Abstract
Musculoskeletal pain impairs postural control and stability. Nine subjects stood as
quietly as possible on a moveable force platform before, during, and after experimental
pain in the right leg muscles. A moveable force platform was used to measure the center
of pressure and provided unexpected perturbations. Lower limb muscle activity, joint
angles, and foot pressure distributions were measured. Hypertonic saline was used
to induce pain in the vastus lateralis, vastus medialis, or biceps femoris muscle
of the right leg. Compared to baseline and control sessions, pain in the knee extensor
muscles during quiet standing evoked: 1) larger sway area, greater medial-lateral
center of pressure displacement and higher speed (P < .05); 2) increased sway displacement in the anterior-posterior direction (P < .05); and 3) increased electromyography (EMG) activity for left tibialis anterior
and left erector spinae muscles (P < .05). Pain provoked longer time to return to an equilibrium posture after forward
EMG activity for, and pain in vastus medialis muscle decreased the time for the maximum
hip flexion during this perturbation (P < .05). These results show that muscle pain impairs postural stability during quiet
standing and after unexpected perturbation, which suggest that people suffering from
leg muscle pain are more vulnerable to falls.
Perspective
This article presents the acute responses to leg muscle pain on the postural control.
This measure could potentially help clinicians who seek to assess how pain responses
may contribute to patient’s postural control and stability during quiet standing and
after recovering from unexpected perturbations.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of PainAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Reciprocal angular acceleration of the ankle and hip joints during quiet standing in humans.Exp Brain Res. 2001; 136: 463-473
- Effects of experimental muscle pain on shoulder-abduction force steadiness and muscle activity in healthy subjects.Eur J Appl Physiol. 2008; 102: 643-650
- Effect of experimentally induced knee pain on standing balance in healthy older individuals.Rheumatology (Oxford). 2005; 44: 378-381
- Postural stability is altered by the stimulation of pain but not warm receptors in humans.BMC Musculoskelet Disord. 2003; 4: 23
- Pain and falls in older people.Eur J Pain. 2007; 11: 564-571
- Effects of intensity and locus of painful stimulation on postural stability.Pain. 2004; 108: 43-50
- Effects of joint immobilization on standing balance.Hum Mov Sci. 2009; 28: 515-528
Doornik JV, Sinkjaer T: Hydraulically Actuated Platform for Human Gait and Posture Analysis. In Second International Conference on Biomechanical Engineering (IASTED), Austria, 2004
- The effects of impaired joint position sense on the development and progression of pain and structural damage in knee osteoarthritis.Arthritis Rheum. 2009; 61: 1070-1076
- Falls risk is associated with pain and dysfunction but not radiographic osteoarthritis in older adults: Tasmanian Older Adult Cohort study.Osteoarthritis Cartilage. 2006; 14: 533-539
- Kinematic and kinetic validity of the inverted pendulum model in quiet standing.Gait Posture. 2004; 19: 124-132
- Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects.Ann Rheum Dis. 2001; 60: 612-618
- Development of recommendations for SEMG sensors and sensor placement procedures.J Electromyogr Kinesiol. 2000; 10: 361-374
- Balance impairments in individuals with symptomatic knee osteoarthritis: A comparison with matched controls using clinical tests.Rheumatology (Oxford). 2002; 41: 1388-1394
- Experimental calf muscle pain attenuates the postural stability during quiet stance and perturbation.Clin Biomech (Bristol, Avon). 2010 Aug 8; ([Epub ahead of print])
- Pain induced by injection of hypertonic saline into the infrapatellar fat pad and effect on coordination of the quadriceps muscles.Arthritis Rheum. 2009; 61: 70-77
- Influence of central set on human postural responses.J Neurophysiol. 1989; 62: 841-853
- Predicted region of stability for balance recovery: Motion at the knee joint can improve termination of forward movement.J Biomech. 2000; 33: 1619-1627
- From balance regulation to body orientation: Two goals for muscle proprioceptive information processing?.Exp Brain Res. 1999; 124: 80-88
- Anticipation of elbow joint perturbation shortens the onset time of the reflex EMG response in biceps brachii and triceps brachii.Neurosci Lett. 2007; 412: 56-61
- Anticipatory modulation of neck muscle reflex responses induced by mechanical perturbations of the human forehead.Neurosci Lett. 2004; 366: 206-210
- Musculoskeletal pain and risk for falls in older disabled women living in the community.J Am Geriatr Soc. 2002; 50: 671-678
- Nociception from skeletal muscle in relation to clinical muscle pain.Pain. 1993; 54: 241-289
- Declines in strength and balance in older adults with chronic knee pain: A 30-month longitudinal, observational study.Arthritis Rheum. 2002; 47: 141-148
- The labor productivity effects of chronic backache in the United States.Med Care. 1998; 36: 1471-1488
- Pain and its relationship with muscle strength and proprioception in knee OA: Results of an 8-week home exercise pilot study.J Musculoskelet Neuronal Interact. 2008; 8: 35-42
Takagi A, Fujimura E, Suehiro S: A new method of statokinesigram area measurement. Application of a statistically calculated ellipse, in Igarashi M and Black O (eds): Vestibular and visual control on posture and locomotor equilibrium. New York, Karger, 1985, pp 74-79
- Experimental neck muscle pain impairs standing balance in humans.Exp Brain Res. 2009; 192: 723-729
- Static and dynamic balance responses in persons with bilateral knee osteoarthritis.J Orthop Sports Phys Ther. 1997; 25: 13-18
- A.B.C. (Anatomy, Biomechanics, Control) of Balance During Standing and Walking.1st ed. Waterloo Biomechanics, Waterloo, Ontario, Canada1995
- Relationship between balance performance and musculoskeletal pain in lower body comparison healthy middle aged and older adults.Arch Gerontol Geriatr. 2007; 45: 109-119
Article Info
Publication History
Published online: June 17, 2011
Accepted:
February 16,
2011
Received in revised form:
February 3,
2011
Received:
September 28,
2010
Footnotes
Supported by The Danish Ministry of Health and Prevention .
There are no conflicts of interest from any author in the present study.
Identification
Copyright
© 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.
