Relation Between Temporal Summation and Fatigue

NCT05146960 | Completed

• 1 other identifier: BC-10785
• Study Type: interventional
• Target: 55
• Locations: 1 country
• Sites: 1

Brief Summary

Central sensitization (CS) is a common feature in chronic musculoskeletal pain conditions including rheumatoid arthritis, chronic whiplash syndrome, fibromyalgia, temporomandibular joint disorders, low back pain and lateral elbow pain. CS is defined as "an amplification of neural signaling within the central nervous system that elicits pain hypersensitivity". Clinical signs are allodynia, hyperalgesia and widespread pain, originating from the enhanced activity of central nervous system to peripheral afferent input from unimodal and polymodal receptors. CS not only induces abnormal pain processing, it may also lead to motor performance dysfunction in chronic pain population. CS induce cortical reorganization including changes in gray matter, cortical representation and cortical excitability both in motor and somatosensory cortex. This process ultimately generates sensorimotor conflict that described as a mismatch between motor intention and sensory feedback, and may directly effect on motor performance. The structural changes in basal ganglia and reduced GABAergic activity in the motor cortex contribute to the alteration of the motor performance. It has been known that CS and fatigue, another indicator of the motor performance, has a bidirectional effect and fatigue is predicted by CS, independently of the presence of pain. CS affect fatigue via causing disrupted reward process, increased effort and pain expactation. The increased cervical spine hypersensitivity in patients with LEP even if there is no accompanied neck or upper limb pain may also indicate of the fatigue as pain does not always suggest an injury and biomechanical damage to a tissue does not always suggest that an individual will experience pain. If neck muscle fatigue is effected by central sensitization in patients with LEP, it can be important to develop therapeutic strategies to prevent neck muscle fatigue as there is a relationship between fatigue and increased risk of injury. Despite the fact that central sensitization effect on neck pain has been well documented in patients with LEP, its role on fatigue had not gain enough clinical and research attention. To know about central sensitization effect on motor performance can also be useful for determine subgroup of population who have central sensitization. However, it is unknown whether remote body endurance alteration occur in lateral elbow pain or not.

Conditions

Central Sensitisation; Elbow Pain; Fatigue

Keywords

motor performance; pain; temporal summation

Outcome Measures

Primary Outcomes (1)

• Change from baseline Sternocleidomastoid muscle normalized median frequency of the slope at 20 minutes

  It shows fatigue characteristic of the muscle

  Baseline and minutes 20

Secondary Outcomes (3)

• Change from baseline upper trapezius muscle normalized median frequency of the slope at 20 minutes

  Baseline and minutes 20

• Changes from baseline mean amplitude of the sternocleidomastoid muscle at 20 minutes

  Baseline and minutes 20

• Changes from baseline mean amplitude of the upper trapezius muscle at 20 minutes

  Baseline and minutes 20

Study Arms (2)

Temporal summation

EXPERIMENTAL

Temporal summation will be evoked in ECRL muscle origin, ECRB muscle belly, Brachioradialis. Pressure pain thresholds (PPTs) will be identified two times with a 30 s interval for each predetermined area. The average of two measurements will be used as a PPTs value. Temporal summation was induced two minutes after last PPTs was recorded. To evoke temporal summation at the lateral elbow, the probe will be applied with the pressure of the predefined PPT threshold at the rate of approximately 2 kg/s where it will be maintained for 1 s before being released with a 1 s interstimulus interval (ISI). This procedure will be repeated 10 times in each predetermined area. Pain intensity will be asked to participants at first, fifth and tenth pulse using a Visual Analog Scale range from "0 indicate no pain" to "10 most painful

Other: Temporal summation

Placebo

PLACEBO COMPARATOR

pressure pain threshold will be evaluated once in each predetermined region with a 30 second interval.

Other: Placebo

Interventions

Temporal summation OTHER

Temporal summation will be evoked in each predetermined area

Temporal summation

Placebo OTHER

PPTs will be assessed once in each predetermined area

Placebo

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• To be healthy

You may not qualify if:

• have suffered pain at an intensity of more than 2/10 for more than 8 days in the preceding year;
• having had a pain condition in the last 6 months for which treatment was sought;
• have undergone surgery in the neck or elbow region in the preceding year;
• suffer major depression or psychiatric illness (diagnosed by a psychiatrist and being in medical or psychiatric treatment);
• be diagnosed with life threatening, metabolic, cardiovascular, neurologic, systemic diseases;
• be pregnant or have given birth in the preceding year.

Sponsors & Collaborators

• University Ghent: lead

Study Sites (1)

Ghent University

Ghent, Oost-Vlaanderen, 9000, Belgium

Location

Related Publications (1)

• Canli K, Palmans T, Meeus M, De Meulemeester K. Excitation of the bottom-up pathways has no effect on remote muscle fatigue in healthy participants. Exp Brain Res. 2024 Nov 27;243(1):2. doi: 10.1007/s00221-024-06958-w.

  PMID: 39601827 DERIVED

MeSH Terms

Conditions

Fatigue; Pain

Interventions

Postsynaptic Potential Summation

Condition Hierarchy (Ancestors)

Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Neurologic Manifestations

Intervention Hierarchy (Ancestors)

Synaptic Transmission; Signal Transduction; Biochemical Phenomena; Chemical Phenomena; Synaptic Potentials; Membrane Potentials; Cell Physiological Phenomena; Electrophysiological Phenomena; Physiological Phenomena; Nervous System Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 29, 2021
• First Posted: December 7, 2021
• Study Start: November 9, 2021
• Primary Completion: December 20, 2021
• Study Completion: January 1, 2022
• Last Updated: December 11, 2023

Record last verified: 2023-12

Data Sharing

• IPD Sharing: Will not share

Locations

BE (1)