Less efficacious conditioned pain modulation and sensory hypersensitivity in chronic whiplash-associated disorders in Singapore

Ng, Tze Siong, Pedler, Ashley, Vicenzino, Bill and Sterling, Michele (2013) Less efficacious conditioned pain modulation and sensory hypersensitivity in chronic whiplash-associated disorders in Singapore. Clinical Journal of Pain, Published Ahead-of-Print 5: 1-7. doi:10.1097/AJP.0b013e3182a03940

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Author Ng, Tze Siong
Pedler, Ashley
Vicenzino, Bill
Sterling, Michele
Title Less efficacious conditioned pain modulation and sensory hypersensitivity in chronic whiplash-associated disorders in Singapore
Journal name Clinical Journal of Pain   Check publisher's open access policy
ISSN 0749-8047
1536-5409
Publication date 2013-08-08
Year available 2013
Sub-type Article (original research)
DOI 10.1097/AJP.0b013e3182a03940
Volume Published Ahead-of-Print
Issue 5
Start page 1
End page 7
Total pages 7
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2014
Language eng
Formatted abstract
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.
Keyword Physical
Whiplash
Conditioned pain modulation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 6 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 7 times in Scopus Article | Citations
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Created: Mon, 14 Oct 2013, 11:05:01 EST by Chesne McGrath on behalf of Physiotherapy