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Biomedical subjects

Bengt H Sjölund

Publications and source records attributed to Bengt H Sjölund.

8 recordsLinked to original sources
PubMed2007

Pressure pain threshold changes after repeated mechano-nociceptive stimulation of the trapezius muscle: possible influence of previous pain experience.

UNLABELLED: We examined the relation between repeated noxious pressure over the trapezius muscle and changes in pressure pain thresholds (PPTs) in a before-after trial design. A conditioning series of 30 mechano-nociceptive stimuli was applied manually with a handheld algometer probe, and PPTs were measured over 1 trapezius muscle (skin anaesthetized) in 27 healthy women before and after the intervention. With a mean stimulation rate of 0.40 Hz and a mean nociceptive stimulation intensity of 1.78 x Threshold, subjects were found to systematically react with a change in PPT, either a decrease or an increase. Normalized data, transformed into mean unidirectional PPT differences, showed statistically highly significant changes after intervention. The relative risk of reacting with lowered PPTs on noxious stimulation was 3.7 times higher for subjects who had not given birth to children than for subjects who had given birth to 1 or several children (P<.046). When 11 subjects were tested at a second session, a clear correlation of PPT reactions (r=0.527; P<.001) was found. In summary, repetitive mechano-nociceptive stimulation of the trapezius muscle in healthy females evokes moderate and temporary changes in PPT that last for at least 35 minutes after cessation of stimulation. PERSPECTIVE: A possible development of the response with transiently decreased PPTs into a model for human muscle pain is an intriguing possibility, since other models usually involve the introduction of chemical or thermal agents in the muscle, but this must await further research.

Adult↗
PubMed2006

Constraint-induced movement therapy in patients with stroke: a pilot study on effects of small group training and of extended mitt use.

OBJECTIVE: (1) To evaluate constraint-induced movement therapy for chronic stroke patients modified into group practice to limit the demand on therapist resources. (2) To explore whether extended mitt use alone may enhance outcome. DESIGN: A combined case-control and randomized controlled study with pre- and post-treatment measures by blinded observers. SETTING: A university hospital rehabilitation department. PARTICIPANTS: Sixteen stroke patients (nine men and seven women; mean age 56.7 years; on average 28.9 months post stroke, five of whom were 6-9 months post stroke) with moderate motor impairments in the contralateral upper limb. INTERVENTION: Constraint-induced therapy (mitt on the less affected hand 90% of waking hours for 12 days) with 2-3 patients per therapist and 6 h of group training per day. After the training period, the patients were randomized either to using the mitt at home every other day for two-week periods for another three months (in total 21 days) or to no further treatment. OUTCOME MEASURES: Modified Motor Assessment Scale, Sollerman Hand Function Test, Two-Point Discrimination test and Motor Activity Log. RESULTS: The mean motor performance improved significantly after two weeks of constraint-induced group therapy on Motor Assessment Scale (1.44 (95% confidence interval (95% CI) 0.59-2.28) points; P = 0.003) and on Sollerman Hand Function Test (3.81 (95% CI 0.26-7.36) points; P = 0.037) but showed no sensory change in the Two-Point Discrimination Test (P = 0.283). The median difference in self-reported motor ability (Motor Activity Log) also improved (P < 0.001). However, no additional effect was seen from wearing a mitt for another three months. CONCLUSION: Constraint-induced group therapy, allowing several patients per therapist, seems to be a feasible alternative to improve upper limb motor function. The restraint alone, extended in time, did not enhance the treatment effect.

Analysis of Variance↗
PubMed2004

Tender or not tender: test-retest repeatability of pressure pain thresholds in the trapezius and deltoid muscles of healthy women.

OBJECTIVE: To examine the test-retest repeatability of pressure pain thresholds in the shoulder muscles of healthy women. DESIGN: Four experimental sessions (days 1, 3, 28, 30), each including 4 consecutive pressure pain threshold measurements at 10-minute intervals. SUBJECTS: Twenty-four healthy female volunteers, mean age 42 years. METHODS: Two examiners measured pressure pain thresholds bilaterally over the trapezius and deltoid muscles with an electronic algometer. Student's paired t-test, intraclass correlation coefficient, ANOVA repeated measures, 95% confidence interval and mean maximal absolute measurement error, were used for statistics. RESULTS: Reliability for each point in all sessions was high; ICC range 0.70-0.94, mean maximal differences; 53-102 kPa (all 4 muscles), and between points in each muscle: ICC right trapezius 0.59-0.77, left 0.67-0.84, right deltoid 0.66-0.83, left 0.70-0.90. Mean maximal differences were 69-101 kPa and 65-111 kPa for the trapezius and deltoid muscles, respectively. The inter-individual variation was 5-fold (trapezius 88-574 kPa; deltoid 91-529 kPa). At the group level, the variation was limited when the first measurement was excluded. Inter-rater and intra-rater repeatability was high without significant differences. Only small side-to-side differences were seen. CONCLUSION: Repeated measurements show stable intra-individual values. The method can be recommended when used by trained and experienced examiners.

Adult↗
PubMed2003

Increases in local pressure pain thresholds after muscle exertion in women with chronic shoulder pain.

