ORCID Profile
0000-0001-9068-0641
Current Organisations
Aalborg University
,
University College of Northern Denmark
,
Professionshøjskolen UCN
,
Aalborg Universitet
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Publisher: Aalborg University Press
Date: 2017
Publisher: Wiley
Date: 29-05-2017
DOI: 10.1111/SMS.12905
Abstract: Delayed onset muscle soreness (DOMS) occurs within 1‐2 days after eccentric exercise, but the mechanism mediating hypersensitivity is unclear. This study hypothesized that eccentric exercise reduces the blood flow response following muscle contractions and cuff occlusion, which may result in accumulated algesic substances being a part of the sensitization in DOMS. Twelve healthy subjects (five women) performed dorsiflexion exercise (five sets of 10 repeated eccentric contractions) in one leg, while the contralateral leg was the control. The maximal voluntary contraction (MVC) of the tibialis anterior muscle was recorded. Blood flow was assessed by ultrasound Doppler on the anterior tibialis artery (ATA) and within the anterior tibialis muscle tissue before and immediately after 1‐second MVC, 5‐seconds MVC, and 5‐minutes thigh cuff occlusion. Pressure pain thresholds (PPTs) were recorded on the tibialis anterior muscle. All measures were done bilaterally at day 0 (pre‐exercise), day 2, and day 6 (post‐exercise). Subjects scored the muscle soreness on a Likert scale for 6 days. Eccentric exercise increased Likert scores at day 1 and day 2 compared with day 0 ( P .001). Compared with pre‐exercise (day 0), reduced PPT (~25%, P .002), MVC (~22%, P .002), ATA diameter (~8%, P .002), ATA post‐contraction/occlusion blood flow (~16%, P .04), and intramuscular peak blood flow (~23%, P .03) were found in the DOMS leg on day 2 but not in the control leg. These results showed that eccentric contractions decreased vessel diameter, impaired the blood flow response, and promoted hyperalgesia. Thus, the results suggest that the blood flow reduction may be involved in the increased pain response after eccentric exercise.
Publisher: Oxford University Press (OUP)
Date: 22-02-2018
DOI: 10.1093/PM/PNY015
Abstract: To investigate if attention to additional sensory information from the fingertip can improve postural stability during pain, which is known to impair balance. In 16 healthy volunteers, experimental pain was induced by intramuscular injection of hypertonic saline in the right vastus medialis muscle (isotonic saline used as nonpainful control, intramuscular injection in the same location). Pain intensity was assessed on an 11-point numeric rating scale (NRS 0 representing "no pain" and 10 "maximum pain"). Subjects were asked to stand as still as possible on a force plate for 40 seconds with their eyes closed. Their postural stability was quantified by the area and velocity of center of pressure (CoP) displacement. The CoP was recorded with and without pain during two different conditions: 1) no touch and 2) the subjects were asked to lightly touch a curtain with their right index finger and focus their attention on keeping it as still as possible. Hypertonic injections induced higher NRS scores compared with control injections (P < 0.05). During the hypertonic injection condition, the CoP area and velocity in both directions increased during no touch compared with the light touch condition (P < 0.05). No differences were found during light touch between the hypertonic and isotonic injection conditions. Although experimental knee-related pain impaired postural stability, lightly touching a curtain with the fingertip decreased postural sway during painful conditions. Providing additional sensory information while pain patients are performing balance exercises may improve postural stability and increase the quality of exercise, consequent rehabilitation protocols, and clinical outcomes.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.JBMT.2019.02.004
Abstract: To determine intra- and interrater reliability of ultrasonographic imaging (USI) measurements of patellar tendon (PT) thickness using 16 measurement sites covering the entire tendon. Reliability study. Physiotherapy outpatient clinic. Twenty healthy and physically active volunteers (9 women). Mean age: 24 years (SD ± 2.73). Mean body mass: 75.8 kg (SD ± 11.8). Intraclass correlation coefficient (ICC) and 95% limits of agreement (LOA) in cm and in percentage relative to the mean PT thickness. Intrarater reliability ranged from 0.59 to 0.87 and 0.59 to 0.93 for examiners I and II, respectively. Interrater reliability ranged from 0.37 to 0.89. Measurement precision for examiner I ranged from 0.05 to 0.09 cm (17.5%-26.7%) while ranging from 0.04 to 0.13 cm (13.3%-38.7%) for examiner II. Interrater measurement precision ranged from 0.07 to 0.15 cm (19.1%-42.5%). In an attempt to replicate daily clinical USI practice, this was the first study extensively assessing reliability throughout the full range of the patellar tendon - revealing a considerable variation in intra- and interrater reliability as well as measurement precision throughout the 16 in idual PT sites. In a clinical context, the low interrater reliability and precision found at the proximal tendon insertion site may have implications for USI of the symptomatic PT, as this is the site mainly associated with underlying pathologic changes. Further reliability studies are needed to clarify the region-specific reliability of the full length PT.
Publisher: Elsevier BV
Date: 2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 23-02-2021
DOI: 10.1097/AJP.0000000000000927
Abstract: Altered balance in nociception in response to noxious stimuli is commonly reported in chronic low back pain (LBP). However, it is unclear whether an improvement in the clinical presentation is contingent on a reduction in pain sensitivity. This study investigated whether the quantitative sensory testing (QST) profile changes in people undergoing rehabilitation for LBP. A prospective, observational case-control study. Forty males and females, 18 to 40 years’ old (20 with LBP) participated in 2 sessions. QST was performed at baseline and after discharge from rehabilitation (LBP) or after 3 to 8 weeks (controls). The QST battery consisted of determining pressure-pain thresholds at the low back and shoulder, temporal summation of pain, and conditioned pain modulation. Questionnaire data was used to determine pain (Numeric Rating Scale [NRS]), disability (Roland-Morris Questionnaire [RMQ]), Fear Avoidance Beliefs (FABQ), and The Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) at baseline and discharge. The treatment effect was determined by calculating the Cohen d . No significant group×time interactions or main factor effect was found for any of the QST measures. The LBP group reported a significant reduction in NRS ( P .0002, d =1.23), RMQ ( P .0001, d =1.58), FABQ ( P .001, d =0.87), and in the ÖMPSQ ( P .00001, d =1.44). The results indicate that an improvement of clinical LBP is not contingent upon changes in the pain sensory profile. The value of screening pain sensitivity in LBP patients in primary care, needs to be investigated further, due to the patient population heterogeneity and the sensitivity of assessment methods.
Publisher: Elsevier BV
Date: 07-2023
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.MSKSP.2017.02.010
Abstract: With conflicting evidence regarding the effectiveness of manual therapy calls have arisen within some quarters of the physiotherapy profession challenging the continued use of manual skills for assessment and treatment. A reconceptualisation of the importance of manual examination findings is put forward, based upon a contemporary understanding of pain science, rather than considering these skills only in terms of how they should "guide" manual therapy interventions. The place for manual examination findings within complex, multidimensional presentations is considered using vignettes describing the presentations of five people with low back pain. As part of multidimensional, in idualised management, the balance of evidence relating to the effectiveness, mechanisms of action and rationale for manual skills is discussed. It is concluded that if manual examination and therapeutic skills are used in a manner consistent with a contemporary understanding of pain science, multidimensional patient profiles and a person-centred approach, their selective and judicious use still has an important role.
