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Two point discrimination and chronic pain

Samantha M Meints, Ishtiaq Mawla, Vitaly Napadow, Jian Kong, Jessica Gerber, Suk-Tak Chan, Ajay D Wasan, Ted J Kaptchuk, Christina McDonnell, Junie Carriere, Bruce Rosen, Randy L Gollub, Robert R Edwards
Changes in central pain processing have been shown in patients with chronic low back pain (cLBP). We used quantitative sensory testing (QST) methods to identify differences in pain sensitization between patients with cLBP (N=167) and healthy controls (N=33). Results indicated that, compared to healthy pain-free controls, cLBP patients showed increased sensitivity and greater painful aftersensations for mechanical pressure and pin prick stimuli and lower tactile spatial acuity in the two-point discrimination task (ps<...
December 7, 2018: Pain
Pawan Agarwal, Piyush Shukla, D Sharma
BACKGROUND: Loss of protective sensation of the sole may lead to repeated trauma, chronic nonhealing ulcers, and even amputation. Saphenous nerve (SN) to posterior tibial nerve (PTN) transfer can restore sensation of the sole. METHOD: This study was conducted in a tertiary referral center in Central India. Twenty-one patients (32 feet) diagnosed with loss of sensation of the sole were included in this study. Causes of loss of sensation were Hansen's disease (n = 18), complex sciatic nerve injury (n = 1), lumbosacral spinal tumor (n = 1), and lumbosacral meningomyelocele (n = 1)...
December 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Fabio Antonaci, Elena Rossi, Cristina Voiticovschi-Iosob, Giorgio Dalla Volta, Sara Marceglia
Background The use of frontal infrared thermography in the diagnosis of primary headaches provided scattering results due to measurement fluctuations and different types of headaches or research protocols. Objective This study aims to assess the reliability of frontal infrared thermography in healthy individuals and provide a preliminary evaluation in chronic migraine patients using a commercial infrared thermal camera. Methods Thermographic images were acquired in 20 controls and 15 patients at three consecutive time-points in two daily sessions...
January 1, 2018: Cephalalgia: An International Journal of Headache
Kerstin Luedtke, Waclaw Adamczyk, Katrin Mehrtens, Inken Moeller, Louisa Rosenbaum, Axel Schaefer, Janine Schroeder, Tibor Szikszay, Christian Zimmer, Bettina Wollesen
BACKGROUND: Chronic pain including migraine is associated with structural and functional changes in the somatosensory cortex. Previous reports proposed two-point discrimination (TPD) as a measurement for cortical alterations. Limited evidence exists for tactile acuity in the neck and no data is available for migraine. METHODS: To introduce a standardized protocol for the measurement of TPD in the upper cervical spine, 51 healthy participants were investigated with a newly developed paradigm which was evaluated for intra-rater reliability...
June 26, 2018: Journal of Headache and Pain
Katja Ehrenbrusthoff, Cormac G Ryan, Christian Grüneberg, Denis J Martin
BACKGROUND: Deficits in the sensorimotor system and its peripheral and central processing of the affected body part might be a contributing factor to chronic low back pain (CLBP). Hence, sensorimotor assessment is important. Valid and reliable sensorimotor measurement instruments are needed. OBJECTIVE: To investigate the reliability and validity of sensorimotor measurement instruments for people with chronic low back pain (CLBP). DESIGN: Systematic review and meta-analysis...
June 2018: Musculoskeletal Science & Practice
Alexandre de Matos Soeiro, Danielle Menosi Gualandro, Aline Siqueira Bossa, Cindel Nogueira Zullino, Bruno Biselli, Maria Carolina Feres de Almeida Soeiro, Tatiana de Carvalho Andreucci Torres Leal, Carlos Vicente Serrano, Mucio Tavares de Oliveira Junior
INTRODUCTION: Despite having higher sensitivity as compared to conventional troponins, sensitive troponins have lower specificity, mainly in patients with renal failure. OBJECTIVE: Study aimed at assessing the sensitive troponin I levels in patients with chest pain, and relating them to the existence of significant coronary lesions. METHODS: Retrospective, single-center, observational. This study included 991 patients divided into two groups: with (N = 681) and without (N = 310) significant coronary lesion...
