A Novel Experimental Knee-Pain Model Affects Perceived Pain and Movement Biomechanics

Seeley, Matthew K.; Park, Jihong; King, Daniel; Hopkins, J. Ty

doi:10.4085/1062-6050-48.2.02

Cited by 38 publications

(42 citation statements)

References 47 publications

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“…30 We also reported reduced peak ankle plantar-flexion angles during running. The primary difference between our study and previously mentioned studies 30,54 is the chronicity of pain in our participants. This might have influenced their response to pain by dampening the effect of the RSLS protocol, as can be seen in the relatively smaller magnitude of changes in pain we found (0.99-1.50 cm) compared with previous investigators (2.58 cm by Henriksen et al 54 and 4.29 cm by Seeley et al 30 ).…”

Section: Kinematicsmentioning

confidence: 87%

“…53 Authors of experimental knee-pain studies have reported few kinematic changes, including decreased knee-flexion 54 and ankle plantar-flexion 30 angles during walking and decreased plantar-flexion and hip-adduction angles during running. 30 We also reported reduced peak ankle plantar-flexion angles during running. The primary difference between our study and previously mentioned studies 30,54 is the chronicity of pain in our participants.…”

Section: Kinematicsmentioning

confidence: 99%

“…It is also possible that the inhibitory effects of pain remain even after pain has been relieved, which has been previously demonstrated in some 46,50,51 but not other experimental knee-pain studies. 30,52 It should be noted that TENS might be beneficial for long-term use. Strength increased when TENS was combined with rehabilitation compared with placebo TENS and rehabilitation or with rehabilitation alone.…”

Section: Strengthmentioning

confidence: 99%

“…Some researchers have proposed kinematic invariance 53 after acute increases in pain. 30 Kinematic invariance could be described as maintaining kinematics after a perturbation (ie, increased pain) while the kinetics are adjusted. 53 Authors of experimental knee-pain studies have reported few kinematic changes, including decreased knee-flexion 54 and ankle plantar-flexion 30 angles during walking and decreased plantar-flexion and hip-adduction angles during running.…”

Section: Kinematicsmentioning

confidence: 99%

“…Using experimental knee-pain models, researchers 29,30 have demonstrated changes in pain that are similar to those seen in participants with PFP. However, these experimental knee-pain studies involved acute changes in healthy persons, not in those with chronic pain.…”

mentioning

confidence: 99%

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Acute Responses of Strength and Running Mechanics to Increasing and Decreasing Pain in Patients With Patellofemoral Pain

Bazett-Jones

Huddleston

Cobb

et al. 2017

Journal of Athletic Training

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; †University of Wisconsin-MilwaukeeContext: Patellofemoral pain (PFP) is typically exacerbated by repetitive activities that load the patellofemoral joint, such as running. Understanding the mediating effects of changes in pain in individuals with PFP might inform injury progression, rehabilitation, or both.Objective: To investigate the effects of changing pain on muscular strength and running biomechanics in those with PFP.Design: Crossover study. Setting: University research laboratory.Patients or Other Participants: Seventeen participants (10 men, 7 women) with PFP.Intervention(s): Each participant completed knee painreducing and pain-inducing protocols in random order. The pain-reducing protocol consisted of 15 minutes of transcutaneous electric nerve stimulation (TENS) around the patella. The pain-inducing protocol was sets of 20 repeated single-legged squats (RSLS). Participants completed RSLS sets until either their pain was within at least 1 cm of their pain during an exhaustive run or they reached 10 sets.Main Outcome Measure(s): Pain, isometric hip and trunk strength, and running mechanics were assessed before and after the protocols. Dependent variables were pain, normalized strength (abduction, extension, external rotation, lateral trunk flexion), and peak lower extremity kinematics and kinetics in all planes. Pain scores were analyzed using a Friedman test. Strength and mechanical variables were analyzed using repeated-measures analyses of variance. The a level was set at P , .05.Results: Pain was decreased after the TENS (pretest: 3.10 6 1.95, posttest: 1.89 6 2.33) and increased after the RSLS (baseline: 3.10 6 1.95, posttest: 4.38 6 2.40) protocols (each P , .05). The RSLS protocol resulted in a decrease in hipextension strength (baseline: 0.355 6 0.08 kg/kg, posttest: 0.309 6 0.09 kg/kg; P , .001). Peak plantar-flexion angle was decreased after RSLS (baseline: À13.978 6 6.418, posttest: À12.848 6 6.458; P ¼ .003). Peak hip-extension (pretest: À2.31 6 0.46) and hip-abduction (pretest: À2.02 6 0.35) moments decreased after both the TENS (extension: À2.15 6 0.48 Nm/ kg, P ¼ .015; abduction: À1.91 6 0.33 Nm/kg, P ¼ .015) and RSLS (extension: À2.18 6 0.52 Nm/kg, P ¼ .003; abduction: À1.87 6 0.36 Nm/kg, P ¼ .039) protocols.Conclusions: This study presents a novel and effective method of increasing pain in persons with PFP. Functionally increased pain after RSLS coincides with reduced hip-extensor muscle strength and decreased plantar-flexion angle during running. The TENS treatment decreased pain during running in those with PFP but failed to influence strength. Hip moments were reduced by both protocols, which may demonstrate that acute increases or decreases in pain cause runners to change their mechanics.