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.JPAIN.2015.01.008
Abstract: Clinical neck pain affects pain sensitivity and coordination of neck muscles, but the impact on the shoulder muscles is unclear. This study investigated the effect of experimental neck pain on the activity of the axioscapular muscles during arm movements and changes in pain sensitivity. Experimental neck pain was induced in 24 healthy volunteers by injecting hypertonic saline into the splenius capitis. Isotonic saline was injected as control. Before, during, and after injections, electromyography was recorded bilaterally from 8 muscles during standardized arm movements (140° scapular plane elevation), and the root mean square litude was extracted. Likewise, pressure pain thresholds were assessed bilaterally on 3 sites. The root mean square electromyography was decreased for the ipsilateral upper trapezius (P < .01) and increased for the ipsilateral middle deltoid (P < .03) during upward movements. The root mean square electromyography was reduced for the ipsilateral upper trapezius (P < .01) during downward movement, whereas an increase was recorded in the contralateral external oblique (P < .02). At the injection site, the pressure pain threshold increased during pain compared with the post condition (5 minutes after potential pain had subsided P < .03). In this study, trunk and axioscapular muscle activities were reorganized in response to localized and referred pain evoked by hypertonic saline injection into an intrinsic neck muscle with no direct attachments to the trunk or shoulder girdle. Reorganized activity of the axioscapular muscles has been shown previously in neck pain patients and is believed to happen during the transition from acute to chronic pain. The present study demonstrates for the first time that such reorganization may happen acutely, adding to our understanding of the effects of acute neck pain.
Publisher: Walter de Gruyter GmbH
Date: 04-12-2019
Abstract: Assessing personality in research can be of importance, especially due to the potential relationship between different personality traits and the manifestation of symptoms in different clinical conditions. Therefore, it is important to have valid and reliable tools that allow for the assessment of personality traits. In this study, the aim was to translate and culturally adapt the Big Five Inventory (BFI) to the Danish language. A dual panel approach, consisting of a 4-person bilingual panel and an 8-person panel with laymen, was used to translate and culturally adapt the questionnaire. A third 9-person panel consisting of people with different medical diagnosis was used to assess the face validity. Internal consistency (Cronbach’s α) and test-retest reliability (intraclass correlation coefficients (ICC)) were tested amongst 96 subjects. The translated version demonstrated adequate internal consistency (0.66–0.84) and good-excellent test-retest reliability (0.86–0.95). The smallest detectable change is between 1.13–1.70 for the five subscales. Both the healthy and patient panels of laymen considered the questionnaire too long. This translated version of the Big Five Inventory demonstrated high to very high test-retest reliability and, for most parts, an acceptable internal consistency. The construct validity was however different from versions translated into languages geographically and culturally similar to Danish. Assessing the Big Five personality traits in Danish populations can be valuable for many reasons, e.g. when assessing people in pain in both clinical and experimental settings. Improved knowledge of the underlying driver of pain conditions is important. Here, understanding how personality may interact with pain can help researchers and clinicians.
Publisher: Springer Science and Business Media LLC
Date: 16-03-2020
Publisher: Informa UK Limited
Date: 08-04-2023
Publisher: Oxford University Press (OUP)
Date: 24-08-2016
DOI: 10.1093/PM/PNW168
Abstract: Cuff algometry is useful to assess pain sensitivity mechanisms, but effects of cuff position and stimulation pattern are not clear. In 20 healthy volunteers, cuff pain detection threshold (PDT) and pain tolerance (PTT) were recorded with cuffs accommodating two in idual chambers at four locations (eight positions) along the leg, using r inflation (1 kPa/s) until subjects indicated PDT and PTT. Repeated stimulations (1-s stimulation, 4-s break) with a staircase increase in stimulus intensity (5 kPa/step) were used to assess PDT and PTT on a single location. Spatial pain summation was calculated as the ratio between PTTs recorded with one chamber or simultaneously with two neighbor chambers. Temporal pain summation was assessed by repeated cuff stimulations (1-s stimulation, 1-s break) and the pain intensity was recorded on a visual analog scale (VAS) the PTT from r and staircase assessments were used as stimulus intensity. For the most distal cuff position, the PTT was higher compared with other leg positions except when in proximity to the knee ( P < 0.01). The PDT was higher for the distal part compared with the mid-portions of the lower and upper leg ( P < 0.01). Compared with other leg locations, the spatial summation ratio was highest at the proximal lower leg ( P < 0.02). The staircase versus r pattern revealed higher PDT and PTT (P < 0.01), as well as pronounced temporal pain summation ( P < 0.01). The mid-portion of the lower leg is recommended for cuff placement, and the staircase paradigm provides relevant stimulus intensity for assessment of temporal pain summation.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.JMPT.2022.03.003
Abstract: The purpose of this study was to investigate the effect of a posture-cueing shirt on sitting posture during a functional task. Thirty healthy male participants were seated at a standardized workstation while completing 3 laptop writing tasks of 15-minute duration wearing either a posture-cueing shirt, a compression shirt, or no shirt. Posture was assessed based on photos taken at minutes 1 and 15 into the writing task from which the head and shoulder angles were measured and extracted for analysis. After each task, participants rated any potential pain they felt during the task on an 11-point numeric rating scale (NRS). The results showed that none of the shirts significantly affected the head or shoulder angles at any time point. Participants reported lower pain levels after using the posture-cueing shirt (NRS 0 [0-1]) compared with no shirt (NRS 1 [0-2] P = .012). No significant difference in pain levels was observed between shirts. Although posture did not change in any conditions for these healthy male participants, the posture-cueing shirt resulted in a lower pain intensity compared with no shirt but not with a compression shirt. Although a significant difference was found for pain intensity favoring the posture-cueing shirt, this difference was negligible, and thus its value to reduce pain or improve posture in healthy participants remains in question.
Publisher: Walter de Gruyter GmbH
Date: 25-09-2019
Abstract: Neck pain can impair perception of cervical movement, but how this is affected by attention is unknown. In this study, the effects of experimental neck pain on head repositioning accuracy during standardized head movements were investigated. Experimental neck pain was induced by injecting hypertonic saline into the right splenius capitis muscle in 28 healthy participants (12 women). Isotonic saline was used as control. Participants were blindfolded while performing standardized head movements from neutral (start) to either right-rotation, left-rotation, flexion or extension, then back to neutral (end). Movements were triplicated for each direction, separated by 5-s, and performed with or without a cognitive task at baseline, immediately after the injection, and 5-min after pain disappeared. Repositioning accuracy was assessed by 3-dimensional recordings of head movement and defined as the difference between start and end position. Participants were grouped into most/least accurate based on a median split of head repositioning accuracy for each movement direction at baseline without the cognitive task. The most accurate group got less accurate following hypertonic injection during right-rotation without a cognitive task, compared with the least accurate group and the isotonic condition ( p 0.01). No group difference was found when testing head repositioning accuracy while the participants where distracted by the cognitive task. Experimental neck pain alters head repositioning accuracy in healthy participants, but only in those who are most accurate at baseline. Interestingly, this impairment was no longer present when a cognitive task was added to the head repositioning accuracy test. The results adds to our understanding of what factor may influence the head repositioning accuracy test when used in clinical practice and thereby how the results should be interpreted.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.JPAIN.2016.06.013
Abstract: Musculoskeletal pain is associated with multiple adaptions in movement control. This study aimed to determine whether changes in movement control acquired during acute pain are maintained over days of pain exposure. On day 0, the extensor carpi radialis brevis muscle of healthy participants was injected with nerve growth factor (NGF) to induce persistent movement-evoked pain (n = 13) or isotonic saline as a control (n = 13). On day 2, short-lasting pain was induced by injection of hypertonic saline into extensor carpi radialis brevis muscles of all participants. Three-dimensional force components were recorded during submaximal isometric wrist extensions on day 0, day 4, and before, during, and after saline-induced pain on day 2. Standard deviation (variation of task-related force) and total excursion of center of pressure (variation of force direction) were assessed. Maximal movement-evoked pain was 3.3 ± .4 (0-10 numeric scale) in the NGF-group on day 2 whereas maximum saline-induced pain was 6.8 ± .3 cm (10-cm visual analog scale). The difference in centroid position of force direction relative to day 0 was greater in the NGF group than in the control group (P < .05) on day 2 (before saline-induced pain) and day 4, reflecting changes in tangential force direction used to achieve the task. During saline-induced pain in both groups, tangential and task-related force variation was greater than before and after saline-induced pain (P < .05). Persistent movement-evoked pain changes force direction from the pain-free direction. Acute pain leads to increased variation in force direction irrespective of persistent movement-evoked pain preceding the acutely painful event. These differences provide novel insight into the search for and consolidation of new motor strategies in the presence of pain.
