


Assuntos
Síndromes da Dor Miofascial , Limiar da Dor , Pontos-Gatilho , Humanos , Feminino , Masculino , Pontos-Gatilho/fisiopatologia , Adulto , Limiar da Dor/fisiologia , Síndromes da Dor Miofascial/terapia , Adulto Jovem , Medição da Dor , Terapia de Tecidos Moles/métodos , Pressão , Manejo da Dor/métodos , Temperatura Alta
11.
Headache ; 64(6): 652-662, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38700141

RESUMO

OBJECTIVE: Migraine, a prevalent and debilitating disease, involves complex pathophysiology possibly including inflammation and heightened pain sensitivity. The current study utilized the complete Freund's adjuvant (CFA) model of inflammation, with onabotulinumtoxinA (BoNT/A) as a treatment of interest due to its use in clinical migraine management. Using an animal model, the study sought to investigate the role of BoNT/A in modulating CFA-induced inflammation, alterations in pain sensitivity, and the regulation of calcitonin gene-related peptide (CGRP) release. Further, we aimed to assess the changes in SNAP-25 through western blot analysis to gain insights into the mechanistic action of BoNT/A. METHODS: BoNT/A or control was administered subcutaneously at the periorbital region of rats 3 days before the induction of inflammation using CFA. Periorbital mechanical sensitivity was assessed post-inflammation, and alterations in CGRP release were evaluated. Changes in SNAP-25 levels were determined using western blot analysis. RESULTS: Upon CFA-induced inflammation, there was a marked increase in periorbital mechanical sensitivity, with the inflammation side showing increased sensitivity compared to other periorbital areas. BoNT/A did decrease the withdrawal thresholds in the electronic von Frey test. Despite not being able to observe differences in pain thresholds or CGRP release, BoNT/A reduced baseline release under CFA inflamed conditions. Analysis of SNAP-25 levels in the trigeminal ganglion revealed both intact and cleaved forms that were notably elevated in BoNT/A-treated animals. These findings, derived from western blot analysis, suggest an effect on neurotransmitter release. CONCLUSION: Our investigation highlights the role of BoNT/A in reducing baseline CGRP in the context of inflammation and its involvement in SNAP-25 cleavage. In contrast, BoNT/A did not appear to alter facial pain sensitivity induced by inflammation, suggesting that mechanisms other than baseline CGRP could be implicated in the elevated thresholds in the CFA model.


Assuntos
Toxinas Botulínicas Tipo A , Peptídeo Relacionado com Gene de Calcitonina , Modelos Animais de Doenças , Inflamação , Transtornos de Enxaqueca , Ratos Sprague-Dawley , Proteína 25 Associada a Sinaptossoma , Animais , Toxinas Botulínicas Tipo A/farmacologia , Toxinas Botulínicas Tipo A/administração & dosagem , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/metabolismo , Proteína 25 Associada a Sinaptossoma/metabolismo , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Inflamação/tratamento farmacológico , Ratos , Masculino , Adjuvante de Freund , Dor/tratamento farmacológico , Limiar da Dor/efeitos dos fármacos , Fármacos Neuromusculares/farmacologia , Fármacos Neuromusculares/administração & dosagem
12.
Support Care Cancer ; 32(6): 334, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38722345

RESUMO

PURPOSE: To describe the characteristics of and the associations between health-related quality of life, pain, craniomandibular function, and psychosocial factors related to pain and fear of movement in patients with head and neck cancer. METHODS: Seventy-eight patients diagnosed with HNC were recruited. Measurements of the maximum mouth opening range and pressure pain thresholds on the masseter muscle and the distal phalanx of the thumb were conducted, as well as a battery of self-report questionnaires were administrated, including the QoL Questionnaire (EORT QLQ-H&N35), Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), the Spanish translation of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD), and the short version of the Craniofacial Pain and Disability Inventory (CF-PDI-11). RESULTS: The study sample (66.7% men, mean age 60.12 [11.95] years) experienced a moderate impact on their QoL levels (57.68 [18.25] EORT QLQ-H&N35) and high kinesiophobia values (20.49 [9.11] TSK-TMD). Pain was present in 41% of the patients, but only 3.8% reported severe pain. 26.4% had a restricted mouth opening range, and 34.62% showed significant catastrophism levels. There were strong positive correlations between EORT QLQ-H&N35 and CF-PDI-11 (r = 0.81), between NRS and CF-PDI-11 (r = 0.74), and between PCS and CF-PDI-11 (r = 0.66). CONCLUSION: Patients with HNC experience negative effects in their QoL, related to their impairment in craniomandibular function. Fear of movement, pain intensity, and catastrophism are associated with poorer functionality; relationships that should be considered when attempting to improve health care.


