Nociception, pain, neuroplasticity and the practice of Osteopathic Manipulative Medicine

Pelletier, René; Bourbonnais, Daniel; Higgins, Johanne

doi:10.1016/j.ijosm.2017.08.001

Cited by 19 publications

(12 citation statements)

References 190 publications

(147 reference statements)

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“…This review found moderate-quality evidence indicating decreased spinal reflex excitability of the soleus and fibularis longus muscles in young adults with CAI when compared to age-matched controls without a history of ankle sprain. These findings appear to be in line with a growing body of evidence showing that neural adaptations occur in other musculoskeletal conditions [37,59,60] and support the emerging therapeutic strategies addressing neuroplasticity in the field of sports medicine [61,62,63,64]. However, we did not see a group difference in corticospinal excitability of either muscle between CAI and healthy control subjects.…”

Section: Discussionsupporting

confidence: 91%

Changes in Spinal and Corticospinal Excitability in Patients with Chronic Ankle Instability: A Systematic Review with Meta-Analysis

Kim

Cruz‐Díaz

et al. 2019

JCM

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The objective of this systematic review with meta-analysis was to determine alterations in spinal and corticospinal excitability of ankle muscles in patients with chronic ankle instability (CAI) compared to uninjured controls. Independent researchers performed comprehensive literature searches of electronic databases and included studies that compared groups with and without CAI and investigated neural excitability with Hoffmann reflex (H-reflex) and/or transcranial magnetic stimulation (TMS). A fixed-effect meta-analysis was conducted to determine group differences for (1) soleus and fibularis maximal H-reflex (Hmax)/maximal M-wave (Mmax)-ratios, and (2) soleus and fibularis longus cortical motor thresholds (CMTs). Seventeen studies were included in the current meta-analysis. They showed that the Hmax/Mmax-ratios of the soleus and the fibularis longus in the CAI group were significantly lower than those in the uninjured control group (soleus: d = −0.41, p < 0.001; fibularis longus: d = −0.27, p = 0.04). There was no evidence for changes in the CMT. This systematic review is the first to demonstrate evidence that patients with CAI present decreased spinal reflex excitability in the soleus and fibularis longus. However, there is no evidence of changes in supraspinal excitability when considering only the CMT. The latter result needs to be interpreted with caution as all except one study demonstrate some changes at the supraspinal level with CAI.

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Section: Discussionsupporting

confidence: 91%

Changes in Spinal and Corticospinal Excitability in Patients with Chronic Ankle Instability: A Systematic Review with Meta-Analysis

Kim

Cruz‐Díaz

et al. 2019

JCM

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“…Unnecessary pain occurs when these physiological or behavioral responses are unsuccessful [24]. Pain is, therefore, a complex disorder that involves sensory, motor, emotional-affective, and cognitive components [25,26] that can be represented visually in the nociceptive arch (Figure -1) [8,[27][28][29].…”

Section: Neurophysiological Pathway Of Painmentioning

confidence: 99%

“…A previous study demonstrated that laminae I and V are the best exit points for projections towards higher centers [ 46 ], as they lead to such structures as the hypothalamus, thalamus, limbic system, and certain cortical areas, primarily SI and SII. These structures codify the information to produce the real, conscious experience of pain ( Figure-1 ) – whether sensory (localization, character, discrimination) or affective (emotional) – which occurs when the nervous impulse reaches the specific brain structures (hypothalamus and thalamus) that modulate nociception [ 29 , 47 - 49 ].…”

Section: Neurophysiological Pathway Of Painmentioning

confidence: 99%

Nociceptive pain and anxiety in equines: Physiological and behavioral alterations

et al. 2021

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Pain and anxiety are two of the most important concerns in clinical veterinary medicine because they arise as consequences of multiple factors that can severely affect animal welfare. The aim of the present review was to provide a description and interpretation of the physiological and behavioral alterations associated with pain and anxiety in equines. To this end, we conducted an extensive review of diverse sources on the topic. The article begins by describing the neurophysiological pathway of pain, followed by a discussion of the importance of the limbic system in responses to pain and anxiety, since prolonged exposure to situations that cause stress and pain generates such physiological changes as tachycardia, tachypnea, hypertension, hyperthermia, and heart rate variability (HRV), often accompanied by altered emotional states, deficient rest, and even aggressiveness. In the long term, animals may show deficiencies in their ability to deal with changes in the environment due to alterations in the functioning of their immune, nervous, and endocrinologic systems. In conclusion, pain and anxiety directly impact the homeostasis of organisms, so it is necessary to conduct objective evaluations of both sensations using behavioral scales, like the horse grimace scale, complemented by assessments of blood biomarkers to analyze their correlation with physiological parameters: Heart rate, respiratory rate, HRV, the parasympathetic tone activity index, lactate and glucose levels, and temperature. Additional tools – infrared thermography, for example – can also be used in these efforts to improve the quality of life and welfare of horses.

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“…While some propose a neuro–fasciagenic perspective to somatic dysfunction ( Tozzi, 2015a , b ), others emphasized the relation between palpatory findings and allostatic load ( Lunghi et al, 2020 ) or movement variability ( Bergna et al, 2020 ). Apart from ongoing work on the conceptual basis of the somatic dysfunction framework, more recently, special attention has been given to the effects of touch in general ( Manzotti et al, 2020 ; Baroni et al, 2021 ) and the underlying neurological mechanisms of osteopathic care ( D’Alessandro et al, 2016 ; Pelletier et al, 2018 ; Gyer et al, 2019 ).…”

Section: Osteopathymentioning

confidence: 99%

Osteopathy and Mental Health: An Embodied, Predictive, and Interoceptive Framework

Bohlen¹,

Shaw

Cerritelli

et al. 2021

Front. Psychol.

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Globally, mental and musculoskeletal disorders present with high prevalence, disease burden, and comorbidity. In order to improve the quality of care for patients with persistent physical and comorbid mental health conditions, person-centered care approaches addressing psychosocial factors are currently advocated. Central to successful person-centered care is a multidisciplinary collaboration between mental health and musculoskeletal specialists underpinned by a robust therapeutic alliance. Such a collaborative approach might be found in osteopathy, which is typically utilized to treat patients with musculoskeletal disorders but may arguably also benefit mental health outcomes. However, research and practice exploring the reputed effect of osteopathy on patients with mental health problems lack a robust framework. In this hypothesis and theory article, we build upon research from embodied cognition, predictive coding, interoception, and osteopathy to propose an embodied, predictive and interoceptive framework that underpins osteopathic person-centered care for individuals with persistent physical and comorbid mental health problems. Based on the premise that, for example, chronic pain and comorbid depression are underlined by overly precise predictions or imprecise sensory information, we hypothesize that osteopathic treatment may generate strong interoceptive prediction errors that update the generative model underpinning the experience of pain and depression. Thus, physical and mental symptoms may be reduced through active and perceptual inference. We discuss how these theoretical perspectives can inform future research into osteopathy and mental health to reduce the burden of comorbid psychological factors in patients with persistent physical symptoms and support person-centered multidisciplinary care in mental health.

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Nociception, pain, neuroplasticity and the practice of Osteopathic Manipulative Medicine

Cited by 19 publications

References 190 publications

Changes in Spinal and Corticospinal Excitability in Patients with Chronic Ankle Instability: A Systematic Review with Meta-Analysis

Changes in Spinal and Corticospinal Excitability in Patients with Chronic Ankle Instability: A Systematic Review with Meta-Analysis

Nociceptive pain and anxiety in equines: Physiological and behavioral alterations

Osteopathy and Mental Health: An Embodied, Predictive, and Interoceptive Framework

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