scholarly journals THU0572 THE ROLE OF PRESSURE PAIN THRESHOLD IN A REHABILITATIVE APPROACH TO ANALYZE PAIN PROCESSING MECHANISM IN HAND OSTEOARTHRITIS PATIENTS: A PILOT STUDY.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 527.1-527
Author(s):  
P. Pedersini ◽  
R. La Touche ◽  
E. A. Sanchez Romero ◽  
J. H. Villafañe
Keyword(s):  
Functional Mri ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Hand Osteoarthritis ◽  
Pain Processing ◽  
Pressure Pain ◽  
Anterior Tibial ◽  
Pain Mechanism ◽  
Processing Mechanism

Background:The hand pain experienced by patients with hand osteoarthritis (OA) is often accompanied by hypersensitivity and sings of peripheral and central sensitization1. The European League Against Rheumatism (EULAR) published a systematic literature review that summarized the current non-pharmacological, pharmacological and surgical approaches for the management of hand OA2. The identified review did not consider interventions that specifically targeted reducing pain sensitivity. A reliable method to assess the presence of hypersensitivity is the pressure pain threshold (PPT)3. During the rehabilitation management considering the pain mechanism involved could be an important factor to address more effective treatments4.Objectives:The aim of the present study was to investigate the role of pain processing mechanism in patients with hand OA through PPT and using a specific functional Magnetic Resonance Imaging (fMRI).Methods:20 patients with hand OA and 20 healthy controls, aged 50 to 90 years, were recruited. Pressure pain threshold (PPT) was assessed bilaterally over the hand, on the C5-C6 zigoapophyseal joint, median, ulnar, radial nerves, and anterior tibial muscle by a blinded assessor respect to the condition of the subjects3. In five participants for each group, PPT over the hand was assessed neurophysiologically by advanced modalities including functional MRI to analyze the pain mechanisms related to hand OA5.Results:The results showed that PPTs were significantly lower over the hand and the median, ulnar, radial nerves (P<0.05), but not over the C5-C6 zigoapophyseal joint and anterior tibial (P>0.05) in OA patients as compared to healthy controls. Both groups demonstrated activation of the thalamus, frontal and somatosensory cortex area during PPT over the hand, although the total brain area activated in OA patients was greater than in control participants.Conclusion:Patients with hand OA shown features of altered pain mechanism that were evident both in PPTs measures than using functional MRI. PPT is a useful marker in detecting pain sensitivity in hand OA and could be used in future pain studies to evaluate pain modulation strategies.References:[1]Villafañe JH, Valdes K, Pedersini P, Berjano P. Osteoarthritis: a call for research on central pain mechanism and personalized prevention strategies.Clin Rheumatol. August 2018.[2]Kroon FPB, Carmona L, Schoones JW, Kloppenburg M. Efficacy and safety of non-pharmacological, pharmacological and surgical treatment for hand osteoarthritis: a systematic literature review informing the 2018 update of the EULAR recommendations for the management of hand osteoarthritis.RMD Open. 2018;4(2):e000734.[3]Pedersini P, Negrini S, Cantero-Tellez R, Bishop MD, Villafañe JH. Pressure algometry and palpation of the upper limb peripheral nervous system in subjects with hand osteoarthritis are repeatable and suggest central changes.J Hand Ther. January 2019.[4]O’Leary H, Smart KM, Moloney NA, Blake C, Doody CM. Pain sensitization associated with nonresponse after physiotherapy in people with knee osteoarthritis.Pain. 2018;159(9):1877-1886.[5]Sofat N, Smee C, Hermansson M, et al. Functional MRI demonstrates pain perception in hand osteoarthritis has features of central pain processing.J Biomed Graph Comput. 2013;3(4).Disclosure of Interests:None declared

Pressure pain threshold of the cervico-facial muscles in healthy elderly people: the role of gender, age and dominance

Gerodontology ◽  
2014 ◽  
Vol 32 (4) ◽  
pp. 274-280 ◽  
Author(s):  
Marina De Rui ◽  
Ida Marini ◽  
Maria Lavinia Bartolucci ◽  
Emine Meral Inelmen ◽  
Francesco Bortolotti ◽  
...  
Keyword(s):  
Elderly People ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Pressure Pain ◽  
Facial Muscles ◽  
Healthy Elderly ◽  
Healthy Elderly People

Local hyperalgesia, normal endogenous modulation with pain report beyond its origin: a pilot study prompting further exploration into plantar fasciopathy

2020 ◽  
Vol 20 (2) ◽  
pp. 375-385
Author(s):  
Henrik Riel ◽  
Melanie L. Plinsinga ◽  
Rebecca Mellor ◽  
Shellie A. Boudreau ◽  
Viana Vuvan ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Plantar Fascia ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Pain Processing ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Plantar Fasciopathy