Assuntos
Neoplasias de Cabeça e Pescoço , Qualidade de Vida , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias de Cabeça e Pescoço/psicologia , Neoplasias de Cabeça e Pescoço/complicações , Idoso , Inquéritos e Questionários , Medição da Dor , Movimento , Transtornos da Articulação Temporomandibular/psicologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Medo/psicologia , Estudos Transversais , Dor do Câncer/psicologia , Adulto , Limiar da Dor/psicologia
13.
Res Dev Disabil ; 150: 104760, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38795555

RESUMO

BACKGROUND: Pain perception mechanisms in cerebral palsy remain largely unclear. AIMS: This study investigates brain activity in adults with cerebral palsy during painful and non-painful stretching to elucidate their pain processing characteristics. METHODS AND PROCEDURES: Twenty adults with cerebral palsy and 20 controls underwent EEG in three conditions: rest, non-painful stretching, and painful stretching. Time-frequency power density of theta, alpha, and beta waves in somatosensory and frontal cortices was analyzed, alongside baseline pressure pain thresholds. OUTCOMES AND RESULTS: Cerebral palsy individuals exhibited higher theta, alpha, and beta power density in both cortices during painful stretching compared to rest, and lower during non-painful stretching. Controls showed higher power density during non-painful stretching but lower during painful stretching. Cerebral palsy individuals had higher pain sensitivity, with those more sensitive experiencing greater alpha power density. CONCLUSIONS AND IMPLICATIONS: These findings confirm alterations in the cerebral processing of pain in individuals with cerebral palsy. This knowledge could enhance future approaches to the diagnosis and treatment of pain in this vulnerable population.


Assuntos
Paralisia Cerebral , Eletroencefalografia , Limiar da Dor , Humanos , Paralisia Cerebral/fisiopatologia , Paralisia Cerebral/complicações , Masculino , Feminino , Adulto , Limiar da Dor/fisiologia , Estudos de Casos e Controles , Adulto Jovem , Exercícios de Alongamento Muscular , Percepção da Dor/fisiologia , Dor/fisiopatologia , Dor/etiologia , Lobo Frontal/fisiopatologia , Córtex Somatossensorial/fisiopatologia
14.
Codas ; 36(3): e20230066, 2024.
Artigo em Português, Inglês | MEDLINE | ID: mdl-38808856

RESUMO

PURPOSE: To analyze the sensation of pain and the range of mandibular movements of adult individuals with temporomandibular disorder, before and after the application of the athletic tape. METHOD: This is a double-blind randomized clinical trial, in which 22 adults with temporomandibular disorder participated, randomly allocated into two groups, with group A comprising 10 women and one man (mean age 28.2±8.3 years) and group B comprising nine women and two men (mean age 26.2±3.9 years). Group A was submitted to the application of the athletic tape on the masseter with 40% stretch and the group B to the application of the athletic tape on the masseter without stretching. All participants underwent the application of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Pain threshold assessment was performed using an algometer to apply pressure to measurement points. The measurement of mandibular movements was performed using a caliper. The athletic tape was glued using the I technique, with a fixed point over the insertion and a movable point over the origin of the masseter muscle. Participants remained with the athletic tape for 24 hours and were re-evaluated. RESULTS: There was pain relief in the group A in the temporomandibular joint on the right and at the origin of the masseter on the left. The group B showed a reduction in pain in the left anterior temporal region. No differences were found in mandibular movements after intervention, as well as no difference was found in the comparison by groups. CONCLUSION: The use of the athletic tape over the masseter muscle, with stretching, for 24 hours produced relief from the sensation of pain, on the origin of the right masseter and in the right temporomandibular joint, and, without stretching, in the left anterior temporal muscle. There was no difference in the range of mandibular movements.


