Localization of Muscle Edema and Changes on Muscle Contractility After Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle.
Background Myofascial trigger points (TrPs) are hyperirritable spots within taut bands of skeletal muscles that elicit local and referred pain when stimulated. Among the variety of techniques used for treating TrPs, dry needling (DN) is the most commonly applied intervention. The physiological mechanisms underlying the effects of DN remain to be elucidated. Objective To examine changes in skeletal muscle after DN in the area where the TrP is located. Methods We measured in vivo changes that occur in human skeletal muscle one hour after DN over a TrP with magnetic resonance imaging (MRI) and tensiomyography. The study included 18 asymptomatic subjects with a latent TrP in one medial gastrocn…
Mathematical Modeling for Neuropathic Pain: Bayesian Linear Regression and Self-Organizing Maps Applied to Carpal Tunnel Syndrome
A better understanding of the connection between risk factors associated with pain and function may assist therapists in optimizing therapeutic programs. This study applied mathematical modeling to analyze the relationship of psychological, psychophysical, and motor variables with pain, function, and symptom severity using Bayesian linear regressions (BLR) and self-organizing maps (SOMs) in carpal tunnel syndrome (CTS). The novelty of this work was a transfer of the symmetry mathematical background to a neuropathic pain condition, whose symptoms can be either unilateral or bilateral. Duration of symptoms, pain intensity, function, symptom severity, depressive levels, pinch tip grip force, a…
Spectral Clustering Reveals Different Profiles of Central Sensitization in Women with Carpal Tunnel Syndrome
Identification of subgroups of patients with chronic pain provides meaningful insights into the characteristics of a specific population, helping to identify individuals at risk of chronification and to determine appropriate therapeutic strategies. This paper proposes the use of spectral clustering (SC) to distinguish subgroups (clusters) of individuals with carpal tunnel syndrome (CTS), making use of the obtained patient profiling to argue about potential management implications. SC is a powerful algorithm that builds a similarity graph among the data points (the patients), and tries to find the subsets of points that are strongly connected among themselves, but weakly connected to others.…
Direct and Indirect Effects of Function in Associated Variables Such as Depression and Severity on Pain Intensity in Women with Carpal Tunnel Syndrome
Objective To determine the direct and indirect effects of function on clinical variables such as age, pain intensity, years of the disease, severity of symptoms, and depression in women with electrodiagnostic and clinical diagnosis of carpal tunnel syndrome (CTS). Design A cross-sectional study. Setting Patients from an urban hospital referred to a university clinic. Methods Two hundred and forty-four (n = 224) women with CTS were included. Demographic and clinical data, duration of symptoms, function, symptom's severity of the symptoms, pain intensity, and depression were self-reported collected. Correlation and path analysis with maximum likelihood estimation were conducted to assess the …
Sleep disturbances in tension-type headache and migraine
Current research into the pathogenesis of tension-type headache (TTH) and migraine is focused on altered nociceptive pain processing. Among the potential factors that influence sensitization mechanisms, emotional stress, depression, or sleep disorders all have an essential role: they increase the excitability of nociceptive firing and trigger hyperalgesic responses. Sleep disturbances and headache disorders share common brain structures and pathogenic mechanisms and TTH, migraine, and sleep disturbances often occur together; for example, 50% of individuals who have either TTH or migraine have insomnia. Moreover, insomnia and poor sleep quality have been associated with a higher frequency an…
Patient Profiling Based on Spectral Clustering for an Enhanced Classification of Patients with Tension-Type Headache
Profiling groups of patients in clusters can provide meaningful insights into the features of the population, thus helping to identify people at risk of chronification and the development of specific therapeutic strategies. Our aim was to determine if spectral clustering is able to distinguish subgroups (clusters) of tension-type headache (TTH) patients, identify the profile of each group, and argue about potential different therapeutic interventions. A total of 208 patients (n = 208) with TTH participated. Headache intensity, frequency, and duration were collected with a 4-week diary. Anxiety and depressive levels, headache-related burden, sleep quality, health-related quality of life, pre…
Is the association between health-related quality of life and fatigue mediated by depression in patients with multiple sclerosis? A Spanish cross-sectional study.
