Highlights
- •Sensory and psychologic predictors of shoulder outcomes were investigated in a high-risk phenotype.
- •First pulse thermal pain sensitivity predicted resting pain intensity and movement evoked pain.
- •Pressure pain threshold and fear of pain improved prediction of shoulder disability.
Abstract
Our prior studies identified a high-risk phenotype (ie, high pain sensitivity variant
of the catechol-O-methyltransferase gene (Single Nucleotide Polymorphism [SNP] rs6269)
and pain catastrophizing scores) for shoulder pain. The current study identified sensory
and psychological predictors of heightened pain responses following exercise-induced
shoulder injury. Healthy participants (N = 131) with the SNP rs6269 catechol-O-methyltransferase
gene and Pain Catastrophizing Scale scores ≥5 underwent baseline sensory and psychological
testing followed by an established shoulder fatigue protocol, to induce muscle injury.
Movement-evoked pain, pain intensity, disability, and strength were assessed 24 hours
postinjury. Demographic, sensory, and psychological variables were included as predictors
in full and parsimonious models for each outcome. The highest variance explained was
for the shoulder disability outcome (full model R2 = .20, parsimonious R2 = .13). In parsimonious models, the individual predictors identified were: 1) 1st
pulse heat pain sensitivity for isometric shoulder movement-evoked pain and pain intensity;
2) pressure pain threshold for shoulder disability; 3) fear of pain for active shoulder
movement-evoked pain and shoulder disability; and 4) depressive symptoms for shoulder
strength. Findings indicate specific pain sensitivity and psychological measures may
have additional prognostic value for self-reported disability within a high-risk phenotype.
These findings should be tested in a clinical cohort for validation.
Perspective
The current study extends previous work by providing insight regarding how poor shoulder
outcomes may develop within a high-risk phenotype. Specifically, 1st pulse heat pain
sensitivity and pressure pain threshold were sensory measures, and fear of pain and
depressive symptoms were psychological measures, that improved prediction of different
shoulder outcomes.
Key words
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Article info
Publication history
Published online: January 02, 2021
Accepted:
December 6,
2020
Received in revised form:
November 25,
2020
Received:
October 8,
2020
Footnotes
MDB, WHG III, RS, MRW, PAB, RBF, and SZG were supported by funding from the National Institutes of Health (NIAMS AR055899). Some aspects of the study protocol were conducted at the University of Florida Clinical and Translational Science Institute, which is supported in part by NIH National Center for Advancing Translational Sciences UL1TR001427. Study data were collected and managed using REDCap electronic data capture tools hosted at the University of Florida. KAB received support from the NIH T-32 Neuromuscular Plasticity Pre-Doctoral Fellowship (NIH T32 HD 043730), the NIH Division of Loan Repayment (NIH Loan Repayment Award 2019-2021), the Foundation for Physical Therapy Research Promotion of Doctoral Studies Level I and II Scholarships, the International Chapter of the P.E.O. Sisterhood Scholar Award, and the Brooks-PHHP Research Collaboration.
The authors have no conflicts of interest to disclose.
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© 2021 by United States Association for the Study of Pain, Inc.