OBJETIVO: Analisar a sensação de dor e amplitude dos movimentos mandibulares de indivíduos adultos com disfunção temporomandibular, antes e após aplicação da bandagem elástica por 24 horas. MÉTODO: Trata-se de um ensaio clínico randomizado duplo-cego, do qual participaram 22 sujeitos adultos com disfunção temporomandibular, alocados aleatoriamente em dois grupos, sendo grupo A composto por 10 mulheres e um homem (média de idade de 28,2±8,3 anos) e grupo B por nove mulheres e dois homens (média de idade de 26,2±3,9 anos). Todos os participantes foram submetidos à aplicação do Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Foi realizada a avaliação do limiar da dor, com uso de um algômetro, para aplicação da pressão no masseter e temporal e medição dos movimentos mandibulares, com paquímetro. O grupo A foi submetido à aplicação da bandagem sobre o músculo masseter com estiramento de 40% e o grupo B sem estiramento. A colagem da bandagem foi realizada, com corte em "I", com ponto fixo sobre a inserção e ponto móvel sobre a origem do músculo masseter. Os participantes permaneceram com a bandagem por 24 horas e foram reavaliados. RESULTADOS: Houve alívio da dor no grupo A na articulação temporomandibular à direita e na origem do masseter à esquerda. O grupo B apresentou redução da dor em região de temporal anterior à esquerda. Não foram encontradas diferenças nos movimentos mandibulares após intervenção, bem como não houve diferença na comparação entre os grupos. CONCLUSÃO: O uso da bandagem sobre o masseter, por 24 horas, com estiramento, produziu alívio da dor na origem do masseter direito e na região da articulação temporomandibular direita e, sem estiramento, no temporal anterior esquerdo. Não houve diferença na amplitude de movimentos mandibulares.


Assuntos
Fita Atlética , Dor Facial , Músculo Masseter , Medição da Dor , Amplitude de Movimento Articular , Transtornos da Articulação Temporomandibular , Humanos , Feminino , Adulto , Método Duplo-Cego , Masculino , Dor Facial/fisiopatologia , Dor Facial/diagnóstico , Transtornos da Articulação Temporomandibular/fisiopatologia , Músculo Masseter/fisiopatologia , Adulto Jovem , Amplitude de Movimento Articular/fisiologia , Limiar da Dor/fisiologia , Mandíbula/fisiopatologia
15.
Mol Pain ; 20: 17448069241261940, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38818809

RESUMO

This study investigated the ERK pathway of the peripheral nervous system and discovered a gender-specific pattern of ERK activation in the dorsal root ganglion of an acid-induced chronic widespread muscular pain model. We employed a twice acid-induced chronic musculoskeletal pain model in rats to evaluate mechanical pain behavior in both male and female groups. We further conducted protein analysis of dissected dorsal root ganglions from both genders. Both male and female rats exhibited a similar pain behavior trend, with females demonstrating a lower pain threshold. Protein analysis of the dorsal root ganglion (DRG) showed a significant increase in phosphorylated ERK after the second acid injection in all groups. However, phosphorylation of ERK was observed in the dorsal root ganglion, with higher levels in the male ipsilateral group compared to the female group. Moreover, there was a no difference between the left and right sides in males, whereas the significant difference was observed in females. In conclusions, the administration of acid injections induced painful behavior in rats, and concurrent with this, a significant upregulation of pERK was observed in the dorsal root ganglia, with a greater magnitude of increase in males than females, and in the contralateral side compared to the ipsilateral side. Our findings shed light on the peripheral mechanisms underlying chronic pain disorders and offer potential avenues for therapeutic intervention.