OBJECTIVES: To determine the mediating effects of depression on health-related quality of life and fatigue in individuals with multiple sclerosis (MS). DESIGN: A cross-sectional study. SETTING: Tertiary urban hospital. PARTICIPANTS: One hundred and eight patients (54% women) with MS participated in this study. OUTCOME MEASURES: Demographic and clinical data (weight, height, medication and neurological impairment), fatigue (Fatigue Impact Scale), depression (Beck Depression Inventory-II) and health-related quality of life (Short-Form Health Survey 36) were collected. RESULTS: Fatigue was significantly associated with bodily pain, physical function, mental health and depression. Depression wa…
Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample
Background Myogenic temporomandibular disorders (MTMD) frequently coexist with other clinical conditions in the same individual. In the last decades, several authors have analyzed these comorbidities looking for the origin of this overlapping. Objetives The aim of this study was to perform a comparative anaylisis between a group of patients with MTMD and a control group of dental patients without dysfunctional pathology to assess whether there are significant differences in the presence of systemic medical comorbidities between the two groups. Material and Methods Restrospective epidemiological analysis, based on medical questionnaires in a group of 31 patients, women, aged from 24 to 58 (a…
Gender differences in variables associated with sleep quality in chronic tension type headache
We aimed to evaluate gender differences in the relationships between headache features, sleep quality, anxiety, depressive symptoms, and burden of headache in 193 patients (73 percent women) with chronic tension type headache (CTTH). Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Headache features were collected with a four-week diary. The Hospital Anxiety and Depression Scale was used to assess anxiety/depressive symptoms. Headache Disability Inventory was used to evaluate the burden of headache. In men with CTTH, sleep quality was positive correlated with headache frequency (r = 0.310; p = .018), emotional (r = 0.518; p < .001) and physical (r = 0.468; p < .001) burde…
Effects of Adding Motor Imagery to Early Physical Therapy in Patients with Knee Osteoarthritis who Had Received Total Knee Arthroplasty
Abstract Objective To investigate the effects of the inclusion of motor imagery (MI) principles into early physical therapy on pain, disability, pressure pain thresholds (PPTs), and range of motion in the early postsurgical phase after total knee arthroplasty (TKA). Methods A randomized clinical trial including patients with knee osteoarthritis who have received TKA was conducted. Participants were randomized to receive five treatment sessions of either physical therapy with or without MI principles in an early postsurgical phase after a TKA (five days after surgery). Pain intensity (visual analog scale [VAS], 0–100), pain-related disability (short-form Western Ontario McMaster Universities…
The number of symptoms at the acute COVID-19 phase is associated with anxiety and depressive long-term post-COVID symptoms: A multicenter study
Differences in Long-COVID Symptoms between Vaccinated and Non-Vaccinated (BNT162b2 Vaccine) Hospitalized COVID-19 Survivors Infected with the Delta Variant
This study compared differences in the presence of post-COVID symptoms among vaccinated and non-vaccinated COVID-19 survivors requiring hospitalization due to the Delta (B.1.617.2) variant. This cohort study included hospitalized subjects who had survived SARS-CoV-2 infection (Delta variant) from July to August 2021 in an urban hospital in Madrid, Spain. Individuals were classified as vaccinated if they received full administration (i.e., two doses) of BNT162b2 (“Pfizer-BioNTech”) vaccines. Other vaccines were excluded. Those with just one dose of the BNT162b2 vaccine were considered as non-vaccinated. Patients were scheduled for a telephone interview at a follow-up around six months after …
Subgrouping factors influencing migraine intensity in women: A semi-automatic methodology based on machine learning and information geometry
[EN] Background Migraine is a heterogeneous condition with multiple clinical manifestations. Machine learning algorithms permit the identification of population groups, providing analytical advantages over other modeling techniques. Objective The aim of this study was to analyze critical features that permit the differentiation of subgroups of patients with migraine according to the intensity and frequency of attacks by using machine learning algorithms. Methods Sixty-seven women with migraine participated. Clinical features of migraine, related disability (Migraine Disability Assessment Scale), anxiety/depressive levels (Hospital Anxiety and Depression Scale), anxiety state/trait levels (S…
Post-COVID functional limitations on daily living activities are associated with symptoms experienced at the acute phase of SARS-CoV-2 infection and internal care unit admission: A multicenter study
Identification of Subgroups of Women with Carpal Tunnel Syndrome with Central Sensitization.
Identification of subjects with different sensitization mechanisms can help to identify better therapeutic strategies for carpal tunnel syndrome (CTS). The aim of the current study was to identify subgroups of women with CTS with different levels of sensitization.A total of 223 women with CTS were recruited. Self-reported variables included pain intensity, function, disability, and depression. Pressure pain thresholds (PPT) were assessed bilaterally over median, ulnar, and radial nerves, C5-C6 joint, carpal tunnel, and tibialis anterior to assess widespread pressure pain hyperalgesia. Heat (HPT) and cold (CPT) pain thresholds were also bilaterally assessed over the carpal tunnel and the the…
Electromyographic Activity Evolution of Local Twitch Responses During Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle: A Cross-Sectional Study
Abstract Objective Trigger points (TrPs) are hypersensitive spots within taut bands of skeletal muscles that elicit referred pain and motor changes. Among the variety of techniques used for treating TrPs, dry needling is one of the most commonly applied interventions. The question of eliciting local twitch responses (LTRs) during TrP dry needling is unclear. Our main aim was to investigate the evolution of the electromyographic (EMG) peak activity of each LTR elicited during dry needling into latent TrPs of the gastrocnemius medialis muscle. Methods Twenty asymptomatic subjects with latent TrPs in the gastrocnemius medialis muscle participated in this cross-sectional study. Changes in EMG s…
Data from: Is the association between health-related quality of life and fatigue mediated by depression in patients with multiple sclerosis? A Spanish cross sectional study
Objectives: To determine the mediating effects of depression on health-related quality of life and fatigue in individuals with multiple sclerosis (MS). Design: A cross-sectional study. Setting: Tertiary urban hospital. Participants: One hundred and eight patients (54% women) with MS participated in this study. Outcome measures: Demographic and clinical data (weight, height, medication, and neurological impairment), fatigue (Fatigue Impact Scale-FIS), depression (Beck Depression Inventory-BDI/II) and health-related quality of life (Short-Form Health Survey 36 - SF36) were collected. Results: Fatigue was significantly associated with bodily pain, physical function, mental health and depressio…