ORCID Profile
0000-0001-9080-4202
Current Organisations
University of Sydney
,
St. Luke's International University
,
Queensland University of Technology
,
Western Sydney University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.MSKSP.2019.01.013
Abstract: Implicit theories of pain represent a socio-cognitive mechanism linked to important coping, emotional, and expressive reactions to chronic pain. Evidence suggests that chronic low back pain (CLBP) patients who hold an incremental theory of pain (i.e., view pain as a malleable) use more active coping strategies, display less pain behavior, and report lower levels of depression than those with an entity theory of pain (i.e., view pain as a fixed). However, a link between implicit theories of pain and symptoms of pain and disability in people with CLBP has not been established. This study investigated the relationship between implicit theories of pain and the level of pain and disability reported by people with CLBP. Cross-sectional observational study. One hundred and two participants with CLBP completed an online survey distributed through social media channels. The online survey assessed pain intensity and pain-related disability (Chronic Pain Grade Scale), implicit theories of pain (Implicit Theory of Pain Scale), and perceived control over pain (Survey of Pain Attitudes control scale). Participants with an incremental theory of pain reported significantly less pain and disability compared to those with an entity theory of pain (p < 0.001). These findings suggest that implicit theories of pain may guide self-reported symptoms of pain and disability in a CLBP population. Prospective studies are required to confirm the relevance of these findings for risk of future low back pain, and to confirm whether this relationship changes with and without treatment.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2019
DOI: 10.1097/PR9.0000000000000737
Abstract: Joint position sense (JPS) is impaired in clinical musculoskeletal pain conditions, but when this impairment develops in the transition from initial to prolonged pain is not known. This study assessed whether progressively developing sustained experimentally induced muscle pain impacts JPS in healthy in iduals. Twenty-eight healthy in iduals received injection of nerve growth factor (NGF) into the right extensor carpi radialis brevis muscle on days 0 and 2 to induce sustained pain and hyperalgesia. Wrist JPS was assessed 2 days before day 0 (day −2), before the injection on days 0 and 2, and on days 4 and 14. Joint position sense was quantified as the ability to return the wrist to a neutral position following movements in the direction of radial and ulnar deviation. A 3-dimensional motion analysis system was used to calculate absolute, relative, and joint-angle repositioning errors. Numerical rating scale scores of pain intensity, body chart pain drawings, and pressure pain thresholds (PPTs) were recorded on each day. Compared with baseline, pressure pain thresholds decreased while pain intensity and area increased at day 2 ( P 0.001) and day 4 ( P 0.001) before returning to baseline on day 14 ( P 0.13). Relative to day 0, there was no change in wrist JPS at day 2, 4, and 14 following movements in either target direction ( P 0.05). Despite the presence of sustained muscle pain and hyperalgesia for 4 days at the elbow, no statistical change in wrist joint position error was observed. These findings suggest that pain and hyperalgesia lasting as long as 4 days does not impair JPS.
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.GAITPOST.2022.02.004
Abstract: The Sensory Organisation Test (SOT) of computerised dynamic posturography (CDP) is a well-established clinical test used to measure postural control. Advances in technology have enabled new CDP systems to use immersive virtual reality, such as the Bertec® Balance Advantage®. While the Bertec provides an innovative approach to posturography, the reliability and learning effects of the Bertec in administering the SOT has not been thoroughly investigated. To evaluate the reliability and performance during repeated administration of the Bertec® Balance Advantage® SOT. Fourteen healthy adults (age 27.17 ± 5.5years 10 females) participated. Each participant performed five SOTs over three sessions. The first two sessions were approximately two days apart and the third one month later. In the first two sessions, two SOTs were conducted, and in the third session, one was performed. Composite, equilibrium, and ratio scores were used for analysis. Poor within-session reliability was found in the first session for the composite score (ICC: 0.73, 95% CI: 0.32-0.91), which improved by the second session (ICC: 0.84, 95% CI: 0.58-0.94). Poor within-session reliability (ICC <0.5) was found for all ratio and equilibrium scores, except for the equilibrium score of condition 3, which demonstrated moderate reliability (ICC: 0.84, 95% CI: 0.57-0.95). Poor between-session reliability was found for all outcomes. There was an increase in the composite and equilibrium scores for conditions 5 and 6 over the 5 tests, which plateaued after the fourth test, and were retained at 1 month. The data demonstrate a steady increase in performance with repeated exposure to the Bertec SOT, which was maintained one month later, indicating a learning effect. We recommend that a minimum of two familiarisation sessions should be administered to establish baseline performance and improve reliability.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-07-2019