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Section: Kinematicsmentioning

confidence: 87%

Section: Kinematicsmentioning

confidence: 99%

Section: Strengthmentioning

confidence: 99%

Section: Kinematicsmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Acute Responses of Strength and Running Mechanics to Increasing and Decreasing Pain in Patients With Patellofemoral Pain

Bazett-Jones

Huddleston

Cobb

et al. 2017

Journal of Athletic Training

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Relationship Between Knee Biomechanics and Pain in People With Knee Osteoarthritis: A Systematic Review and Meta‐Analysis

Hutchison

Grayson

Hiller

et al. 2022

Arthritis Care & Research

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Objective Our primary aim was to determine the cross‐sectional relationship between knee biomechanics during gait and pain in people with medial knee osteoarthritis. Our secondary aim was to evaluate differences in knee biomechanics between symptomatic and asymptomatic participants with medial knee osteoarthritis. Methods Four online databases were searched from inception to July 2021. Eligible studies included people with medial/nonspecific knee osteoarthritis and a reported relationship between knee biomechanics during gait and pain or biomechanics of symptomatic and asymptomatic participants. Two reviewers independently extracted data and evaluated risk of bias. Random‐effects meta‐analyses were performed when three or more studies reported the same biomechanical variable for pooling (knee adduction moment [KAM], KAM impulse, varus thrust, and peak knee flexion moment [KFM]). Results Forty studies were included. Methodological quality ranged from 4 to 9/10. Forty‐seven unique biomechanical variables were reported. For the KAM, there was no correlation with pain for peak values pooled (early stance and overall) (r = 0.00, 95% confidence interval [95% CI]: −0.12, 0.11, k = 16), a small negative correlation for early stance peak alone (r = −0.09, 95% CI −0.18, −0.002, k = 12), and a medium positive correlation for the overall peak during stance (r = 0.30, 95% CI 0.17, 0.42, k = 4). Metaregression identified that body mass index moderated the peak KAM–pain relationship (P < 0.001). KAM impulse had a small positive correlation with pain (r = 0.23, 95% CI 0.04, 0.40, k = 5), and people with varus thrust had 3.84 greater odds of reporting pain compared with people without (95% CI 1.72, 8.53, k = 3). Meta‐analyses for the peak KFM and pain correlation and secondary aim were nonsignificant. Conclusion Some knee gait biomechanics were associated with pain in this cohort. Longitudinal studies are required to determine causality.

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Impact of medial versus lateral knee pain on deep tissue hyperalgesia and muscle strength

Oda

Izumi

Aso

et al. 2018

European Journal of Pain

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A Novel Experimental Knee-Pain Model Affects Perceived Pain and Movement Biomechanics

Cited by 38 publications

References 47 publications

Acute Responses of Strength and Running Mechanics to Increasing and Decreasing Pain in Patients With Patellofemoral Pain

Acute Responses of Strength and Running Mechanics to Increasing and Decreasing Pain in Patients With Patellofemoral Pain

Relationship Between Knee Biomechanics and Pain in People With Knee Osteoarthritis: A Systematic Review and Meta‐Analysis

Impact of medial versus lateral knee pain on deep tissue hyperalgesia and muscle strength

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