AbstractBackground and aimsPersistent tendinopathies were previously considered solely as peripheral conditions affecting the local tendinous tissue until quantitative sensory testing identified involvement of altered pain processing. In similar fashion, pain in patients with persistent plantar fasciopathy may also involve more than local tissue. The aim of this pilot study was to investigate potential differences in conditioned pain modulation and pressure and thermal pain thresholds, between individuals with PF and healthy pain-free controls, as a precursor to a larger-scale study.MethodsWe assessed 16 individuals with plantar fasciopathy and 11 pain-free controls. Plantar fasciopathy diagnosis was: palpation pain of the medial calcaneal tubercle or the proximal plantar fascia, duration ≥3 months, pain intensity ≥2/10, and ultrasound-measured plantar fascia thickness ≥4 mm. Quantitative sensory tests were performed locally at the plantar heel and remotely on the ipsilateral elbow. Assessments included pain thresholds for pressure, heat and cold, and conditioned pain modulation measured as change in local resting pressure pain threshold with cold water hand immersion. Participants rated pain intensity at pain threshold. Additionally, the area and distribution of plantar fasciopathy pain was drawn on a digital body chart of the lower limbs. Descriptive analyses were performed and between-group differences/effects expressed as standardised mean differences (d).ResultsThere was no conditioned pain modulation difference between participants with plantar fasciopathy and controls (d = 0.1). Largest effects were on local pressure pain threshold and reported pain intensity on pressure pain threshold (d > 1.8) followed by pain intensity for heat and cold pain thresholds (d = 0.3–1.5). According to the digital body chart, pain area extended beyond the plantar heel.ConclusionsThe unlikelihood of a difference in conditioned pain modulation yet a pain area extending beyond the plantar heel provide a basis for exploring altered pain processing in a larger-scale study.ImplicationsThis was the first study to investigate the presence of altered pain processing in individuals with plantar fasciopathy using a conditioned pain modulation paradigm and thermal pain thresholds. We found no indication of an altered pain processing based on these measures, however, patients rated pain higher on thresholds compared to controls which may be important to clinical practice and warrants further exploration in the future.

Metformin increases pressure pain threshold in lean PCOS women

2017 ◽  
Author(s):  
Marta Kialka ◽  
Tomasz Milewicz ◽  
Krystyna Sztefko ◽  
Iwona Rogatko ◽  
Renata Majewska
Keyword(s):  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Pressure Pain

scholarly journals A novel metric of reliability in pressure pain threshold measurement

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bernard Liew ◽  
Ho Yin Lee ◽  
David Rügamer ◽  
Alessandro Marco De Nunzio ◽  
Nicola R. Heneghan ◽  
...  
Keyword(s):  
Mixed Models ◽  
Variance Components ◽  
Pain Threshold ◽  
Intraclass Correlation ◽  
Pressure Pain Threshold ◽  
Total Variance ◽  
Lumbar Region ◽  
Pressure Pain ◽  
Pressure Algometer ◽  
Testing Protocols

AbstractThe inter-session Intraclass Correlation Coefficient (ICC) is a commonly investigated and clinically important metric of reliability for pressure pain threshold (PPT) measurement. However, current investigations do not account for inter-repetition variability when calculating inter-session ICC, even though a PPT measurement taken at different sessions must also imply different repetitions. The primary aim was to evaluate and report a novel metric of reliability in PPT measurement: the inter-session-repetition ICC. One rater recorded ten repetitions of PPT measurement over the lumbar region bilaterally at two sessions in twenty healthy adults using a pressure algometer. Variance components were computed using linear mixed-models and used to construct ICCs; most notably inter-session ICC and inter-session-repetition ICC. At 70.1% of the total variance, the source of greatest variability was between subjects ($${\sigma }_{subj}^{2}$$ σ subj 2 = 222.28 N2), whereas the source of least variability (1.5% total variance) was between sessions ($${\sigma }_{sess}^{2}$$ σ sess 2 = 4.83 N2). Derived inter-session and inter-session-repetition ICCs were 0.88 (95%CI: 0.77 to 0.94) and 0.73 (95%CI: 0.53 to 0.84) respectively. Inter-session-repetition ICC provides a more conservative estimate of reliability than inter-session ICC, with the magnitude of difference being clinically meaningful. Quantifying individual sources of variability enables ICC construction to be reflective of individual testing protocols.

scholarly journals Comparative study of the effectiveness of a low-pressure hyperbaric oxygen treatment and physical exercise in women with fibromyalgia: randomized clinical trial

2020 ◽  
Vol 12 ◽  
pp. 1759720X2093049
Author(s):  
Ruth Izquierdo-Alventosa ◽  
Marta Inglés ◽  
Sara Cortés-Amador ◽  
Lucia Gimeno-Mallench ◽  
Núria Sempere-Rubio ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Physical Performance ◽  
Hyperbaric Oxygen ◽  
Functional Capacity ◽  
Pain Threshold ◽  
Cortical Excitability ◽  
Pressure Pain Threshold ◽  
Low Pressure ◽  
Pressure Pain ◽  
Perceived Pain

Background: Fibromyalgia (FM) is characterized by chronic pain and fatigue, among other manifestations, thus advising interventions that do not aggravate these symptoms. The main purpose of this study is to analyse the effect of low-pressure hyperbaric oxygen therapy (HBOT) on induced fatigue, pain, endurance and functional capacity, physical performance and cortical excitability when compared with a physical exercise program in women with FM. Methods: A total of 49 women with FM took part in this randomized controlled trial. They were randomly allocated to three groups: physical exercise group (PEG, n = 16), low-pressure hyperbaric oxygen therapy group (HBG, n = 17) and control group (CG, n = 16). Induced fatigue, perceived pain, pressure pain threshold, endurance and functional capacity, physical performance and cortical excitability were assessed. To analyse the effect of the interventions, two assessments, that is, pre and post intervention, were carried out. Analyses of the data were performed using two-way mixed multivariate analysis of variance. Results: The perceived pain and induced fatigue significantly improved only in the HBG ( p < 0.05) as opposed to PEG and CG. Pressure pain threshold, endurance and functional capacity, and physical performance significantly improved for both interventions ( p < 0.05). The cortical excitability (measured with the resting motor threshold) did not improve in any of the treatments ( p > 0.05). Conclusions: Low-pressure HBOT and physical exercise improve pressure pain threshold, endurance and functional capacity, as well as physical performance. Induced fatigue and perceived pain at rest significantly improved only with low-pressure HBOT. Trial registration: ClinicalTrials.gov identifier NCT03801109.

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