Publisher: Elsevier BV
Date: 08-2023
Publisher: Oxford University Press (OUP)
Date: 21-01-2015
Abstract: Primary motor cortical (M1) adaptation has not been investigated in the transition to sustained muscle pain. Daily injection of nerve growth factor (NGF) induces hyperalgesia reminiscent of musculoskeletal pain and provides a novel model to study M1 in response to progressively developing muscle soreness. Twelve healthy in iduals were injected with NGF into right extensor carpi radialis brevis (ECRB) on Days 0 and 2 and with hypertonic saline on Day 4. Quantitative sensory and motor testing and assessment of M1 organization and function using transcranial magnetic stimulation were performed prior to injection on Days 0, 2, and 4 and again on Day 14. Pain and disability increased at Day 2 and increased further at Day 4. Reorganization of M1 was evident at Day 4 and was characterized by increased map excitability. These changes were accompanied by reduced intracortical inhibition and increased intracortical facilitation. Interhemispheric inhibition was reduced from the "affected" to the "unaffected" hemisphere on Day 4, and this was associated with increased pressure sensitivity in left ECRB. These data provide the first evidence of M1 adaptation in the transition to sustained muscle pain and have relevance for the development of therapies that seek to target M1 in musculoskeletal pain.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Mary Ann Liebert Inc
Date: 08-2023
Publisher: Elsevier BV
Date: 10-2019
Publisher: Walter de Gruyter GmbH
Date: 10-05-2019
Abstract: The concept of bad posture being a dominant driver of pain is commonly held belief in the society. This may explain the significant attention supportive clothing such as posture-correcting shirts has recently gained in Scandinavia and the USA. The aim of this scoping review was to present an overview and synthesis of the available evidence for the use of posture-correcting shirts aimed at reducing pain or postural discomfort and optimising function osture. A systematic search was conducted for literature investigating the effect of posture-correcting shirts on musculoskeletal pain or function. PubMed, Embase, CINAHL, PEDro and the Cochrane Library were searched for relevant literature. Results of the searches were evaluated by two independent reviewers in three separate steps based on title, abstract and full text. For data synthesis, the population, intervention, comparator and outcome were extracted. The quality of the literature was evaluated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the risk of bias was assessed using the Risk Of Bias In Non-randomized Studies – of Interventions (ROBINS-I) assessment tool or the RoB 2.0 tool for in idually randomized, parallel group trials. The overall confidence in the literature was determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of 136 articles were identified and six of these were included in the review. These studies were heterogeneous with regards to aims, outcomes and methods, presenting contrasting results. The overall findings were that posture-correcting shirts change posture and subjectively have a positive effect on discomfort, energy levels and productivity. The quality of the included literature was poor to fair with only one study being of good quality. The risk of bias was serious or critical for the included studies. Overall, this resulted in very low confidence in available evidence. An important limitation of all studies was that they were conducted in pain-free in iduals. The contrasting findings and the low quality of current literature, questions the intended effect of posture-correcting shirts and whether the changes it creates are in fact useful for clinical practice. Moreover, the findings are contrasted by the available evidence regarding posture and pain with a particular focus on whether this management strategy may have a detrimental effect on people living with musculoskeletal pain. A major limitation to the existing literature on the effect of posture-correcting shirts is that no studies have investigated their effect in clinical populations. Based on the available literature and the major limitation of no studies investigating clinical populations, there is no good quality evidence to support recommendation of posture-correcting shirts as a management strategy for musculoskeletal pain. Promotion of this product may reinforce the inaccurate and unhelpful message that poor posture leads to pain. The efficacy of such garments should be tested in clinical populations and not only in pain-free in iduals, to assess whether there is any meaningful benefit of this management approach. Until then, the use of posture-correcting shirts for musculoskeletal pain is not supported by current evidence.
Publisher: BMJ
Date: 02-2020
DOI: 10.1136/BMJOPEN-2019-032668
Abstract: Musculoskeletal (MSK) pain is the primary contributor to disability worldwide. There is a growing consensus that MSK pain is a recurrent multifactorial condition underpinned by health and lifestyle factors. Studies suggest that education on work-related pain and in idualised advice could be essential and effective for managing persistent MSK pain. The objective of this scoping review was to map the existing educational resources for work-related MSK (WRMSK) pain, and the effects of implementing educational strategies in the workplace on managing WRMSK pain. This scoping review assessed original studies that implemented and assessed education as a strategy to manage WMSK pain. Literature search strategies were developed using thesaurus headings (ie, MeSH and CINAHL headings) and free-text search including words related to MSK in an occupational setting. The search was carried out in PubMed, CINAHL, Cochrane Library and Web of Science in the period 12–14 February 2019. A total of 19 peer-reviewed articles were included and the study design, aim and outcomes were summarised. Of the 19 peer-reviewed articles, 10 randomised controlled trial (RCT) studies assessed the influence of education on work-related MSK pain. Many studies provided a limited description of the education material and assessed/used different methods of delivery. A majority of studies concluded education positively influences work-related MSK pain. Further, some studies reported additive effects of physical activity or ergonomic adjustments. There is a gap in knowledge regarding the best content and delivery of education of material in the workplace. Although beneficial outcomes were reported, more RCT studies are required to determine the effects of education material as compared with other interventions, such as exercise or behavioural therapy.