Assuntos
MAP Quinases Reguladas por Sinal Extracelular , Fibromialgia , Gânglios Espinais , Ratos Sprague-Dawley , Caracteres Sexuais , Animais , Masculino , Feminino , Fibromialgia/metabolismo , Gânglios Espinais/metabolismo , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Fosforilação/efeitos dos fármacos , Ratos , Limiar da Dor , Modelos Animais de Doenças , Dor/metabolismo , Dor/fisiopatologia
16.
Biol Psychol ; 190: 108818, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38762001

RESUMO

Negative expectations can increase pain sensitivity, leading to nocebo hyperalgesia. However, the physiological and psychological factors that predispose individuals to this phenomenon are still not well understood. The present study examined whether stress induced by a social stressor affects nocebo hyperalgesia, and whether this effect is mediated by self-reported and physiological stress responses. We recruited 52 healthy participants (15 men) who were randomly assigned to either the Trier Social Stress Test (TSST) or a control condition (a friendly version of the TSST). Nocebo hyperalgesia was induced using negative suggestions combined with a validated pain conditioning paradigm. We assessed self-reported (anxiety and stress) and physiological (cortisol, alpha-amylase, heart rate, and skin conductance) responses to stress. Both groups exhibited significant nocebo hyperalgesia. The stress group showed higher levels of anxiety, self-reported stress, and cortisol levels compared to the control group while no significant differences were found in other physiological markers. The stress and control groups did not differ in the magnitude of nocebo hyperalgesia, but anxiety levels partially mediated the effects of the stress test on nocebo hyperalgesia. Our findings suggest that an external social stressor does not directly affect nocebo hyperalgesia, but that increased anxiety due to the stressor enhances its magnitude. Thus, it may be worthwhile to investigate whether reducing stress-related anxiety in clinical settings would help alleviate nocebo effects.


Assuntos
Resposta Galvânica da Pele , Frequência Cardíaca , Hidrocortisona , Hiperalgesia , Efeito Nocebo , Autorrelato , Estresse Psicológico , Humanos , Masculino , Feminino , Hiperalgesia/fisiopatologia , Hiperalgesia/psicologia , Hidrocortisona/metabolismo , Hidrocortisona/análise , Adulto Jovem , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Resposta Galvânica da Pele/fisiologia , Adulto , Frequência Cardíaca/fisiologia , Ansiedade/fisiopatologia , Ansiedade/psicologia , Estresse Fisiológico/fisiologia , Medição da Dor , Saliva/metabolismo , Saliva/química , alfa-Amilases/metabolismo , alfa-Amilases/análise , Limiar da Dor/fisiologia , Limiar da Dor/psicologia
17.
Med Sci Monit ; 30: e944149, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38805404

RESUMO

BACKGROUND Cold and heat therapies for recovery in sports are commonly used, including in the mixed martial arts (MMA). The Game Ready (GR) device can be used for local monotherapy with either heat or cold and for contrast therapy. This study aimed to compare the effects of duration of cold and heat compression on biomechanical changes in the forearm muscles of 20 healthy mixed martial arts athletes. MATERIAL AND METHODS Twenty MMA volunteers (26.5±4.5 years old) underwent 3 different phases of the GR: (1) stimulation time 10 min (eGR-10, GR experimental group), (2) 10 min (cGR-10, sham control group) and (3) 20 min (eGR-20, GR experimental group). The following outcomes were assessed: muscle tone (T), stiffness (S), flexibility (E), pressure pain threshold (PPT), microvascular response (PU), and maximum isometric strength (Fmax). All measurements were performed before GR (rest) and after GR stimulation (post). RESULTS Both eGR-10 and eGR-20 significantly improved outcomes T (p<0.001), S (p<0.001), E (p=0.001, and p<0.001, respectively), PPT (p<0.001), PU (p<0.001), and Fmax (p<0.001). Notably, eGR-20 exhibited superior improvements in PU, Fmax, and PPT, with larger effect sizes (p<0.001). While eGR-10 demonstrated more pronounced reductions in T and S (p<0.001), these results underscore the potential for tailored GR therapy durations to optimize specific recovery goals for MMA athletes. CONCLUSIONS GR stimulation affects muscle biomechanical changes, pain threshold, muscle strength, and tissue perfusion. The study results suggest that 10 min of GR stimulation is sufficient to achieve changes that can be used to optimize recovery for MMA athletes.