January 2018: Arquivos Brasileiros de Cardiologia
Wacław M Adamczyk, Kerstin Luedtke, Oskar Saulicz, Edward Saulicz
Patients with chronic low back pain often report that they do not perceive their painful back accurately. Previous studies confirmed that sensory dissociation and/or discrepancy between perceived body image and actual size is one of the specific traits of patients with chronic pain. Current approaches for measuring sensory dissociation are limited to two-point-discrimination or rely on pain drawings not allowing for quantitative analysis. This case study reports the sensory dissociation of two cases with chronic low back pain using a recently published test (point-to-point-test (PTP)) and a newly developed test (two-point-estimation (TPE))...
August 2018: Physiotherapy Theory and Practice
Daniel S Harvie, Grace Edmond-Hank, Ashley D Smith
BACKGROUND: Tactile acuity deficits have been demonstrated in a range of persistent pain conditions and may reflect underlying cortical re-organisation. OBJECTIVE: This study aimed to determine whether tactile acuity is impaired in people with chronic neck pain relative to controls, and whether deficits relate to pain location, duration and intensity. METHODS: In this cross-sectional study, 20 people with chronic neck pain (5 idiopathic neck pain; 15 whiplash-associated disorder) and 20 pain-free controls underwent two-point discrimination (TPD) testing at the neck, back and arm, and point-to-point (PTP) and graphesthesia tests of tactile acuity at the neck and arm...
February 2018: Musculoskeletal Science & Practice
Wacław M Adamczyk, Oskar Saulicz, Edward Saulicz, Kerstin Luedtke
Research shows that chronic pain is related to cortical alterations that can be reflected in reduced tactile acuity, but whether acute pain perception influences tactile acuity has not been tested. Considering the biological role of nociception, it was hypothesized that nociceptive pain will lead to a rapid improvement in tactile acuity and that this effect is correlated with pain intensity and pain distribution. In this randomised double-blind controlled experiment (trial no. NCT03021278), healthy participants were exposed to 1 of 3 experimental conditions: acute, nociceptive low back pain induced by saline injection, a sham injection (without piercing the skin) potentially inducing nocebo pain, or no intervention...
March 2018: Pain
Edith Elgueta-Cancino, Siobhan Schabrun, Paul Hodges
AIM/BACKGROUND: Primary motor cortex (M1) organization differs between individuals with and without chronic low back pain (CLBP), in parallel with motor and sensory impairments. This study investigated whether movement behaviour and tactile/pain sensation are related to M1 organisation in CLBP. METHODS: Transcranial magnetic stimulation (TMS) was used to map the M1 representation of the erector spinae and multifidus muscles in 20 participants with and without CLBP...
March 2018: Clinical Journal of Pain
M Bouchoucha, G Devroede, C Bon, B Bejou, F Mary, R Benamouzig
BACKGROUND: The Rome III criteria classify patients complaining of constipation into two main groups: patients with functional constipation (FC) and patients with constipation predominant irritable bowel syndrome (IBS-C). The purpose of this study was to identify differences in the intensity of symptoms and total and segmental colonic transit time in these two types of patients. METHODS: We performed a prospective evaluation of 337 outpatients consecutively referred for chronic constipation and classified according to the Rome III criteria as FC or IBS-C...
February 2017: Techniques in Coloproctology
Karin S Coyne, Brooke M Currie, Sean Donevan, Marina Brodsky, Michael J Asmus, Daniel W Krichbaum, Joseph C Cappelleri, Rozelle Hegeman-Dingle, Alesia Sadosky, Samuel Z Whipple, Claire Burbridge, Elie Mulhem, J Bruce Hillenberg
OBJECTIVE: Collecting data that helps evaluate different types of pain may improve physicians' decision-making with regard to treatment selection and on-going monitoring of patients. To date, no chronic pain assessments have been widely implemented in primary care. The aim of this study was to psychometrically validate the electronic Chronic Pain Questions (eCPQ) in a primary care setting. RESEARCH DESIGN AND METHODS: All men and women ≥18 years arriving at two similar primary care clinics in southeastern Michigan were invited to participate...
January 2017: Current Medical Research and Opinion
Carrie Falling, Ramakrishnan Mani
BACKGROUND AND AIMS: Alterations in central somatosensory function (e.g. cortical reorganisation) occurs secondary to chronic knee pain. The reorganization can be quantified using a clinical signatory measure, the two-point discrimination threshold (TPDT). In order to differentiate normal variability of TPDT against abnormal thresholds for clinical practice, development of body region specific reference values are required and the factors that determine the TPDT have to be established...