DOI: 10.1097/J.PAIN.0000000000001656
Abstract: Repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex (M1) is increasingly being investigated as a means of alleviating chronic pain. However, rTMS interventions are typically initiated once pain has already become chronic and maladaptive patterns of neural activity are likely to have been established. A critical question is whether M1 rTMS applied soon after pain onset can prevent the development of maladaptive neural activity and promote recovery. This study investigated the effect of 5 consecutive days of excitatory M1 rTMS on pain, functional limitation, mechanical hyperalgesia, descending inhibitory pain control, and M1 organisation in the transition from acute to sustained pain. Thirty healthy participants attended 8 sessions over a 16-day period. On days 0, 2, and 4, nerve growth factor was injected into the right forearm to induce progressively developing muscle soreness and mechanical hyperalgesia. Active or sham excitatory rTMS was delivered on days 4 to 8. Clinical and neurophysiological outcomes were recorded on days 0, 2, 4, 6, 8, 11, and 14. Active rTMS promoted recovery of muscle soreness, pain, and mechanical hyperalgesia when compared with sham rTMS (all between-group P 0.05). Corticomotor excitability and descending inhibitory pain control did not differ between groups. These findings suggest that active excitatory M1 rTMS promotes recovery of muscle soreness, pain, and mechanical hyperalgesia in the transition from acute to sustained experimental pain. The analgesic effects of M1 rTMS do not seem to be modulated by descending inhibitory pain control or local changes in corticomotor excitability.
Publisher: Springer Science and Business Media LLC
Date: 20-06-2020
Publisher: BMJ
Date: 08-2022
DOI: 10.1136/BMJOPEN-2021-058928
Abstract: Repetitive transcranial magnetic stimulation (rTMS), a form of non-invasive brain stimulation, is a novel avenue for the management of chronic musculoskeletal pain. Despite evidence for the effectiveness of rTMS in chronic pain conditions, the clinical uptake of rTMS remains limited and little is known regarding patient perceptions of this therapeutic technique. Qualitative study using a phenomenological approach, reported in accordance with the Consolidated criteria for Reporting Qualitative research checklist. Sydney, Australia. Fifteen participants were recruited from the community and completed the study. All participants had a diagnosis of chronic musculoskeletal pain, a history of seeking treatment and no prior experience with rTMS. All participants completed a semistructured interview to explore overall knowledge, preconceived concerns and attitudes regarding rTMS as a treatment for chronic musculoskeletal pain. The interviews were transcribed verbatim and analysed thematically. The key themes that influenced an in idual’s hypothetical acceptance of rTMS for chronic pain management were (1) the in idual’s initial impression of the equipment appearance, (2) the participant’s in idual history and familiarity with technology, (3) the accessibility and availability of rTMS and (4) knowledge regarding pain physiology and rTMS. This was the first qualitative study to explore the perception of rTMS as a treatment among people with chronic musculoskeletal pain. RTMS appears to be accepted as a treatment option among in iduals with chronic musculoskeletal pain. Developing targeted strategies to address accessibility, funding support and medical endorsements may encourage use of rTMS in a clinical chronic pain setting.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-04-2021
DOI: 10.1097/J.PAIN.0000000000002308
Abstract: Exercise and pain neuroscience education (PNE) have both been used as standalone treatments for chronic musculoskeletal pain. The evidence supporting PNE as an adjunct to exercise therapy is growing but remains unclear. The aim of this systematic review and meta-analysis was to evaluate the effect of combining PNE and exercise for patients with chronic musculoskeletal pain, when compared with exercise alone. A systematic search of electronic databases was conducted from inception to November 6, 2020. A quality effects model was used to meta-analyze outcomes where possible. Five high-quality randomized controlled studies (n = 460) were included in this review. The PEDro scale was used to assess the quality of in idual studies, and Grading of Recommendations, Assessment, Development, and Evaluation analysis was conducted to determine the quality of evidence for each outcome. Meta-analyses were performed for pain intensity, disability, kinesiophobia, and pain catastrophizing using data reported between 0 and 12 weeks postintervention. Long-term outcomes ( weeks) were only available for 2 studies and therefore were not suitable for meta-analysis. Meta-analysis revealed a significant difference in pain (weighted mean differences, −2.09/10 95% confidence interval [CI], −3.38 to −0.80 low certainty), disability (standardized mean difference, −0.68 95% CI, −1.17 to −0.20 low certainty), kinesiophobia (standardized mean difference, −1.20 CI, −1.84 to −0.57 moderate certainty), and pain catastrophizing (weighted mean differences, −7.72 95% CI, −12.26 to −3.18 very low certainty) that favoured the combination of PNE and exercise. These findings suggest that combining PNE and exercise in the management of chronic musculoskeletal pain results in greater short-term improvements in pain, disability, kinesiophobia, and pain catastrophizing relative to exercise alone.