Publisher: Wiley
Date: 11-11-2016
DOI: 10.1002/EJP.972
Abstract: Neck pain is a large clinical problem where reorganized trunk and axioscapular muscle activities have been hypothesised contributing to pain persistence and pain hypersensitivity. This study investigated the effects of bilateral experimental neck pain on trunk and axioscapular muscle function and pain sensitivity. In 25 healthy volunteers, bilateral experimental neck pain was induced in the splenius capitis muscles by hypertonic saline injections. Isotonic saline was used as control. In sitting, subjects performed slow, fast and slow-resisted unilateral arm movements before, during and after injections. Electromyography (EMG) was recorded from eight shoulder and trunk muscles bilaterally. Pressure pain thresholds (PPTs) were assessed bilaterally at the neck, head and arm. Data were normalized to the before-measures. Compared with control and post measurements, experimental neck pain caused (1) decreased EMG activity of the ipsilateral upper trapezius muscles during all but slow-resisted down movements (p < 0.001), and (2) increased EMG activity in the ipsilateral erector spinae muscle during slow and fast movements (p < 0.02), and in the contralateral erector spinae muscle during all but fast up and slow-resisted down movements (p < 0.007). The PPTs in the painful condition increased at the head and arm compared with post measurements and the control condition (p < 0.001). In the post-pain condition, the neck PPT was decreased compared with the control condition (p < 0.001). Acute bilateral neck pain reorganized axioscapular and trunk muscle activity together with local hyperalgesia and widespread hypoalgesia indicating that acute neck pain immediately affects trunk and axioscapular function which may affect both assessment and treatment. Bilateral clinical neck pain alters axioscapular muscle coordination but only effects of unilateral experimental neck pain has been investigated. Bilateral experimental neck pain causes task-dependent reorganized axioscapular and trunk muscle activity in addition to widespread decrease in pressure pain sensitivity.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-08-2021
DOI: 10.1097/AJP.0000000000000970
Abstract: The objective of this study was to investigate the pain-sensory profile of patients with whiplash-associated disorders (WADs) prior and post 2 weeks of standardized rehabilitation and after a 6-month follow-up. Twenty-two WAD participants (grade II 14 women) and 22 sex-matched and age-matched healthy pain-free controls were enrolled. Pressure pain thresholds (PPTs) were assessed at local and distal muscles. Conditioned pain modulation (CPM) of PPTs was assessed using cuff pressure around the upper arm. Referred area of pain following supra-threshold pressure stimulation of the infraspinatus muscle was recorded on a body chart. Psychometric variables (pain intensity, area of perceived pain, pain catastrophizing, kinesiophobia, sleep problems, and depression level) were assessed. WAD group additionally completed the Neck Disability Index. The WAD group demonstrated lower local PPTs compared with controls at all time points ( P .05) and lower distal PPTs at baseline and at 2 weeks when compared with 6 months (within-group) ( P .05). The WAD group had a reduced CPM response and larger induced referred pain areas compared with controls ( P .05), while no within-group changes were observed at any time point. The WAD group reported higher pain intensity and perceived area of pain compared with controls at all time points ( P .05) and a mean Neck Disability Index score of 41% at baseline, 16% at 2 weeks, and 4% at 6 months. Furthermore, the WAD group reported improvements in all other psychometric variables ( P .05), although only pain catastrophizing levels were comparable to controls at 2 weeks. PPTs but not CPM improved in the WAD group and were comparable to controls following 2 weeks following standardized rehabilitation, indicating that normalization of CPM may not be required to recover from WAD.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-01-2022
Publisher: Walter de Gruyter GmbH
Date: 04-05-2023
Abstract: Exercise-induced hypoalgesia (EIH) is characterized by an increase in pain threshold following acute exercise. EIH is reduced in some in iduals with chronic musculoskeletal pain, although the mechanisms are unknown. It has been hypothesized that this may relate to whether exercises are performed in painful or non-painful body regions. The primary aim of this randomized experimental crossover study was to investigate whether the presence of pain per se in the exercising muscles reduced the local EIH response. The secondary aim was to investigate if EIH responses were also reduced in non-exercising remote muscles. Pain-free women (n=34) participated in three separate sessions. In session 1, the maximal voluntary contraction (MVC) for a single legged isometric knee extension exercise was determined. In sessions 2 and 3, pressure pain thresholds (PPT) were assessed at the thigh and shoulder muscles before and after a 3-min exercise at 30 % of MVC. Exercises were performed with or without thigh muscle pain, which was induced by either a painful injection (hypertonic saline, 5.8 %) or a non-painful injection (isotonic saline, 0.9 %) into the thigh muscle. Muscle pain intensity was assessed with an 11-point numerical rating scale (NRS) at baseline, after injections, during and after exercises. PPTs increased at thigh and shoulder muscles after exercise with painful (14.0–24.9 %) and non-painful (14.3–19.5 %) injections and no significant between-injection EIH differences were observed (p .30). Muscle pain intensity was significantly higher following the painful injection compared to the non-painful injection (p .001). Exercising painful muscles did not reduce the local or remote hypoalgesic responses, suggesting that the pain-relieving effects of isometric exercises are not reduced by exercising painful body regions. S-20210184. NCT05299268.
Publisher: Wiley
Date: 06-04-2023
DOI: 10.1002/PRI.2004
Abstract: Personality traits are associated with pain‐related beliefs and coping strategies, and different chronic conditions are linked through specific personality profiles. This highlights the importance of having valid and reliable measures of personality traits for use in clinical and research settings when assessing patients in chronic pain. To translate and cross‐culturally adapt the 10‐item Big Five Inventory (BFI‐10) into Danish. A bilingual expert panel ( N = 4) and a panel of laymen ( N = 8) translated and culturally adapted the questionnaire into Danish. Face validity was evaluated in a group of persons suffering from recurring or ongoing painful conditions ( N = 9). Data were collected to evaluate the internal consistency, test–retest reliability and factor structure ( N = 96). Some of the participants in the lay panel considered the questionnaire too short, considering its aim of assessing personality. Acceptable internal consistency was found for two out of five subscales (0.78 for both Extraversion and Neuroticism), while the internal consistency was non‐acceptable for the remaining subscales (0.17–0.45). Test–retest reliability was acceptable for three subscales (0.80 for Neuroticism, 0.84 for Conscientiousness, and 0.85 for Extraversion). Assumptions for determining the factor structure were not met and therefore was this analysis omitted. Although face valid, only two out of five subscales had acceptable internal consistency and only three subscales had acceptable test–retest reliability. These findings indicate that interpreting findings regarding personality using the Danish BFI‐10 should be done with caution.
Publisher: Universidad San Jorge
Date: 2022
Abstract: Las acciones dirigidas a la mejora de la seguridad y de la salud laboral surgieron de la necesidad de proteger frente a los accidentes a los empleados que trabajaban en industrias europeas como en centrales nucleares o en industrias químicas de gran escala. Actualmente, este c o ha evolucionado en multitud de direcciones, siendo la prevención y el manejo de los trastornos musculoesqueléticos (TME) una de sus principales líneas de actuación, debido a que son el principal motivo de baja laboral en los trabajadores. Concretamente, la prevalencia de los TME representa más de 1,3 mil millones de personas y una pérdida de más de 100 millones de años de vida por incapacidad siendo una causa común de incapacidad y de bajas laborales. Históricamente, el abordaje de los TME desde el lugar de trabajo se ha focalizado en la adopción de medidas ergonómicas, lo que ha sido positivo en algunos casos. Sin embargo, a pesar de las ergonómicas y biomecánicas llevadas de manera generalizada en los puestos de trabajo, el aumento de la prevalencia de los TME a escala global indica que no son medidas suficientes por si solas., Por lo tanto, nuevos enfoques holísticos que tengan en cuenta aspectos biológicos, psicológicos y sociales para su abordaje son necesarios. Desde la Alianza Europea Prevent4Work para la prevención de los TME en el ámbito laboral, se ha elaborado este documento en forma de guía en base al conocimiento científico más reciente y relevante. Tanto las empresas como sus trabajadores se pueden beneficiar de las recomendaciones de esta guía.