Assuntos
Atletas , Antebraço , Temperatura Alta , Artes Marciais , Músculo Esquelético , Humanos , Masculino , Adulto , Músculo Esquelético/fisiologia , Artes Marciais/fisiologia , Antebraço/fisiologia , Fenômenos Biomecânicos , Feminino , Adulto Jovem , Temperatura Baixa , Limiar da Dor/fisiologia , Força Muscular/fisiologia
18.
Chiropr Man Therap ; 32(1): 19, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38811985

RESUMO

BACKGROUND: Lumbar spinal manipulative therapy (SMT) is a common intervention used to treat low back pain (LBP); however, the exact neurophysiological mechanisms of SMT reducing pain measured through pain pressure threshold (PPT) have not been fully explored beyond an immediate timeframe (e.g., immediately or five-minutes following) referencing a control group. Therefore, the purpose of this study was to investigate the neurophysiological effects of lumbar SMT compared to deactivated ultrasound using PPT immediately following and 30-minutes following SMT. METHODS: A longitudinal, randomized controlled trial design was conducted between September to October 2023. Fifty-five participants were randomized into a control group of deactivated ultrasound (n = 29) or treatment group of right sidelying lumbar SMT (n = 26). PPT, recorded at the right posterior superior iliac spine (PSIS), was documented for each participant in each group prior to intervention, immediately, and 30-minutes after. A repeated measures ANOVA, with a post-hoc Bonferroni adjustment, was used to assess within-group and between-group differences in PPT. The significance level was set at a < 0.05 a priori. RESULTS: Statistically significant differences were found between the deactivated ultrasound and lumbar SMT groups immediately (p = .05) and 30-minutes (p = .02) following intervention. A significant difference in the lumbar SMT group was identified from baseline to immediately following (p < .001) and 30-minutes following (p < .001), but no differences between immediately following and 30-minutes following intervention (p = .10). The deactivated ultrasound group demonstrated a difference between baseline and immediately after intervention with a reduced PPT (p = .003), but no significant difference was found from baseline to 30-minutes (p = .11) or immediately after intervention to 30-minutes (p = 1.0). CONCLUSION: A right sidelying lumbar manipulation increased PPT at the right PSIS immediately after that lasted to 30-minutes when compared to a deactivated ultrasound control group. Future studies should further explore beyond the immediate and short-term neurophysiological effects of lumbar SMT to validate these findings. TRIAL REGISTRATION: This study was retrospectively registered on 4 December 2023 in ClinicalTrials (database registration number NCT06156605).


Assuntos
Dor Lombar , Manipulação da Coluna , Limiar da Dor , Humanos , Manipulação da Coluna/métodos , Feminino , Masculino , Adulto , Dor Lombar/terapia , Dor Lombar/fisiopatologia , Adulto Jovem , Vértebras Lombares , Estudos Longitudinais , Voluntários Saudáveis , Região Lombossacral , Pessoa de Meia-Idade , Pressão
19.
Neurosci Lett ; 832: 137806, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38714229