Publisher: SAGE Publications
Date: 10-12-2020
Abstract: Medication errors often occurred due to the breach of medication rights that are the right patient, the right drug, the right time, the right dose and the right route. The aim of this study was to develop a medication-rights detection system using natural language processing and deep neural networks to automate medication-incident identification using free-text incident reports. We assessed the performance of deep neural network models in classifying the Advanced Incident Reporting System reports and compared the models' performance with that of other common classification methods (including logistic regression, support vector machines and the decision-tree method). We also evaluated the effects on prediction outcomes of several deep neural network model settings, including number of layers, number of neurons and activation regularisation functions. The accuracy of the models was measured at 0.9 or above across model settings and algorithms. The average values obtained for accuracy and area under the curve were 0.940 (standard deviation: 0.011) and 0.911 (standard deviation: 0.019), respectively. It is shown that deep neural network models were more accurate than the other classifiers across all of the tested class labels (including wrong patient, wrong drug, wrong time, wrong dose and wrong route). The deep neural network method outperformed other binary classifiers and our default base case model, and parameter arguments setting generally performed well for the five medication-rights datasets. The medication-rights detection system developed in this study successfully uses a natural language processing and deep-learning approach to classify patient-safety incidents using the Advanced Incident Reporting System reports, which may be transferable to other mandatory and voluntary incident reporting systems worldwide.
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.BBR.2017.01.016
Abstract: Peripheral electrical stimulation (PES) modulates corticomotor excitability but its effect on motor performance has not been thoroughly investigated. The purpose of this study was to assess whether increases and/or decreases in corticomotor excitability, induced by PES, influenced motor performance using a visuomotor adaptation task. Three PES interventions (motor stimulation, sensory stimulation or sham) were delivered to the first dorsal interosseous (FDI) in 30 healthy participants matched for age, gender and handedness. Motor stimulation was applied to increase corticomotor excitability, sensory stimulation to decrease corticomotor excitability, while sham stimulation acted as a control. Corticomotor excitability was assessed using the litude of motor evoked potentials to transcranial magnetic stimulation recorded from FDI before and after each intervention. Following PES, participants completed a visuomotor adaptation task. This required participants to move a cursor accurately towards virtual targets with index finger movements when the cursor trajectory was rotated 30° counter clockwise. Performance was assessed as angular error (a measure of movement accuracy) and reaction time. The rate of visuomotor adaptation was greater following motor PES compared to sham, but not sensory, with no difference observed between sensory and sham. However, visuomotor adaptation performance overall (the total change in performance from beginning to end) was similar across intervention groups. These findings suggest that motor PES applied prior to task acquisition can facilitate the speed of adaptation.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Wiley
Date: 28-09-2020
DOI: 10.1002/EJP.1657
Publisher: BMJ
Date: 2023
DOI: 10.1136/BMJOPEN-2022-066634
Abstract: Concussion is a form of mild traumatic brain injury that disrupts brain function. Although symptoms are mostly transient, recovery can be delayed and result in persistent postconcussive symptoms (PPCS). Vestibular and oculomotor dysfunction are among the most debilitating impairments associated with PPCS. However, pharmacological interventions for these impairments are associated with deleterious side effects. Accordingly, increasing research has examined the utility of non-pharmacological interventions for PPCS. The aim of this review is to synthesise and evaluate the effectiveness of non-pharmacological interventions for the treatment of vestibular and oculomotor dysfunction for patients with PPCS. Systematic searches of MEDLINE, PubMed, Web of Science and Scopus will identify randomised controlled trials employing non-pharmacological treatments for vestibular and/or oculomotor dysfunction for PPCS. Such interventions may include, but are not limited to, vestibular rehabilitation, optokinetic stimulation and vestibulo-ocular reflex exercises. Assessments of oculomotor function will include versional eye movements, vergence eye movements, visual-fixation movements and accommodation response. Assessments of vestibular function will include the Fukuda Step test, functional balance tests, force displacement tests, and subjective reports of balance disruption or vertigo. Where appropriate, meta-analyses of standardised mean differences will be conducted using a random effects model for continuous outcomes. For dichotomous outcomes (improved vs not improved following treatment), effects will be expressed as relative risk. The impact of heterogeneity will be calculated using the I 2 statistic. The Physiotherapy Evidence Database scale will be used to determine the methodological quality of in idual studies and Grading of Recommendations, Assessment, Development and Evaluations used to assess the certainty and quality of evidence for each outcome. Ethical approval is not required for this review. Findings will be disseminated through peer-reviewed publications and conference presentations. CRD42021254720.
