METHODS FOR EVALUATION OF CONDITIONED PAIN MODULATION IN PATIENTS WITH MUSCULOSKELETAL DISORDERS: A SCOPING REVIEW
DOI:
https://doi.org/10.20873/abef.2595-0096v6n16581Keywords:
modulação condicionada da dor, controle inibitório descendenteAbstract
Introduction: Pain is a complex experience that can vary significantly between individuals depending on the context. The processing and modulation of pain involve many brain regions. The Diffuse noxious inhibitory controls can be evaluated through a psychophysical test called conditioned pain modulation. Despite the progress in understanding the mechanism and how to perform the evaluation, there is significant variability in the methods used to perform this test, making its use in research and clinical practice difficult.
Objectives: To identify the main methods used in the evaluation of conditioned pain modulation and to evaluate the different ways each method has been performed in the last ten years.
Methods: A search was carried out in the Medline database via PubMed in July 2021. The search strategy used the following descriptors in English: (conditioned pain modulation) AND ((conditioning stimuli) OR (conditioning stimulus) OR (test stimuli ) OR (test stimulus) OR (cold pressor test) OR (cuff pressor test) OR (cuff pressor stimulation) OR (cuff algometry)). Studies written in English or Portuguese and published from 2012 onwards were considered.
Results: The initial search identified a total of 324 studies. Title and abstract screening resulted in 77 potential articles. After a detailed full-text analysis of the selected studies, 59 remained in the final sample. Among the protocols developed to assess conditioned pain modulation, the most used test stimulus, according to the included studies (n = 59), was the pressure pain threshold (n = 45). The most frequent conditioning stimulus among the studies was the cold pressor test (n = 35).
Conclusion: This scoping review identified that the pressure pain threshold and the cold pressure test were the most used test and conditioning stimuli, respectively, among the included studies. However, there is a lack of standardization in relation to the protocols adopted to perform conditioned pain modulation, making it difficult to interpret the results and choose a methodology for application in clinical practice.
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