Please use this identifier to cite or link to this item: https://cris.library.msu.ac.zw//handle/11408/6118
Title: Conditioned Pain Modulation Does Not Differ Between People With Lower-Limb Tendinopathy and Nontendinopathy Controls: A Systematic Review With Individual Participant Data Meta-analysis
Authors: Myles C. Murphy
Nonhlanhla Mkumbuzi
Jordan Keightley
William Gibson
Patrick Vallance
Henrik Riel
Melanie Plinsinga
Ebonie K. Rio
Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia; School of Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia.
Department of Sports, Exercise, and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom; Department of Rehabilitation, Midlands State University, Gweru, Zimbabwe; Department of Human Movement Science, Nelson Mandela University, Gqeberha, South Africa; NtombiSport, Cape Town, South Africa
Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
School of Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia.
Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Frankston, Australia.
Centre for General Practice at Aalborg University, Aalborg, Denmark; Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
School of Health Sciences and Social Work, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
The Australian Ballet, Southbank, Australia; Victorian Institute of Sport, Albert Park, Australia; La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Australia.
Keywords: exercise
muscle
pain
Rehabilitation
tendon
Issue Date: 17-Nov-2023
Publisher: Journal of Orthopaedic and Sports Physical Therapy
Abstract: OBJECTIVE: To explore whether people with lower-limb tendinopathy have reduced relative conditioned pain modulation (CPM) when compared to nontendinopathy controls. DESIGN: Systematic review with individual participant data (IPD) meta-analysis. LITERATURE SEARCH: Eight databases were searched until August 29, 2022. STUDY SELECTION CRITERIA: Cross-sectional studies comparing the magnitude of the CPM effect in people with lower-limb tendinopathy to nontendinopathy controls in a case-control design. DATA SYNTHESIS: Included studies provided IPD, which was reported using descriptive statistics. Generalized estimating equations (GEEs) determined between-group differences in the relative CPM effect, when adjusting for co-variables. Study quality was assessed using a Joanna Briggs Institute checklist, and certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluations. RESULTS: Five records were included, IPD were provided for 4 studies (n = 219 with tendinopathy, n = 226 controls). The principal GEE (model 1) found no significant relative CPM effects for tendinopathy versus controls (B = −1.73, P = .481). Sex (B = 4.11, P = .160), age (B = −0.20, P = .109), and body mass index (B = 0.28, P = .442) did not influence relative CPM effect. The Achilles region had a reduced CPM effect (B = −22.01, P = .009). In model 2 (adjusting for temperature), temperature (B = −2.86, P = .035) and female sex (B = 21.01, P = .047) were associated with the size of the relative CPM effect. All studies were low-quality, and the certainty of the evidence was moderate. CONCLUSION: There were no between-group differences in the magnitude of the CPM effect, suggesting clinicians should manage lower-limb tendinopathy using interventions appropriate for peripherally dominant pain (eg, tendon loading exercises such as heavy slow resistance). Based on the “moderate”-certainty evidence, future studies are unlikely to substantially change these findings.
URI: https://cris.library.msu.ac.zw//handle/11408/6118
Appears in Collections:Research Papers

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