RESUMO

BACKGROUND: Trigeminal neuralgia (TN) is a common and difficult-to-treat neuropathic pain disorder in clinical practice. Previous studies have shown that Toll-like receptor 4 (TLR4) modulates the activation of the NF-κB pathway to affect neuropathic pain in rats. Voltage-gated sodium channels (VGSCs) are known to play an important role in neuropathic pain electrical activity. OBJECTIVE: To investigate whether TLR4 can regulate Nav1.3 through the TRAF6/NF-κB p65 pathway after infraorbital nerve chronic constriction injury (ION-CCI). STUDY DESIGN: ION-CCI modeling was performed on SD (Sprague Dawley) rats. To verify the success of the modeling, we need to detect the mechanical pain threshold and ATF3. Then, detecting the expression of TLR4, TRAF6, NF-κB p65, p-p65, and Nav1.3 in rat TG. Subsequently, investigate the role of TLR4/TRAF6/NF-κB pathway in ION-CCI model by intrathecal injections of LPS-rs (TLR4 antagonist), C25-140 (TRAF6 inhibitor), and PDTC (NF-κB p65 inhibitor). RESULTS: ION-CCI surgery decreased the mechanical pain threshold of rats and increased the expression of ATF3, TLR4, TRAF6, NF-κB p-p65 and Nav1.3, but there was no difference in NF-κB p65 expression. After inject antagonist or inhibitor of the TLR4/TRAF6/NF-κB pathway, the expression of Nav1.3 was decreased and mechanical pain threshold was increased. CONCLUSION: In the rat model of ION-CCI, TLR4 in the rat trigeminal ganglion regulates Nav1.3 through the TRAF6/NF-κB p65 pathway, and TLR4 antagonist alleviates neuropathic pain in ION-CCI rats.


Assuntos
Canal de Sódio Disparado por Voltagem NAV1.3 , Ratos Sprague-Dawley , Transdução de Sinais , Fator 6 Associado a Receptor de TNF , Receptor 4 Toll-Like , Animais , Receptor 4 Toll-Like/metabolismo , Fator 6 Associado a Receptor de TNF/metabolismo , Masculino , Canal de Sódio Disparado por Voltagem NAV1.3/metabolismo , Transdução de Sinais/fisiologia , NF-kappa B/metabolismo , Neuralgia do Trigêmeo/metabolismo , Ratos , Modelos Animais de Doenças , Fator de Transcrição RelA/metabolismo , Fator 3 Ativador da Transcrição/metabolismo , Limiar da Dor/fisiologia
20.
BMC Oral Health ; 24(1): 552, 2024 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-38735923

RESUMO

Patients who suffer from myofascial orofacial pain could affect their quality of life deeply. The pathogenesis of pain is still unclear. Our objective was to assess Whether Voltage-gated calcium channel α2δ-1(Cavα2δ-1) is related to myofascial orofacial pain. Rats were divided into the masseter tendon ligation group and the sham group. Compared with the sham group, the mechanical pain threshold of the masseter tendon ligation group was reduced on the 4th, 7th, 10th and 14th day after operation(P < 0.05). On the 14th day after operation, Cavα2δ-1 mRNA expression levels in trigeminal ganglion (TG) and the trigeminal spinal subnucleus caudalis and C1-C2 spinal cervical dorsal horn (Vc/C2) of the masseter tendon ligation group were increased (PTG=0.021, PVc/C2=0.012). Rats were divided into three groups. On the 4th day after ligating the superficial tendon of the left masseter muscle of the rats, 10 ul Cavα2δ-1 antisense oligonucleotide, 10 ul Cavα2δ-1 mismatched oligonucleotides and 10 ul normal saline was separately injected into the left masseter muscle of rats in Cavα2δ-1 antisense oligonucleotide group, Cavα2δ-1 mismatched oligonucleotides group and normal saline control group twice a day for 4 days. The mechanical pain threshold of the Cavα2δ-1 antisense oligonucleotides group was higher than Cavα2δ-1 mismatched oligonucleotides group on the 7th and 10th day after operation (P < 0.01). After PC12 cells were treated with lipopolysaccharide, Cavα2δ-1 mRNA expression level increased (P < 0.001). Cavα2δ-1 may be involved in the occurrence and development in myofascial orofacial pain.


Assuntos
Canais de Cálcio , Músculo Masseter , Ratos Sprague-Dawley , Gânglio Trigeminal , Animais , Ratos , Músculo Masseter/metabolismo , Masculino , Canais de Cálcio/metabolismo , Gânglio Trigeminal/metabolismo , Limiar da Dor , Dor Facial/metabolismo , Corno Dorsal da Medula Espinal/metabolismo , Oligonucleotídeos Antissenso/farmacologia , Síndromes da Dor Miofascial , RNA Mensageiro/metabolismo , Canais de Cálcio Tipo L
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