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1111/NER.13461
Abstract: To synthesize and critically appraise literature exploring patient perceptions regarding the therapeutic use of noninvasive brain stimulation. A systematic search of CINHAL, PUBMED, Web of Science, and Medline was performed. Reference lists of relevant articles were also screened. Studies exploring participant perceptions regarding the therapeutic use of noninvasive brain stimulation were eligible for inclusion. Perceptions were ided into three domains: knowledge, experience, and attitudes. Noninvasive brain stimulation was defined as any neuromodulation technique that alters brain activity but does not require invasive methods such as surgery. No restrictions were placed upon study design or participant population. Two reviewers performed data extraction and risk of bias assessment. Data relating to methodological characteristics, participant demographics, type of noninvasive brain stimulation, and nature of perceptions (knowledge, experience, or attitudes) were extracted. Four studies comprising data from 163 participants met the inclusion criteria. All studies investigated perceptions of repetitive transcranial magnetic stimulation (rTMS) in psychiatric populations. Most participants perceived rTMS to be safe and beneficial, demonstrated low-levels of fear, and were willing to recommend the intervention to others. No studies were found investigating patient perception of transcranial direct current stimulation (tDCS). The findings from this review suggest that rTMS is well accepted as a therapeutic treatment among psychiatric populations, providing support for its clinical utility. Future work is needed to determine if similar findings exist for other conditions (e.g., chronic pain) and for other therapeutic forms of brain stimulation (e.g., tDCS).
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.MSKSP.2018.09.007
Abstract: To explore the type of exercise prescribed by Australian health professionals for LBP, and whether the exercises prescribed are pain-free or into pain. A survey of physiotherapists and exercise physiologists was conducted from all states/territories in Australia. The survey contained two chronic LBP vignettes with different pain mechanisms (dominant nociceptive or central sensitisation pain) and one acute LBP vignette. Respondents were asked if they would prescribe advice to stay active and exercise. If exercise was prescribed, respondents were asked to specify the type and pain provoking nature (exercise with no pain, exercise to the start of pain, exercise with pain at a tolerable level or exercise irrespective of pain). The response rate was 17%(218/1276). Most respondents prescribed advice to stay active(≥95%) and exercise(≥90%) for all vignettes. Irrespective of the vignette, several exercises were prescribed [aerobic (57-85% of clinicians), motor control (62-84% of clinicians), range of motion (72-75% of clinicians)]. Strengthening exercise was prescribed more for chronic(>60%) than acute LBP(23%). Irrespective of the exercise, between 20 and 25% of respondents prescribed pain-free exercise, between 71 and 79% of respondents prescribed exercise into pain, and ≤4% prescribed exercise irrespective of pain for acute and chronic LBP. Several exercises are prescribed for LBP, irrespective of pain mechanism or duration, with more clinicians prescribing strengthening exercise for chronic than acute LBP. Most clinicians prescribed exercise into pain for acute and chronic LBP, irrespective of the exercise. Further research should determine which exercises are beneficial based on pain mechanism and duration, and whether exercise into pain should be prescribed for LBP.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-05-2019
DOI: 10.1097/J.PAIN.0000000000001604
Abstract: Musculoskeletal pain is associated with altered motor control that, despite short-term benefit, is hypothesised to have long-term consequences, contributing to the development of chronic pain. However, data on how motor control is altered when pain is sustained beyond a transient event are scarce. Here, we investigated motor adaptation, and its relationship with corticomotor excitability, in the transition to sustained muscle pain. Twenty-eight healthy in iduals were injected with nerve growth factor into the right extensor carpi radialis brevis muscle on days 0 and 2. Motor adaptation and corticomotor excitability were assessed on day −2, before injection on days 0 and 2, and again on days 4 and 14. Motor adaptation was quantified during a radial–ulnar movement as kinematic variability of wrist flexion–extension and pronation–supination, and as electromyographic (EMG) variability of extensor carpi radialis brevis activity. Pain, muscle soreness, and functional limitation were assessed from days 0 to 14. Pain, muscle soreness, and functional limitation were evident at days 2 and 4 ( P 0.001). Electromyographic variability reduced at days 4 and 14 ( P 0.04), with no change in kinematic variability ( P = 0.9). However, data revealed variation in EMG and kinematic variability between in iduals: some displayed increased motor variability, whereas others a decrease. In iduals who displayed an increase in EMG variability after 4 days of pain also displayed an increase in corticomotor excitability ( r = 0.43, P = 0.034). These findings suggest in idual adaptation of the motor system in the transition to sustained pain that could have implications for clinical musculoskeletal pain disorders.