Publisher: Prevent4Work
Date: 2021
Abstract: Storicamente, il ruolo dei professionisti specializzati in salute e sicurezza sul lavoro (SSL) è emerso dalla necessità di proteggere i datori di lavoro che lavorano nelle industrie a maggior rischio come le centrali nucleari e le industrie chimiche su larga scala in Europa. Più di recente, alcuni studi hanno evidenziato che la gamma di attività legate alle responsabilità di gestione della sicurezza include monitoraggio e preparazione di rapporti, ispezioni e audit, conformità normativa, risposta alle emergenze, indagini sugli incidenti, valutazione dei pericoli e dei rischi e formazione. Inoltre, ci sono alcuni obblighi supplementari non relativi alla sicurezza, come l’inclusione della responsabilità ambientale. Considerando che i disturbi muscoloscheletrici legati al lavoro (WRMD) rappresentano un grave onere in tutto il mondo, con un totale di 1,3 miliardi di casi, oltre 100 milioni di anni di perdita di anni di vita adeguati alla disabilità e che tali disturbi sono cause comuni di disabilità e congedo per malattia, questo argomento è molto importante per i professionisti (SSL). Negli Stati membri dell’UE per i quali sono disponibili dati, la grande maggioranza di tutti i lavoratori considera i disordini muscoloscheletrici come i problemi di salute più gravi legati al lavoro. La percentuale di lavoratori che segnalano tali disturbi come il proprio problema di salute più grave, varia dal 40% in Lussemburgo al 70% nella Repubblica ceca e in Finlandia. Inoltre, più della metà dei lavoratori con disturbi muscoloscheletrici ha riferito di essersi dovuti assentare dal lavoro (almeno una volta) in un periodo di 12 mesi. Nell’UE, il 26% dei lavoratori affetti da disturbi muscoloscheletrici presenti da lungo periodo, ossia con durata superiore a 3 mesi, insieme ad altri problemi di salute, segnala più di 8 giorni di assenza all’anno. Gli istituti di istruzione superiore (HEI) hanno un ruolo chiave nella diffusione e nell’aumento dell’accessibilità alle evidenze più aggiornate e recenti disponibili, relative all’impatto e la gestione dei disturbi muscoloscheletrici, per facilitare la diffusione delle conoscenze nella gestione pratica. In questo modo, la “Knowledge Alliance di Prevent4Work” per la prevenzione dei disturbi muscoloscheletrici correlati al lavoro ha elaborato questo documento con le conoscenze più recenti e pertinenti sull’argomento. Gli istituti di istruzione superiore che offrono corsi nell’ambito della SSL, nonché i corsi di laurea e post-laurea per professionisti sanitari che lavorano nel settore, possono beneficiare delle raccomandazioni qui presentate.
Publisher: Prevent4Work
Date: 2021
Abstract: Históricamente, el papel de los profesionales especializados en la seguridad y salud ocupacionales (OHS, por sus siglas en inglés) surgió de la necesidad de proteger a los empleados que trabajaban en industrias de alto riesgo, como en centrales nucleares o en industrias químicas de gran escala en Europa. Más recientemente, ersos estudios señalan que el rango de actividades vinculadas con las responsabilidades de gestión de la seguridad y salud ocupacionales deben incluir control y preparación de informes inspección y verificación cumplimiento normativo respuesta ante emergencias investigación de accidentes evaluación de amenazas y riesgos y formación. Además, hay algunos deberes suplementarios no relacionados directamente con la seguridad, como incluir responsabilidad ecológica. Al considerar que los trastornos musculoesqueléticos en el ámbito laboral (WRMD, por sus siglas en inglés) son un problema a escala mundial, -suman más de 1,3 mil millones de casos una pérdida de más de 100 millones de años de vida por incapacidad y que dichas enfermedades son causas comunes de incapacidad y de bajas laborales - este ámbito es muy importante para los profesionales especializados en la seguridad y salud ocupacionales. En los Estados Miembros de la Unión Europea sobre los que hay datos disponibles, una gran mayoría de los trabajadores informan de quejas relacionadas con los trastornos musculoesqueléticos como sus problemas de salud laborales más graves. El porcentaje de trabajadores que informan de esas quejas como sus problemas más graves oscila entre el 40% en Luxemburgo al 70% en la República Checa y en Finlandia. Además, más de la mitad de los trabajadores con trastornos musculoesqueléticos informaron de haber estado de baja laboral en un periodo que comprendía los últimos 12 meses. En la Unión Europea, el 26% de los trabajadores con trastornos musculoesqueléticos de larga duración (es decir, de más de 3 meses) combinadas con otros problemas de salud, informaron de más de 8 días de ausencia laboral al año. Los Centros de Enseñanza Universitarios tienen un papel clave a la hora de diseminar y de aumentar la accesibilidad de las evidencias más actualizadas disponibles, en cuanto al impacto y a la gestión de trastornos musculoesqueléticos para facilitar la implementación del conocimiento en la puesta en práctica. De esta manera, la Alianza Europea para la prevención de los trastornos musculoesqueléticos en el ámbito laboral Prevent4Work, ha elaborado este documento en base al conocimiento más reciente y relevante en este ámbito. Se pueden beneficiar de las recomendaciones aquí presentadas los Centros de Enseñanza Universitarios que ofrezcan cursos de seguridad y salud ocupacionales, así como los cursos universitarios y de posgraduado para profesionales de la salud que trabajen en dicha área.
Publisher: Wiley
Date: 28-12-2015
DOI: 10.1002/EJP.828
Abstract: Clinical observations indicate that cutaneous hyperalgesia may arise from pain located in deep structures. The objective of this study was to investigate whether combined sensitization of deep and superficial somatic tissues facilitates skin hyperalgesia. The interaction between muscle and cutaneous hyperalgesia was investigated in 16 healthy volunteers. Skin sensitization was induced unilaterally on the same randomly selected part of the body by ultraviolet B (UVB) irradiation above the upper trapezius and low back muscles. The next day, muscle hyperalgesia was induced bilaterally in low back muscles by injections of nerve growth factor (NGF). Thus, 1 day after irradiation there was skin sensitization, whereas after 2 days both skin and muscle sensitizations were present. Cutaneous blood flow, pin-prick thresholds, pressure pain thresholds (PPTs), temporal summation to repetitive painful pressure stimulation, and stimulus-response functions of graded pressure stimulations and pain intensity were assessed within the irradiated skin area and in the surrounding area before and 1, 2 and 3 days after irradiation. Comparing baseline with 1 day after irradiation, UVB and UVB+NGF locations demonstrated: (1) Increased superficial blood flow inside the irradiated area (p < 0.01) (2) Reduced pin-prick (p < 0.01) and PPTs (p < 0.05) within the irradiated area and in the surrounding area (3) Left-shifted pressure stimulus-response function within the irradiated area (p < 0.01) (4) Facilitated temporal summation inside the irradiated area (p < 0.01). Using skin and deep tissue pain sensitization models simultaneously, no significant synergistic effects were found within the 3-day investigation suggesting little integration between the two phenomena in this period.
Publisher: Prevent4Work
Date: 2021
Abstract: Historically, the role of professionals specialized in occupational health and safety (OHS) has emerged from the need to protect employers working in major risk industries such as nuclear plants and large-scale chemical industries in Europe. More recently, a few studies highlighted that the range of activities linked to safety management responsibilities includes monitor and prepare reports, inspection and auditing, regulatory compliance, emergency response, incident investigation, hazard and risk assessment, and training. Additionally, there are some supplementary non-safety related duties, such as including environmental responsibility. Considering that work-related musculoskeletal disorders (WRMD) are a major burden worldwide, adding up to 1.3 billion cases, more than 100 million years loss of disability-adjusted life years and that such disorders are common causes of disability and sick leave, this topic is highly relevant to OHS professionals. In EU Member States for which data are available, a large majority of all workers report complaints related to musculoskeletal disorders as their most serious work-related health problems. The percentage of workers reporting such complaints as their most serious health problem ranges from 40 % in Luxembourg to 70 % in Czech Republic and Finland. Furthermore, more than half of workers with musculoskeletal disorders reported taking time off work in a 12-month period. In the EU, 26 % of workers with musculoskeletal long-lasting disorders, that is lasting over 3 months, combined with other health problems report more than 8 days of absence per year. Higher Education Institutions (HEI) have a key role in disseminating and increasing accessibility to the most up-to-date evidence available regarding the impact and management of musculoskeletal disorders, to facilitate translation of knowledge to implementation in practice. This way, the Knowledge Alliance Prevent4Work for Preventing Work-Related Musculoskeletal Disorders has elaborated this document with the most recent and relevant knowledge within the topic. HEI that offer courses within OHS as well as graduation and post-graduation courses for health professionals that work within the area, may benefit from the recommendations presented here.
