A task-relevant experimental pain model to target motor adaptation

Gallina, A., Abboud, J. et Blouin, J. S. (2021). A task-relevant experimental pain model to target motor adaptation. Journal of Physiology, 599 (9). pp. 2401-2417. ISSN 0022-3751 DOI 10.1113/JP281145

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Key points: Motor adaptation is thought to be a strategy to avoid pain. Current experimental pain models do not allow for consistent modulation of pain perception depending on movement. We showed that low-frequency sinusoidal stimuli delivered at painful intensity result in minimal habituation of pain perception (over 60 s) and minimal stimulation artefacts on electromyographic signals. When the amplitude of the low-frequency sinusoidal stimuli was modulated based on the vertical force participants applied to the ground with their right leg while standing upright, we demonstrated a strong association between perceived pain and motor adaptation. By enabling task-relevant modulation of perceived pain intensity and the recording electromyographic signals during electrical painful stimulation, our novel pain model will permit direct experimental testing of the relationship between pain and motor adaptation. Abstract: Contemporary pain adaptation theories predict that motor adaptation occurs to limit pain. Current experimental pain models, however, do not allow for pain intensity modulation according to one's posture or movements. We developed a task-relevant experimental pain model using low-frequency sinusoidal electrical stimuli applied over the infrapatellar fat pad. In fourteen participants, we compared perceived pain habituation and stimulation-induced artefacts in vastus medialis electromyographic recordings elicited by sinusoidal (4, 10, 20 and 50 Hz) and square electrical waveforms delivered at constant peak stimulation amplitude. Next, we simulated a clinical condition where perceived knee pain intensity is proportional to the load applied on the leg by controlling sinusoidal current amplitude (4 Hz) according to the vertical force the participants applied with their right leg to the ground while standing upright. Pain ratings habituated over a 60 s period for 50 Hz sinusoidal and square waveforms but not for low-frequency sinusoidal stimuli (P < 0.001). EMG filters removed most stimulation artefacts for low-frequency sinusoidal stimuli (4 Hz). While balancing upright, participants’ pain ratings were correlated with the force applied by the right leg (R2 = 0.65), demonstrating task-relevant changes in perceived pain intensity. Low-frequency sinusoidal stimuli can induce knee pain of constant intensity for 60 s with minimal EMG artefacts while enabling task-relevant pain modulation when controlling current amplitude. By enabling task-dependent modulation of perceived pain intensity, our novel experimental model replicates key temporal aspects of clinical musculoskeletal pain while allowing quantification of neuromuscular activation during painful electrical stimulation. This approach will enable researchers to test the predicted relationship between movement strategies and pain. © 2021 The Authors. The Journal of Physiology © 2021 The Physiological Society

Type de document:	Article
Mots-clés libres:	adaptation electrical stimulation EMG knee pain adult article artifact controlled study correlation analysis current amplitude electromyography electrostimulation female habituation human human experiment infrapatellar fat pad knee pain male medical research motor performance musculoskeletal pain neuromuscular function normal human pain intensity pain measurement prediction priority journal quantitative analysis standing task performance vastus medialis muscle volunteer waveform weight bearing movement (physiology) skeletal muscle theoretical model adaptation physiological humans models theoretical movement muscle skeletal
Date de dépôt:	13 sept. 2021 12:36
Dernière modification:	13 sept. 2021 12:36
Version du document déposé:	Post-print (version corrigée et acceptée)
URI:	https://depot-e.uqtr.ca/id/eprint/9721

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