OBJECTIVE: To examine the relation between muscular tenderness and local muscular fatigue. DESIGN: Before-after trial, measuring pressure pain thresholds and signs of local muscular fatigue by using surface electromyography before, after, 10 minutes after, and 20 minutes after intervention. SETTING: University rehabilitation department in Sweden. PARTICIPANTS: Nineteen female hospital cleaners with unilateral chronic shoulder pain for 1 year. No previous trauma, surgery, or signs of systemic or neurologic disease. INTERVENTION: Static abduction endurance test with submaximal unilateral activation of the trapezius and deltoid muscles. MAIN OUTCOME MEASURES: Pressure pain thresholds and electromyographic fatigue parameters (root mean square [RMS]; mean power frequency [MPF]). RESULTS: Mean normalized pressure pain threshold values increased significantly (95% confidence interval [CI]) and lasted for 20 minutes: in the trapezius, threshold values increased to 115% to 120% (95% CI, 100%-140%; P=.04-.05); and in the deltoid, the threshold increased to 112% to 115% (95% CI, 100%-130%; P=.02-.05). Development of significant electromyographically defined fatigue was seen: in the trapezius, the RMS increased to 130% (95% CI, 119%-141%), and in the deltoid, the MPF decreased to 78% (95% CI, 74%-82%), but normalized within 15 seconds to 10 minutes. CONCLUSION: Lasting bilateral increases in pressure pain thresholds but transient local muscular fatigue were seen after a unilateral static endurance test. The sensitivity of the sensory nervous system may change during a static muscle contraction and sometimes contributes to a localized sensation of numbness.

Adult↗
PubMed2002

Pain and rehabilitation after spinal cord injury: the case of sensory spasticity?

Sixty percent of patients with posttraumatic para- or tetraplegia suffer from severe, continuous burning and/or lancinating pain. Multiple sclerosis produces pain in more than 30%. This pain can be as important as the absent mobility or sexual function as a cause of lowered quality of life. Two unique types of longstanding neuropathic pain can be recognized in persons with spinal cord injury: (1). segmentally distributed pain at the lesion; and (2). pain in the body below the lesion, often with late onset. The first type could be produced by nerve root entrapment or by direct segmental deafferentation. The second type probably contains several forms of central pain, evoked either by the original spinal lesion, by an expanding syrinx in the spinal cord or by secondary changes at higher levels of the somatosensory systems. Patients with central pain almost always have stimulus-independent pain. Its intensity may vary independently, be related to the presence of visceral activity/inflammation or be constant. In addition, stimulus-dependent pain is sometimes present, usually because skin areas or viscera below the lesion are allodynic. Partial spinal lesions, especially centrally in the cervical spinal cord, may be more prone to produce pain than are complete lesions. There is limited analgesic effectiveness in controlled studies of serotonin reuptake inhibitors, of sodium channel blockers (lidocaine, tetracaine), of the GABA receptor agonist baclofen (one study) and of the NMDA-receptor antagonist ketamine (one study). There are anecdotal reports on oral carbamazepine, on gabapentin, on intrathecal opiates and also on the alpha(2)-agonist clonidine, being effective in central neuropathic pain. Neurostimulation is effective only if it evokes paraesthesia in the painful area; hence TENS may give relief of segmental pain. Neurodestructive procedures and central neurostimulation have been largely unsuccessful. As in other longstanding pain, improved coping through cognitive-behavioural rehabilitation may be helpful for the clinical outcome.

Animals↗
PubMed1982

Psychiatric factors influencing the treatment of pain with peripheral conditioning stimulation.

Sixty-six patients treated with transcutaneous nerve stimulation (TNS) for pain symptoms were studied with respect to the incidence of different psychiatric factors and physical disorders in relation to success or failure of the treatment. In a blind screening procedure, mental illness and pathological personality traits were negative in relation to treatment success, while a state of reactive decompensation was not. Patients without any relevant physical cause of their pain were generally treatment failures and they had an excess of pathological personality traits, mostly of a hysterical nature.

Adjustment Disorders↗
PubMed1979

Long term results of peripheral conditioning stimulation as an analgesic measure in chronic pain.

In the present study 123 patients with chronic pain, consecutively referred for symptomatic pain treatment, were given peripheral conditioning stimulation as an analgesic measure and were followed for 2 years or till they terminated the treatment. The stimulation was either conventional transcutaneous nerve stimulation (TNS) [35] of mainly cutaneous afferents with high frequency (10-100 Hz) or acupuncture-like TNS [11] where muscle nerves are activated at a low repetition rate (1-4 Hz) with small trains of stimuli. The follow-up showed that 55, 41 and 31% of the patients continued the treatment after 3, 12 and 24 months, respectively. About 30% of the patients had to use acupuncture-like TNS to get useful analgesia, defined as a desire of the patient to continue stimulation treatment. Three-quarters of the successfully relieved patients reported more than 50% pain relief as measured from visual analogue scales and half of these reported an increased social activity and a decrease of analgesic drug intake by more than 50%. Psychogenic and visceral pains were less suitable for TNS treatment. It is concluded that peripheral conditioning stimulation is a valuable therapy in cases of chronic pain and that both conventional and acupuncture-like TNS should be tried before considering implantable devices or destructive surgery.

Acupuncture Therapy↗