December 2016: Manual Therapy
K Ehrenbrusthoff, C G Ryan, C Grüneberg, U Wolf, D Krenz, G Atkinson, D J Martin
Two-point discrimination is measured as an indicator of cortical reorganisation in musculoskeletal medicine. Nevertheless, data are lacking for the reliability of this measure in patients with non-specific chronic low back pain (NSCLBP). We aimed to quantify the intra- and inter-observer reliability of a novel protocol for measuring two-point discrimination in these patients. 35 participants (12 males, 23 females, mean age 52, SD 15 years) with NSCLBP were recruited. Three clinicians made 14 consecutive measurements of two-point discrimination with callipers...
July 2016: Physiological Measurement
Carrie Falling, Ramakrishnan Mani
BACKGROUND AND AIMS: Two-point discrimination threshold (TPDT) is increased in individuals with chronic low back pain. TPDT reference values and their determinants are required for clinical applications. Therefore, the aims of this research are to establish reference values for TPDT of the low back regions in healthy individuals, stratified for age, and to investigate the associations of demographic and anthropomorphic variables with TPDT. METHODS: Healthy individuals (n = 79) across four decades (Group-I:18-29; Group-II:30-39; Group-III:40-49; and Group-IV:50-59years) were recruited...
June 2016: Manual Therapy
Shawn M Beaudette, Katelyn J Larson, Dennis J Larson, Stephen H M Brown
The purpose of the current work was to (1) determine whether low back cutaneous sensitivity could be reduced through the use of a topical lidocaine-prilocaine anesthetic (EMLA(®)) to mirror reductions reported in chronic lower back pain (CLBP) patients, as well as to (2) identify whether reductions in cutaneous sensitivity resulted in decreased lumbar spine proprioception, neuromuscular control and dynamic stability. Twenty-eight healthy participants were divided equally into matched EMLA and PLACEBO treatment groups...
August 2016: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Mikhail Saltychev, Esa Bärlund, Ryan Mattie, Zachary McCormick, Jaana Paltamaa, Katri Laimi
OBJECTIVE: To assess the validity of the Finnish translation of the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0). DESIGN: Cross-sectional cohort survey study. SETTING: Physical and Rehabilitation Medicine outpatient university clinic. SUBJECTS: The 501 consecutive patients with chronic musculoskeletal pain. MAIN MEASURES: Exploratory factor analysis and a graded response model using item response theory analysis were used to assess the constructs and discrimination ability of WHODAS 2...
February 2017: Clinical Rehabilitation
Suely Roizenblatt, Altay L Souza, Luciana Palombini, Luciana M Godoy, Sergio Tufik, Lia Rita A Bittencourt
BACKGROUND: We are witnessing the growth of urban populations, particularly in the developing world. São Paulo, the largest city in South America, continues to grow, and this growth is dramatically effecting the environment and human health. The aim of this study was to estimate the point prevalence of chronic pain in São Paulo city dwellers and to explore the influence of aspects related to urbanicity. METHODS: A two-stage cluster randomized sample included 1100 individuals of the city of Sao Paulo, representing the population proportionally in terms of gender, age and social classes in 2007...
2015: PloS One
Zhen-Yu Zhang, Fu-Chun Li, Ming Shao, Cao Yang, Jian Shang, Zheng-Gang Bi
The purpose of this study is to present the long-term outcomes of allogenic hand transplantations performed at our centre. Between January 2001 and October 2002, five allogeneic limb transplantations were performed in three patients (two bilateral forearm and one left hand transplantation). Donors and recipients were matched for blood types (ABO/Rh) and had at least two human leukocyte antigen (HLA) matches. A comprehensive rehabilitation plan integrating preoperative, intraoperative and postoperative management was developed for each patient...
December 2016: International Wound Journal
Isabelle Pagé, Jacques Abboud, Julie O Shaughnessy, Louis Laurencelle, Martin Descarreaux
BACKGROUND: Stratification strategies based on identifying patient's prognosis in order to guide patient care constitute one of the most prominent and recent approach in low back pain research. The STarT Back Screening Tool (SBST) although promising, has not been studied in patients with chronic low back pain (cLBP). Considering how challenging it is to translate research into practice, the value of integrating a new tool should be thoroughly assessed. The purpose was therefore to assess associations between the short- and long-terms clinical status and two types of variables, physiologic measures and the SBST, in participants with cLBP...
August 19, 2015: BMC Musculoskeletal Disorders
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