Publisher: Elsevier BV
Date: 07-2023
Publisher: Korean Pain Society
Date: 04-2023
DOI: 10.3344/KJP.23011
Publisher: BMJ
Date: 09-2021
DOI: 10.1136/BMJOPEN-2021-052602
Abstract: Work-related musculoskeletal (MSK) pain is a highly prevalent condition and one of the main contributors to disability and loss of work capacity. Current approaches to the management and prevention of work-related MSK pain do not consistently integrate current evidence-based knowledge and seem to be outdated. The Prevent4Work (P4W) Project aims to collect and spread evidence-based information to improve the management and prevention of work-related MSK pain. P4W will longitudinally investigate (1) risk factors associated with the prevalence of work-related MSK pain, (2) predictive factors for new events of work-related MSK pain in the short term and (3) the modification of pain beliefs after participating in evidence-based e-learning courses. This project employs a mixed-methods design with international cohorts of workers from Spain, Italy and Denmark. All participants will be assessed using self-reported variables at baseline (ie, cross-sectional design) with follow-up after 3 and 6 months (ie, prospective–predictive design). Throughout the first phase (0–3 months), all participants will be offered to self-enrol in e-learning courses on work-related MSK pain. Changes in pain beliefs (if any) will be assessed. The dataset will include sociodemographic characteristics, physical and psychological job demands, lifestyle-related factors, MSK pain history and pain beliefs. At baseline, all participants will additionally complete the P4W questionnaire developed to detect populations at high risk of suffering work-related MSK pain. Descriptive statistics, binary logistic regression, and analysis of variance will be used to identify the significant factors that influence the history of work-related MSK pain, evaluate the short-term prediction capacity of the P4W questionnaire, and investigate whether workers’ participation in e-learning courses will modify their pain beliefs. The study received ethical approval from the Ethical Committee of San Jorge University (USJ011-19/20). The results will be made available via peer-reviewed publications, international conferences and P4W official channels.
Publisher: Oxford University Press (OUP)
Date: 11-2015
DOI: 10.1111/PME.12824
Abstract: Lateral epicondylalgia presents as lateral elbow pain provoked by upper limb tasks. An experimental model of elbow pain provoked by movement/muscle contraction and maintained over several days is required to better understand the mechanisms underlying sustained elbow pain. This study investigated the time course and pain location induced by nerve growth factor (NGF) injection into a wrist extensor muscle, and whether movement and muscle contraction/stretch provoked pain. On Day 0 twenty-six painfree volunteers were injected with NGF (N = 13) or isotonic saline (randomized) into the extensor carpi radialis brevis (ECRB) muscle of the dominant arm. On Day 2 pain was induced in all participants by hypertonic saline injection into ECRB. A Likert scale and patient-rated tennis elbow evaluation (PRTEE) was used to assess pain and functional limitation (Days 0-10). Pain intensity during contraction/stretch of ECRB, and pressure pain thresholds (PPTs) were recorded before and after injections on Days 0 and 2, and Days 4 and 10. Compared with isotonic saline, NGF evoked: i) greater Likert pain ratings from 12 hours post-injection until Day 6, ii) greater PRTEE scores on Days 2 and 4, iii) greater pain during ECRB contraction/stretch on Day 2, and iv) lower PPTs on Day 4. This article presents a novel experimental human pain model suitable to study the sustained effects of lateral elbow pain on sensorimotor function and to probe the mechanisms underlying persistent musculoskeletal pain.
Publisher: Universidad San Jorge
Date: 2022
Abstract: Le azioni volte a migliorare la salute e la sicurezza sul lavoro sono nate dalla necessità di proteggere dagli incidenti i dipendenti che lavorano nelle industrie europee, come le centrali nucleari o le grandi industrie chimiche. Oggi, questo c o si è evoluto in molte direzioni, e la prevenzione e la gestione dei disturbi muscoloscheletrici (DMS) è una delle sue principali linee d'azione, dato che sono la ragione principale per cui i lavoratori si assentano dal lavoro. In particolare, la prevalenza dei DMS rappresenta più di 1,3 miliardi di persone e una perdita di più di 100 milioni di anni di vita a causa della disabilità sono una causa comune di inabilità e di assenza per malattia. Storicamente, l'approccio ai DMS sul posto di lavoro si è concentrato sull'adozione di misure ergonomiche, che in alcuni casi sono state positive. Tuttavia, nonostante le misure ergonomiche e biomeccaniche siano iamente implementate sul posto di lavoro, la crescente prevalenza dei DMS su scala globale indica che non sono misure sufficienti da sole, quindi sono necessari nuovi approcci olistici che tengano conto degli aspetti biologici, psicologici e sociali per affrontarli. L'Alleanza europea Prevent4Work per la prevenzione dei DMS sul posto di lavoro ha sviluppato questo documento come guida basata sulle più recenti e rilevanti conoscenze scientifiche. Sia le aziende che i loro dipendenti possono beneficiare delle raccomandazioni di questa guida.
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.PHYSIO.2015.01.005
Abstract: Evaluation of scapular posture is an integral component of the clinical assessment of painful neck disorders. The aim of this study was to evaluate agreement between therapist judgements of scapula posture in multiple biomechanical planes in in iduals with neck pain. Inter-therapist reliability study. Research laboratory. Fifteen participants with chronic neck pain. Four physiotherapists recorded ratings of scapular orientation (relative to the thorax) in five different scapula postural planes (plane of scapula, sagittal plane, transverse plane, horizontal plane, and vertical plane) under four test conditions (at rest, and during three isometric shoulder conditions) in all participants. Inter-therapist reliability was expressed using both generalized and paired kappa coefficient. Following adjustment for expected agreement and the high prevalence of neutral ratings (81%), on average both the generalised kappa (0.37) as well as Cohen's Kappa for the two therapist pairs (0.45 and 0.42) demonstrated only slight to moderate inter-therapist reliability. The findings suggest that ratings of scapular posture in in iduals with neck pain by visual inspection has only slight to moderate reliability and should only be used in conjunction with other clinical tests when judging scapula function in these patients.