Publisher: Oxford University Press (OUP)
Date: 27-12-2021
DOI: 10.1093/PM/PNAA425
Abstract: Although acute pain has been shown to reduce corticomotor excitability, it remains unknown whether this response resolves over time or is related to symptom severity. Furthermore, acute pain research has relied upon data acquired from the cranial “hotspot,” which do not provide valuable information regarding reorganization, such as changes to the distribution of a painful muscle’s representation within M1. Using a novel, rapid transcranial magnetic stimulation (TMS) mapping method, this study aimed to 1) explore the temporal profile and variability of corticomotor reorganization in response to acute pain and 2) determine whether in idual patterns of corticomotor reorganization are associated with differences in pain, sensitivity, and somatosensory organization. Corticomotor (TMS maps), pain processing (pain intensity, pressure pain thresholds), and somatosensory (two-point discrimination, two-point estimation) outcomes were taken at baseline, immediately after injection (hypertonic [n = 20] or isotonic saline [n = 20]), and at pain resolution. Follow-up measures were recorded every 15 minutes until 90 minutes after injection. Corticomotor reorganization persisted at least 90 minutes after pain resolution. Corticomotor depression was associated with lower pain intensity than was corticomotor facilitation (r = 0.47 [P = 0.04]). These effects were not related to somatosensory reorganization or peripheral sensitization mechanisms. In idual patterns of corticomotor reorganization during acute pain appear to be related to symptom severity, with early corticomotor depression possibly reflecting a protective response. These findings hold important implications for the management and potential prevention of pain chronicity. However, further research is required to determine whether these adaptations relate to long-term outcomes in clinical populations.
Publisher: Elsevier BV
Date: 2023
DOI: 10.1016/J.APERGO.2022.103891
Abstract: To optimise fit and protection of body armour systems, knowledge of the location of thoracoabdominal organ boundaries is required. The aims of this study were (i) determine the effect of sex on essential and desirable thoracoabdominal organ boundaries, and (ii) compare essential thoracoabdominal organ boundaries with small and large hard ballistic plate sizes from the National Institute of Justice (NIJ) and determine if coverage requirements differ between sexes. 33 males and 33 females underwent supine magnetic resonance imaging of their thoracoabdominal organs. Male participants on average displayed more laterally and inferiorly positioned essential and desirable organ boundaries than females. Based on NIJ plate sizes, insufficient coverage of essential organs was identified for male and female participants. A greater range of body armour sizes and designs that better cater to the erse anatomy of soldier populations is warranted, but must be considered in the context of ergonomic and performance implications.
