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Prevalência e fatores associados à função dos sistemas de modulação endógena da dor em indivíduos saudáveis portugueses
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Abstract(s)
Introdução: Os Sistemas de Modulação Endógenos da Dor (SMED) consistem num termo
que abrange toda a tipologia de ações facilitadoras e/ou inibidoras efetuadas pelo sistema
nervoso central, sendo moduladores responsáveis pelo aumento ou diminuição da dor. A sua
avaliação é essencial para o estabelecimento do perfil modulatório de dor (antinocicepção ou
pronocicepção) em indivíduos saudáveis, e consequentemente efetuar a estratificação do risco
de estes desenvolverem estados de dor e é efetuada através da medição da Somação Temporal
(ST) e da Modulação Condicionada da Dor (MCD). Os SMED encontram-se frequentemente
alterados em populações com dor ou condições músculo-esqueléticas. Contudo, desconhece se a prevalência de disfunção deste sistema em indivíduos saudáveis e sem dor assim como
os fatores potencialmente associados a essas alterações.
Objetivo: Determinar a prevalência e caracterizar os fatores associados à disfunção dos
sistemas de modulação endógenos da dor em indivíduos saudáveis portugueses.
Métodos: A caracterização dos SMED de 37 indivíduos saudáveis portugueses foi efetuada
através da medição da ST usando o Quantitative Sensory Testing (QST) sendo que a MCD
foi mensurada utilizando um protocolo metodológico sequencial, que utilizou como estímulo
de teste o pain pressure treshold no músculo trapézio superior e o Cold Pressor Test como
estímulo de condicionamento. Para o estudo dos fatores associados à alteração dos SMED
foram recolhidos os dados do perfil sociodemográfico, clínico e aptidão física dos
participantes. A análise de dados foi efetuada através da análise dos valores de magnitude
absoluta e relativa da somação temporal e modulação condicionada da dor. A análise
estatística e respetiva comparação entre os grupos foi efetuada através do teste do Qui Quadrado e do teste de Mann-Whitney.
Resultados: A taxa de prevalência de disfunção dos SMED foi de 65% para a amostra em
estudo. Dezasseis por cento dos participantes demonstraram alterações no teste da MCD e
59% na ST. Verificaram-se alterações estatisticamente significativas entre grupos (normal e
disfuncional) nos hábitos tabágicos para a MCD. Na ST verificaram-se diferenças entre
grupos, dependendo da região anatómica em teste, na idade, testes de aptidão física (Hand
Grip Strenght Test e teste de marcha de 6 minutos) e nível de stress laboral. Conclusão: Os resultados do presente estudo apontam para uma elevada taxa de prevalência
da disfunção dos SMED em pessoas saudáveis. Verificou-se a existência de diferenças entre
grupos de participantes com e sem disfunção destes sistemas em relação com fatores
sociodemográficos, clínicos e testes de aptidão física. Estudos futuros, de corte longitudinal,
são necessários para melhor compreender, definir e estabelecer fatores associados à função
destes sistemas.
Introduction: The Endogenous Pain Modulation Systems (EPMS) encompass a term that includes all types of facilitating and/or inhibiting actions carried out by the central nervous system, acting as modulators responsible for the increase or decrease of pain. Their assessment is essential for establishing the pain modulation profile (antinociception or pronociception) in healthy individuals, thereby enabling risk stratification for the potential development of pain conditions. This assessment is conducted through the measurement of Temporal Summation (TS) and Conditioned Pain Modulation (CPM). EPMS are often altered in populations experiencing pain or musculoskeletal conditions. However, the prevalence of dysfunction within this system in healthy, pain-free individuals, as well as the factors potentially associated with these alterations, remains unknown. Objectives: To determine the prevalence and characterize the factors associated with dysfunction in the endogenous pain modulation systems (EPMS) in healthy Portuguese individuals. Methodology: The EPMS characterization of 37 healthy Portuguese individuals was conducted through TS measurement using Quantitative Sensory Testing (QST), while Conditioned Pain Modulation (CPM) was assessed with a sequential methodological protocol using the pain pressure threshold on the trapezius muscle as the test stimulus and the Cold Pressor Test as the conditioning stimulus. Sociodemographic, clinical, and physical fitness data were collected to study factors associated with EPMS alterations. Data analysis included absolute and relative magnitude values for TS and CPM. Statistical analysis and group comparisons were performed using the Chi-square test and the Mann-Whitney test. Results: The prevalence rate of EPMS dysfunction was 65% in the study sample. Sixteen percent of participants showed alterations in the CPM test, and 59% in TS. Statistically significant differences between groups (normal and dysfunctional) were observed in smoking habits for CPM. For TS, differences were found between groups depending on the anatomical region tested, age, physical fitness tests (Hand Grip Strength Test and 6-Minute Walk Test), and work-related stress levels. Conclusion: The results of the present study indicate a high prevalence rate of SMED dysfunction in healthy individuals. Differences were observed between groups of participants with and without dysfunction in these systems regarding sociodemographic, clinical factors, and physical fitness tests. Future longitudinal studies are needed to better understand, define, and establish factors associated with the function of these systems
Introduction: The Endogenous Pain Modulation Systems (EPMS) encompass a term that includes all types of facilitating and/or inhibiting actions carried out by the central nervous system, acting as modulators responsible for the increase or decrease of pain. Their assessment is essential for establishing the pain modulation profile (antinociception or pronociception) in healthy individuals, thereby enabling risk stratification for the potential development of pain conditions. This assessment is conducted through the measurement of Temporal Summation (TS) and Conditioned Pain Modulation (CPM). EPMS are often altered in populations experiencing pain or musculoskeletal conditions. However, the prevalence of dysfunction within this system in healthy, pain-free individuals, as well as the factors potentially associated with these alterations, remains unknown. Objectives: To determine the prevalence and characterize the factors associated with dysfunction in the endogenous pain modulation systems (EPMS) in healthy Portuguese individuals. Methodology: The EPMS characterization of 37 healthy Portuguese individuals was conducted through TS measurement using Quantitative Sensory Testing (QST), while Conditioned Pain Modulation (CPM) was assessed with a sequential methodological protocol using the pain pressure threshold on the trapezius muscle as the test stimulus and the Cold Pressor Test as the conditioning stimulus. Sociodemographic, clinical, and physical fitness data were collected to study factors associated with EPMS alterations. Data analysis included absolute and relative magnitude values for TS and CPM. Statistical analysis and group comparisons were performed using the Chi-square test and the Mann-Whitney test. Results: The prevalence rate of EPMS dysfunction was 65% in the study sample. Sixteen percent of participants showed alterations in the CPM test, and 59% in TS. Statistically significant differences between groups (normal and dysfunctional) were observed in smoking habits for CPM. For TS, differences were found between groups depending on the anatomical region tested, age, physical fitness tests (Hand Grip Strength Test and 6-Minute Walk Test), and work-related stress levels. Conclusion: The results of the present study indicate a high prevalence rate of SMED dysfunction in healthy individuals. Differences were observed between groups of participants with and without dysfunction in these systems regarding sociodemographic, clinical factors, and physical fitness tests. Future longitudinal studies are needed to better understand, define, and establish factors associated with the function of these systems
Description
Keywords
Dor Sistema de Modulação Endógenos da Dor Modulação Condicionada da Dor Somação Temporal Condições Músculo-Esqueléticas Quantitative Sensory Testing (QST) Pain Endogenous Pain Modulation System Conditioned Pain Modulation Temporal Summation Musculoskeletal Conditions