Publisher: Universidad San Jorge
Date: 2022
Abstract: Actions to improve occupational health and safety arose from the need to protect employees working in European industries, such as nuclear power plants or large-scale chemical industries, from accidents. Today, the field has evolved in many directions, with the prevention and management of musculoskeletal disorders (MSDs) being one of its main lines of action. MSDs are the main reason for workers to take time off work. Specifically, the prevalence of MSDs represents more than 1.3 billion people and a loss of more than 100 million years of life due to disability they are a common cause of disability and sick leave. Historically, the workplace approach to MSDs has focused on adopting ergonomic measures, which has been positive in some cases. However, despite ergonomic and biomechanical measures being widely implemented in the workplace, the increasing prevalence of MSDs globally indicates that they are not sufficient measures on their own. Therefore, new holistic approaches that take biological, psychological, and social aspects are needed to address them. The European Prevent4Work Alliance for innovative measures to prevent MSDs in the workplace has developed this document as a guide based on the most recent and relevant scientific knowledge. Both companies and their employees can benefit from the recommendations of this guide
Publisher: Elsevier BV
Date: 10-2021
DOI: 10.1016/J.JBMT.2021.07.032
Abstract: Pelvic floor exercises combined with patient education has shown to be a promising intervention for women suffering from urinary incontinence. This pilot study investigated the effect of patient education combined with group or in idualised pelvic floor exercises, or in idualised pelvic floor exercises with ultrasonography guidance. Thirty-three elderly women with urinary incontinency completed a block-randomised, assessor-blinded study combining patient education with 12-weeks of pelvic floor exercises either group-based or in idual with or without ultrasonography guidance. Urinary incontinence symptoms were assessed using the Incontinence Impact Questionnaire-7 (IQ-7) and Urogenital Distress Inventory-6 (UDI-6). Furthermore, daily fluid intake and number of bathroom visits were recorded. Pelvic floor muscle strength was assessed using a manual squeeze test (Oxford Scale, 6-point). An increase in pelvic floor strength was observed after 12 weeks for both the in idual (P = 0.038) and the in idual ultrasonography-guided (P = 0.01) exercise groups. However, only the latter group maintained an increased strength at the 24-week follow-up (P = 0.008). Across all groups, the intervention led to a decrease in bathroom visits (P = 0.002) that was maintained at the 24-week follow-up (P < 0.001). The interventions led to a decrease in UDI-6 both after the 12-week intervention (P = 0.009) and at the 24-week follow-up (P = 0.032). These findings indicate that pelvic floor exercises together with patient education can reduce urogenital distress and bathroom visits without change in fluid intake. Furthermore, when pelvic floor exercises were conducted in idually, pelvic floor strength increased, but pelvic floor strength was maintained over time only for in idualised pelvic floor exercises with ultrasonography guidance.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.MSKSP.2019.01.002
Abstract: This study had the objective of measuring the validity of using a smartphone-based application to measure range of motion (ROM) and quality of movement (QOM) of neck motion by comparing it with 3D-motion capture analysis. Thirty healthy volunteers participated in this cross-sectional study. A helmet fitted with markers for motion capture analysis and a smartphone were fastened to the head of the participants. The smartphone recorded data using a beta version of Balancy (MEDEI, Denmark). Assessments of full active movement in transverse and sagittal planes were performed. Recordings were made simultaneously with the camera system and the smartphone. ROM and jerkiness were compared with a repeated measures ANOVA and a Pearson product moment was calculated to compare the outcomes from the different applications. Bland-Altman plots were generated to determine the levels of agreement. No difference was found between modalities when comparing measurements of jerkiness or ROM. An excellent Pearson product moment was found for the outcomes of the two modalities for ROM (Pearson's r: 0.83 - 0.96) and jerkiness (Pearson's r: 0.86 - 0.95). The Bland-Altman plot revealed a systemic offset where the phone consistently measured higher values for ROM and lower values for jerkiness. This study demonstrated that a smartphone-based application can be used to accurately measure ROM and jerkiness during neck movements. These results indicate the utility of using a smartphone-based application to assess neck movement in humans. The findings have implications for assessment of neck movement in research and clinical practice.
Publisher: Walter de Gruyter GmbH
Date: 07-2016
DOI: 10.1016/J.SJPAIN.2016.05.027
Abstract: Neck pain is frequent and many develop on-going neck pain after the initial onset. Studies on clinical neck pain suggested that altered axioscapular muscle activity may be an important factor in on-going neck pain. This study investigates the effect of bilateral experimental neck pain on axioscapular muscle activity during standardised resisted arm movements. 25 healthy participants were recruited for this single blinded cross-over study. Experimental pain was induced by bilateral injection of hypertonic saline into the splenius capitis muscle. Isotonic saline was used as a control. Pain intensity was recorded using an electronic visual analogue scale (VAS 0-10 cm). Participants performed standardised arm movements, from a seated position, while wearing 1 kg wrist weights. Six arm abduction movements (30° to frontal plane, 3 per side) were performed to an angle of 140°. Each movement consisted of two 3 s phases (up/down) and was separated by a 6 s break, before moving the opposite arm. Surface electromyography (EMG) was recoded from 8 bilateral muscles. Recordings were done before, immediately after, and 5 min after the experimental pain. Root-mean-square (RMS) of the EMG signals were extracted for each muscle and averaged for the 3 trials. Data was compared between sides and no differences were identified after which data was pooled for further analysis. During the painful condition for the slow upward movement, a reduced RMS-EMG activity was found for the ipsilateral upper trapezius (P 0.01). In addition, increased RMS-EMG was found bilaterally for the erector spinae muscle (P 0.01). Bilateral experimental neck reorganise axioscapular and trunk muscle activity during resisted, slow upward movement. The results of this supports previous studies on neck pain patients suggesting neck pain is linked to axioscapular function and underpins the necessity to include the shoulder girdle in assessment and rehabilitation of neck pain patients.
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.HUMOV.2015.04.001
Abstract: This study assessed how the low back motor control strategies were affected by experimental pain. In twelve volunteers the right m. longissimus was injected by hypertonic and isotonic (control) saline. The pain intensity was assessed on a visual analog scale (VAS). Subjects were seated on a custom-designed chair including a 3-dimensional force sensor adjusted to the segmental height of T1. Electromyography (EMG) was recorded bilaterally from longissimus, multifidus, rectus abdominis, and external oblique muscles. Isometric trunk extensions were performed before, during, and after the saline injections at 5%, 10%, and 20% of maximum voluntary contraction force. Visual feedback of the extension force was provided whereas the tangential force components were recorded. Compared with isotonic saline, VAS scores were higher following hypertonic saline injections (P<.01). Experimental low back pain reduced the EMG activity bilaterally of the rectus abdominis muscles during contractions at 10% and 20% MVC (P<.01) although force accuracy and tangential force variability was not affected. Increased variability in the tangential force composition was found during pain compared with the non-painful condition (P<.05). The immediate adaptation to pain was sufficient to maintain the quality of the task performance however the long-term consequence of such adaptation is unknown and may overload other structures.
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.HUMOV.2014.09.006
Abstract: Experimental muscle pain typically reorganizes the motor control. The pain effects may decrease when the three-dimensional force components are voluntarily adjusted, but it is not known if this could have negative consequences on other structures of the motor system. The present study assessed the effects of acute pain on the force variability during sustained elbow flexion when controlling task-related (one-dimensional) and all (three-dimensional) contraction force components via visual feedback. Experimental muscle pain was induced by bolus injection of hypertonic saline into m. biceps brachii, and isotonic saline was used as control. Twelve subjects performed sustained elbow flexion at different levels of the maximal voluntary contraction (5-30% MVC) before, during, and after the injections. Three-dimensional force components were measured simultaneously with surface electromyography (EMG) from elbow flexors and auxiliary muscles. Results showed that force variability was increased during pain compared to baseline for contractions using one-dimensional feedback (P<.05), but no significant differences were found for three-dimensional feedback. During painful contractions (1) EMG activity from m. trapezius was increased during contractions using both one-dimensional and three-dimensional feedback (P<.05), and (2) the complexity of EMG from m. triceps brachii and m. deltoid was higher for the three-dimensional feedback (P<.05). In conclusion, the three-dimensional feedback reduced the pain-related functional distortion at the cost of a more complex control of synergistic muscles.
Publisher: Springer Science and Business Media LLC
Date: 18-05-2017
DOI: 10.1007/S00586-017-5121-8
Abstract: To summarise recommendations about 21 selected non-surgical interventions for recent onset (<12 weeks) non-specific neck pain (NP) and cervical radiculopathy (CR) based on two guidelines from the Danish Health Authority. Two multidisciplinary working groups formulated recommendations based on the GRADE approach. Twelve recommendations were based on evidence and nine on consensus. Management should include information about prognosis, warning signs, and advise to remain active. For treatment, guidelines suggest different types of supervised exercise and manual therapy combinations of exercise and manual therapy before medicine for NP acupuncture for NP but not CR traction for CR and oral NSAID (oral or topical) and Tramadol after careful consideration for NP and CR. Recommendations are based on low-quality evidence or on consensus, but are well aligned with recommendations from guidelines from North America. The working groups recommend intensifying research relating to all aspects of management of NP and CR.
