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dc.contributor.authorLim, Edwin Choon Wyn
dc.contributor.authorSterling, Michele
dc.contributor.authorStone, Andrew
dc.contributor.authorVicenzino, Bill
dc.date.accessioned2017-05-03T14:41:11Z
dc.date.available2017-05-03T14:41:11Z
dc.date.issued2011
dc.date.modified2014-06-23T04:01:03Z
dc.identifier.issn0304-3959
dc.identifier.doi10.1016/j.pain.2011.03.033
dc.identifier.urihttp://hdl.handle.net/10072/60861
dc.description.abstractChronic musculoskeletal conditions are increasingly conceived as involving altered central nervous system processing, and impaired nociceptive flexor reflex (NFR) appears to reflect altered central nervous system processing. The primary objective was to synthesize the evidence for impaired NFR in these conditions. The secondary objective was to evaluate the NFR stimuli parameters employed by reviewed studies. Electronic databases: MEDLINE, CINAHL, Embase, PEDro, Google Scholar, and Cochrane library were searched from the mid-1960s to June 2010. Experimental reports were systematically reviewed and meta-analysis (where possible) was performed. NFR thresholds and parameters of NFR stimuli were extracted. Sixteen trials were identified, 11 of which were suitable for inclusion in the meta-analysis. Compared to healthy controls, standardized mean differences in NFR threshold were significantly lower in subjects with primary headache (-0.45; 95% confidence interval [CI] -0.77 to -0.13, P = 0.005), fibromyalgia (-0.63; 95% CI -0.93 to -0.34, P < 0.0001), knee pain (-1.51; 95% CI -2.10 to -0.93, P < 0.00001) and whiplash (-0.73; 95% CI -1.11 to -0.35, P = 0.0002). Employed stimuli parameters vary between studies, with inter-pulse duration (P = 0.044) being identified by multiple regression analysis as independent predictors of the variability in NFR threshold in healthy controls. The results indicate that there is evidence of central hyperexcitability in people with chronic musculoskeletal pain. Our review also suggests that shorter inter-pulse duration tends to yield smaller variability in NFR threshold. However, further research investigating optimal stimulation parameters is still warranted.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.languageEnglish
dc.publisherElsevier
dc.publisher.placeNetherlands
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom1811
dc.relation.ispartofpageto1820
dc.relation.ispartofissue8
dc.relation.ispartofjournalPain
dc.relation.ispartofvolume152
dc.rights.retentionY
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchClinical sciences not elsewhere classified
dc.subject.fieldofresearchPsychology
dc.subject.fieldofresearchcode32
dc.subject.fieldofresearchcode320299
dc.subject.fieldofresearchcode52
dc.titleCentral hyperexcitability as measured with nociceptive flexor reflex threshold in chronic musculoskeletal pain: A systematic review
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorSterling, Michele


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