Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials

Charles W Gay,1 Meryl J Alappattu,1 Rogelio A Coronado,1 Maggie E Horn,1 Mark D Bishop21Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, 2Department of Physical Therapy, University of Florida, Gainesville, FLBackground: Muscle-biased therapies (MBT) are commo...

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Main Authors: Gay CW, Alappattu MJ, Coronado RA, Horn ME, Bishop MD
Format: Article
Language:English
Published: Dove Medical Press 2013-02-01
Series:Journal of Pain Research
Online Access:http://www.dovepress.com/effect-of-a-single-session-of-muscle-biased-therapy-on-pain-sensitivit-a12127
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author Gay CW
Alappattu MJ
Coronado RA
Horn ME
Bishop MD
author_facet Gay CW
Alappattu MJ
Coronado RA
Horn ME
Bishop MD
author_sort Gay CW
collection DOAJ
description Charles W Gay,1 Meryl J Alappattu,1 Rogelio A Coronado,1 Maggie E Horn,1 Mark D Bishop21Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, 2Department of Physical Therapy, University of Florida, Gainesville, FLBackground: Muscle-biased therapies (MBT) are commonly used to treat pain, yet several reviews suggest evidence for the clinical effectiveness of these therapies is lacking. Inadequate treatment parameters have been suggested to account for inconsistent effects across studies. Pain sensitivity may serve as an intermediate physiologic endpoint helping to establish optimal MBT treatment parameters. The purpose of this review was to summarize the current literature investigating the short-term effect of a single dose of MBT on pain sensitivity in both healthy and clinical populations, with particular attention to specific MBT parameters of intensity and duration.Methods: A systematic search for articles meeting our prespecified criteria was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE from the inception of each database until July 2012, in accordance with guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analysis. Relevant characteristics from studies included type, intensity, and duration of MBT and whether short-term changes in pain sensitivity and clinical pain were noted with MBT application. Study results were pooled using a random-effects model to estimate the overall effect size of a single dose of MBT on pain sensitivity as well as the effect of MBT, dependent on comparison group and population type.Results: Reports from 24 randomized controlled trials (23 articles) were included, representing 36 MBT treatment arms and 29 comparative groups, where 10 groups received active agents, 11 received sham/inert treatments, and eight received no treatment. MBT demonstrated a favorable and consistent ability to modulate pain sensitivity. Short-term modulation of pain sensitivity was associated with short-term beneficial effects on clinical pain. Intensity of MBT, but not duration, was linked with change in pain sensitivity. A meta-analysis was conducted on 17 studies that assessed the effect of MBT on pressure pain thresholds. The results suggest that MBT had a favorable effect on pressure pain thresholds when compared with no-treatment and sham/inert groups, and effects comparable with those of other active treatments.Conclusion: The evidence supports the use of pain sensitivity measures by future research to help elucidate optimal therapeutic parameters for MBT as an intermediate physiologic marker.Keywords: muscle-biased therapy, pain sensitivity, pressure pain threshold
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spelling doaj.art-15f3b3b05fca44cd94a86cc2ef75cd332022-12-22T02:48:25ZengDove Medical PressJournal of Pain Research1178-70902013-02-012013default722Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trialsGay CWAlappattu MJCoronado RAHorn MEBishop MDCharles W Gay,1 Meryl J Alappattu,1 Rogelio A Coronado,1 Maggie E Horn,1 Mark D Bishop21Rehabilitation Science Doctoral Program, College of Public Health and Health Professions, 2Department of Physical Therapy, University of Florida, Gainesville, FLBackground: Muscle-biased therapies (MBT) are commonly used to treat pain, yet several reviews suggest evidence for the clinical effectiveness of these therapies is lacking. Inadequate treatment parameters have been suggested to account for inconsistent effects across studies. Pain sensitivity may serve as an intermediate physiologic endpoint helping to establish optimal MBT treatment parameters. The purpose of this review was to summarize the current literature investigating the short-term effect of a single dose of MBT on pain sensitivity in both healthy and clinical populations, with particular attention to specific MBT parameters of intensity and duration.Methods: A systematic search for articles meeting our prespecified criteria was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE from the inception of each database until July 2012, in accordance with guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analysis. Relevant characteristics from studies included type, intensity, and duration of MBT and whether short-term changes in pain sensitivity and clinical pain were noted with MBT application. Study results were pooled using a random-effects model to estimate the overall effect size of a single dose of MBT on pain sensitivity as well as the effect of MBT, dependent on comparison group and population type.Results: Reports from 24 randomized controlled trials (23 articles) were included, representing 36 MBT treatment arms and 29 comparative groups, where 10 groups received active agents, 11 received sham/inert treatments, and eight received no treatment. MBT demonstrated a favorable and consistent ability to modulate pain sensitivity. Short-term modulation of pain sensitivity was associated with short-term beneficial effects on clinical pain. Intensity of MBT, but not duration, was linked with change in pain sensitivity. A meta-analysis was conducted on 17 studies that assessed the effect of MBT on pressure pain thresholds. The results suggest that MBT had a favorable effect on pressure pain thresholds when compared with no-treatment and sham/inert groups, and effects comparable with those of other active treatments.Conclusion: The evidence supports the use of pain sensitivity measures by future research to help elucidate optimal therapeutic parameters for MBT as an intermediate physiologic marker.Keywords: muscle-biased therapy, pain sensitivity, pressure pain thresholdhttp://www.dovepress.com/effect-of-a-single-session-of-muscle-biased-therapy-on-pain-sensitivit-a12127
spellingShingle Gay CW
Alappattu MJ
Coronado RA
Horn ME
Bishop MD
Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials
Journal of Pain Research
title Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials
title_full Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials
title_fullStr Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials
title_short Effect of a single session of muscle-biased therapy on pain sensitivity: a systematic review and meta-analysis of randomized controlled trials
title_sort effect of a single session of muscle biased therapy on pain sensitivity a systematic review and meta analysis of randomized controlled trials
url http://www.dovepress.com/effect-of-a-single-session-of-muscle-biased-therapy-on-pain-sensitivit-a12127
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