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  • Less Efficacious Conditioned Pain Modulation and Sensory Hypersensitivity in Chronic Whiplash-associated Disorders in Singapore

    Author(s)
    Ng, Tze Siong
    Pedler, Ashley
    Vicenzino, Bill
    Sterling, Michele
    Griffith University Author(s)
    Sterling, Michele
    Year published
    2014
    Metadata
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    Abstract
    AB Objectives: Cultural differences in pain perception exist. Although chronic whiplash-associated disorder (WAD) is well investigated in western countries, little is known about its presentation in Singapore. We studied the neck motion and pain sensitivity in people with chronic WAD in Singapore. Materials and Methods: Thirty chronic WAD participants [>3 mo, Neck Disability Index: 40% (SD 17%)] were age, sex, and ethnicity matched with 30 pain-free controls. All 60 participants underwent the following tests: active neck motion, pain thresholds [pressure, brachial plexus provocation test (BPPT), cold], cold pain tolerance, ...
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    AB Objectives: Cultural differences in pain perception exist. Although chronic whiplash-associated disorder (WAD) is well investigated in western countries, little is known about its presentation in Singapore. We studied the neck motion and pain sensitivity in people with chronic WAD in Singapore. Materials and Methods: Thirty chronic WAD participants [>3 mo, Neck Disability Index: 40% (SD 17%)] were age, sex, and ethnicity matched with 30 pain-free controls. All 60 participants underwent the following tests: active neck motion, pain thresholds [pressure, brachial plexus provocation test (BPPT), cold], cold pain tolerance, and conditioned pain modulation (CPM). The test stimulus of contact heat and conditioning stimulus of cold water immersion was used to assess CPM. Data were evaluated to determine differences between WAD and control groups. Results: Active neck motion (F1,29=80.02), pain thresholds of blunt pressure (F1,29=20.84), BPPT (F1,29=54.56), and cold (Z=-4.31) were significantly lower in participants with WAD (P<0.0001). Cold pressor pain tolerance was significantly lower in participants with WAD (Z=-2.89, P=0.02). A less efficacious CPM was also demonstrated in participants with WAD (F1,29=9.20, P=0.03). A combination of BPPT and cold hyperalgesia best predicted the WAD group (sensitivity=96.7%, specificity=96.7%). Discussion: These findings of sensory hypersensitivity and decreased neck motion in Singaporeans with chronic WAD are consistent with physical impairments reported in western populations. (C) 2014 by Lippincott Williams & Wilkins
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    Journal Title
    Clinical Journal of Pain
    Volume
    30
    Issue
    5
    DOI
    https://doi.org/10.1097/AJP.0b013e3182a03940
    Subject
    Clinical sciences
    Physiotherapy
    Neurosciences
    Publication URI
    http://hdl.handle.net/10072/60147
    Collection
    • Journal articles

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