Publisher: Springer Science and Business Media LLC
Date: 30-08-2022
Publisher: BMJ
Date: 12-2021
DOI: 10.1136/BMJOPEN-2021-053988
Abstract: The aim of this study was to develop a multifactorial, self-report questionnaire: Prevent for Work Questionnaire (P4Wq). The questionnaire is intended for screening for risk factors in work-related musculoskeletal disorders (WMSDs). Data were collected from otherwise healthy workers employed in three service areas at a specialist hospital in Italy: healthcare, administration and ancillary services. In all, 115 participants were enrolled (67% women average age 41.5±9.94 years). The content of the tool for WMSDs was derived from three participation rounds of analysis involving a select group of experts who identified the questionnaire domains and items. Participants responded to 89 items in addition to the EuroQol 5 Dimensions Questionnaire (EQ-5D-5L), Fear-Avoidance Beliefs Questionnaire (FABq) and Oswestry Disability Index (ODI). The proportion of missing data and the distribution of responses were analysed for each item. Items with a discrimination index .40 and an interitem correlation .80 were retained. Factor analysis was performed using the VARIMAX rotation method, factor extraction, and identification, assignment of items to subscales, and assignment of scores to items. Internal consistency, reliability, construct validity and face validity were also assessed. A total of 52 items were included in the factor analysis and four subscales identified: Physical Stress Subscore (six items) Mental Stress Subscore (six items) Job Satisfaction Subscore (four items) and Kinesiophobia/Catastrophizing Subscore (four items). The items in the final questionnaire version had a factor loading .7. The questionnaire consisted of 20 items with good internal consistency (Cronbach’s alpha 0.81–0.91), reliability (weighted kappa coefficient 0.617–1.00), good construct validity (EQ-5D-5L, r=−0.549, p .001 ODI, r=0.549, p .001 FABq work, r=0.688, p .001) and satisfactory face validity (universal validity index 96.04%). The P4Wq is a 20-item, multifactorial self-report risk assessment questionnaire. It may provide a useful tool for screening for WMSDs by specifically addressing back disorders. It investigates risks for in idual workers and may inform educational programmes and preventive strategies tailored to a worker’s needs. NCT04192604
Publisher: Springer Science and Business Media LLC
Date: 08-06-2020
DOI: 10.1186/S12877-020-01535-6
Abstract: Accidental falls are common among community-dwellers, probably due to the level of physical activity and impaired postural stability. Today, fall risk prediction tools’ discriminative validity are only moderate. In order to increase the accuracy, multiple variables such as highly validated objective field measurements of physical activity and impaired postural stability should be adressed in order to predict falls. The main aim of this paper is to describe the ≥65 years NOrthern jutland Cohort of Fall risk Assessment with Objective measurements (NOCfao) investigating the association between physical activity and impaired postural stability and the risk of fall episodes among community-dwelling older adults. The study consists of a baseline session where the participants are asked to respond to three questionnaires, perform physical tests (i.e., measuring strength in the upper and lower extremities, balance, and walking speed), participate in an assessment of pain sensitivity, and to wear an ankle mounted pedometer for measuring physical activity for 5 days. Subsequently, the fall incidences and the circumstances surrounding the falls during the previous 1 to 2 months will be recorded throughout a one-year follow-up period. This study will add to the present-day understanding of the association between physical activity and impaired postural stability and the risk of fall episodes among community-dwelling older adults. These data will provide valid and reliable information on the relationship between these variables and their significance for community-dwelling older adults. ClinicalTrials.gov identifier: NCT2995317 . Registered December 13th, 2016.
Publisher: Informa UK Limited
Date: 03-04-2017
DOI: 10.1080/08990220.2017.1317241
Abstract: It is unknown whether and how sleep deprivation influences craniofacial muscle sensitivity in healthy humans. We investigated whether total sleep deprivation (TSD) and one night of recovery sleep (RS) can alter mechanical pain sensitivity in temporal and masseter muscles. Fifteen healthy volunteers participated in three consecutive sessions. Pressure pain thresholds were measured on the temporal and masseter muscles. Both temporal and masseter muscles became sensitized after 24 h of TSD. RS reversed the muscle sensitization.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2016
Publisher: BMJ
Date: 04-2021
DOI: 10.1136/BMJOPEN-2020-043800
Abstract: This study aims to define appropriate domains and items for the development of a self-administered questionnaire to assess the risk of developing work-related musculoskeletal disorder (WMSD) and the risk of its progression to chronicity. Literature review and survey study. A literature review and a two-round interview with 15 experts in musculoskeletal pain were performed to identify the available domains for WMSD assessment. To ensure quality, only validated questionnaires were included for the Delphi process. A three-round Delphi method, with three round steps, was used to select the most pertinent and relevant domains and items. Nine questionnaires were identified through the expert discussion and literature review, comprising 38 candidate domains and 504 items. In the first round of the Delphi group, 17 domains reached more than 70% agreement and were selected. In the second round, 10 domains were rejected, while 11 were selected to complete the pool of domains. In the third and final round, 89 items belonging to 28 domains were defined as significant to develop a WMSDs risk assessment questionnaire. No specific risk assessment questionnaires for WMSDs were identified from the literature. WMSD risk of presence and chronicity can be defined by an assessment tool based on the biopsychosocial model and the fear-avoidance components of chronic pain. The present study provides the formulation and operationalisation of the constructs in domains and items needed for developing and validating the questionnaire.
Publisher: Wiley
Date: 27-08-2017
DOI: 10.1002/EJP.1088
Abstract: Previous studies have indicated that neck pain patients feel increased symptoms following upper limb activities, and altered axioscapular muscle function has been proposed as a contributing factor. Pain sensitivity and muscle activity, during arm movements, were assessed in neck pain patients and controls. Patients with ongoing insidious-onset neck pain (IONP, N = 16) and whiplash-associated disorders (WAD, N = 9) were included along with sex- and age-matched controls (N = 25). Six series of repeated arm abductions were performed during electromyographic (EMG) recordings from eight bilateral muscles. The first and last three series were separated by 8 min and 42 s, respectively. Each series consisted of three slow and three fast movements. Pressure pain thresholds (PPTs) were recorded bilaterally from neck, head and arm at baseline, after the third and sixth movement series. Pain intensity was recorded on an electronic visual analogue scale (VAS). Larger pain areas and higher VAS scores were found in patients compared with controls (p < 0.001), and in patients, the VAS scores increased in the course of movements (p < 0.02). PPTs were lower in patients compared with controls at all sites (p < 0.03), and these decreased during arm movements in the IONP group (p < 0.03), while increasing at head and neck sites in controls (p < 0.04). During the slow movements, increasing serratus anterior EMG activity was found in the series with short breaks in-between for the WAD group compared with IONP and controls (p < 0.001). Axioscapular movement caused different responses in pain sensitivity and muscle activity between neck pain patient groups compared with controls. Neck pain patients report increased symptoms following upper limb activities. This study shows that repeated arm movements caused differentiated responses in pain sensitivity and muscle activity between subgroups of neck pain patient and asymptomatic controls. Such findings may be of great clinical significance when planning rehabilitation for this patient population.
No related grants have been discovered for Steffan Christensen.