Publisher: Cambridge University Press (CUP)
Date: 07-02-2017
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.SPINEE.2021.11.013
Abstract: Low back pain is a major cause of morbidity and disability worldwide and is responsible for vast societal impact. Rates of surgical intervention for lumbar spine disorders continue to rise but poor outcomes remain common. Understanding how the social determinants of health (SDH) influence spinal surgical outcomes stands to inform appropriately tailored care practices and lead to better patient outcomes. To determine the relationships between the SDH and pain, opioid use, disability and work absenteeism following lumbar spine surgery. Systematic review and narrative synthesis. We searched Embase, the Cochrane Library, Medline, and Web of Science from inception to April 21, 2020. Studies eligible for inclusion involved participants receiving lumbar spine surgery and investigated the relationship between at least one SDH and post-surgical pain, opioid use, disability or work absenteeism. We evaluated the risk of bias of included studies and used the PROGRESS-Plus framework to organize a narrative synthesis of findings. Relevant data was extracted from twenty-three studies involving 30,987 adults from 12 countries. A total of 107 relationships between the SDH and post-surgical outcomes were evaluated, 67 in multivariate analyses. Education was investigated in 23 analyses (14 studies): 70% revealed significant independent relationships between lower education and poorer outcomes. Socioeconomic status was investigated in nine analyses (four studies): 67% revealed independent relationships between lower socioeconomic status and poorer outcomes. Gender was investigated in 40 analyses (22 studies): indications that male versus female sex was associated with poorer outcomes were equivocal. Place of residence, race/ethnicity, and social capital were infrequently investigated. Low educational attainment and low-income status are clear independent contributors to poorer outcomes following lumbar spine surgery. Occupational factors and work context are likely to be influential. Further research is critical to guide best-practice spinal surgery through a health equity lens. PROSPERO registration number CRD42015015778.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Wiley
Date: 11-04-2023
DOI: 10.1002/BRB3.2996
Abstract: Increasing evidence suggests that pain drives maladaptive corticomotor changes that may increase susceptibility to injury and promote symptom recurrence. However, few studies have evaluated the influence of interin idual corticomotor responses to musculoskeletal pain. Existing research in this area has also been limited largely to the upper limb. This is a pertinent point, given the functional and neurophysiological differences between upper and lower limb muscles, as well as the fact that most acute sporting injuries occur in the lower limb. Accordingly, this study explored the variability of corticomotor responses to experimentally‐induced sustained hamstring pain and whether specific patterns of corticomotor reorganization were associated with poorer outcomes (mechanical sensitivity, pain, or functional limitation). Thirty‐six healthy in iduals participated. Following random allocation on Day 0, the experimental group performed an eccentric exercise protocol of the right hamstring muscles to induce delayed onset muscle soreness. The control group performed repetition‐matched concentric exercise that did not induce soreness. Measures of mechanical sensitivity, pain, function, and corticomotor organization were collected at baseline and on Day 2. Corticomotor responses to sustained hamstring pain were variable. In iduals who developed corticomotor facilitation in response to hamstring pain experienced greater mechanical sensitivity than those who developed corticomotor depression. These novel data could have implications for rehabilitation following lower limb pain or injury.
Publisher: Elsevier BV
Date: 03-2021
DOI: 10.1016/J.JPAIN.2020.08.004
Abstract: Exercise-induced hypoalgesia (EIH) describes acute reductions in pain that occur following exercise. Current evidence suggests that the magnitude of EIH is small-to-moderate at best, warranting exploration of novel avenues to bolster these effects. Transcranial direct current stimulation (tDCS) has been shown to relieve pain and represents a promising intervention that may enhance EIH. This study aimed to determine whether anodal tDCS of the primary motor cortex (M1) can augment EIH in healthy in iduals experiencing experimentally-induced musculoskeletal pain. Twenty-four healthy subjects attended 2 experimental sessions ("Day 0" and "Day 2"). On Day 0, subjects were injected with nerve growth factor into their right extensor carpi radialis brevis to induce persistent elbow pain. On Day 2, each subject received active or sham tDCS over M1 followed by an isometric grip exercise. Pain intensity, muscle soreness, sensitivity (pressure pain thresholds), and conditioned pain modulation were assessed prior to the nerve growth factor injection, on Day 2 before tDCS, immediately post-exercise, and 15 minutes post-exercise. Active tDCS expedited the onset of EIH, inducing immediate reductions in pain intensity that were not present until 15 minutes post-exercise in the sham group. However, active tDCS did not reduce muscle soreness or sensitivity when compared to sham tDCS. PERSPECTIVE: These findings suggest that active tDCS accelerates the onset of EIH in healthy in iduals experiencing experimentally-induced pain. This may represent a promising means of enhancing adherence to exercise protocols. However, larger randomised controlled trials in persistent pain populations are required to confirm the clinical impact of these findings.
Publisher: Elsevier BV
Date: 04-2023
Publisher: Frontiers Media SA
Date: 24-09-2021
DOI: 10.3389/FPSYG.2021.738519
Abstract: To complement and enhance readiness-monitoring capability, the Acute Readiness Monitoring Scale (ARMS) was developed: a widely applicable, simple psychometric measure of perceived readiness. While this tool may have widespread utility in sport and military settings, it remains unknown if the ARMS demonstrates predictive and concurrent validity. Here, we investigated whether the ARMS is: (1) responsive to an acute manipulation of readiness using sleep deprivation, (2) relates to biological markers of readiness [cortisol/heart-rate variability (HRV)], and (3) predicts performance on a cognitive task. Thirty young adults (aged 23 ± 4 years 18 females) participated. All participants engaged in a 24-h sleep deprivation protocol. Participants completed the ARMS, biological measures of readiness (salivary cortisol, HRV), and cognitive performance measures (psychomotor vigilance task) before, immediately after, 24-, and 48-h post-sleep deprivation. All six of the ARMS subscales changed in response to sleep deprivation: scores on each subscale worsened (indicating reductions in perceived readiness) immediately after sleep deprivation, returning to baseline 24/48 h post. Lower perceived readiness was associated with reduced awakening responses in cortisol and predicted worse cognitive performance (slower reaction time). No relationship was observed between the ARMS and HRV, nor between any biological markers of readiness (cortisol/HRV) and cognitive performance. These data suggest that the ARMS may hold practical utility in detecting, or screening for, the wide range of deleterious effects caused by sleep deprivation may constitute a quick, cheap, and easily interpreted alternative to biological measures of readiness and may be used to monitor or mitigate potential underperformance on tasks requiring attention and vigilance.
Publisher: Wiley
Date: 16-01-2023
DOI: 10.1002/MSC.1734
Abstract: Intensity is an important determinant of physiological adaptations and health benefits of exercise, but the role of exercise intensity on improving outcomes in people with chronic low back pain (CLBP) is unclear. This systematic review aimed to determine the effect of higher versus lower intensity exercise intensity on pain, disability, quality of life and adverse events in people with CLBP. Six databases and four clinical trial registries were searched from inception to 21 December 2022, for randomised controlled trials that compared two or more exercise intensities in adults with CLBP. Data were analysed using random‐effects meta‐analysis for disability and synthesised narratively for pain, quality of life and adverse events due to limited studies. Risk of bias was assessed using the Cochrane tool and certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluations framework. Four trials ( n = 214 participants, 84% male) reported across five studies were included. Higher intensity exercise reduced disability more than lower intensity exercise at end‐treatment (SMD [95% CI] = −0.39 [−0.56 to −0.22] very low certainty) but not at 6‐month follow‐up (SMD [95% CI] = −0.20 [−0.53 to 0.13] very low certainty). Higher intensity exercise did not reliably improve pain and quality of life more than lower intensity exercise. Adverse events did not differ between exercise intensities. All studies were at high risk of bias. Based on very low certainty evidence from a limited number of studies, exercise intensity does not appear to meaningfully influence clinical outcomes in people with CLBP.
Publisher: American Physiological Society
Date: 10-2019
Abstract: Heightened pain sensitivity, the amount of pain experienced in response to a noxious event, is a known risk factor for development of chronic pain. We have previously reported that pain-free, sensorimotor peak alpha frequency (PAF) is a reliable biomarker of pain sensitivity for thermal, prolonged pains lasting tens of minutes. To test whether PAF can provide information about pain sensitivity occurring over clinically relevant timescales (i.e., weeks), EEG was recorded before and while participants experienced a long-lasting pain model, repeated intramuscular injection of nerve growth factor (NGF), that produces progressively developing muscle pain for up to 21 days. We demonstrate that pain-free, sensorimotor PAF is negatively correlated with NGF pain sensitivity increasingly slower PAF is associated with increasingly greater pain sensitivity. Furthermore, PAF remained stable following NGF injection, indicating that the presence of NGF pain for multiple weeks is not sufficient to induce the PAF slowing reported in chronic pain. In total, our results demonstrate that slower pain-free, sensorimotor PAF is associated with heightened sensitivity to a long-lasting musculoskeletal pain and also suggest that the apparent slowing of PAF in chronic pain may reflect predisease pain sensitivity. NEW & NOTEWORTHY Pain sensitivity, the intensity of pain experienced after injury, has been identified as an important risk factor in the development of chronic pain. Biomarkers of pain sensitivity have the potential to ease chronic pain burdens by preventing disease emergence. In the current study, we demonstrate that the speed of pain-free, sensorimotor peak alpha frequency recorded during resting-state EEG predicts pain sensitivity to a clinically-relevant, human model of prolonged pain that persists for weeks.
Start Date: 2018
End Date: 2022
Funder: Japan Society for the Promotion of Science
View Funded Activity