University Centre for Sport, Exercise and Health, Centre for Human Movement Sciences, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Scand J Med Sci Sports. 2013 Mar;23(2):149-55. doi: 10.1111/j.1600-0838.2011.01375.x. Epub 2011 Sep 13.
The prevalence of tendinopathies in sports is high. The etiology and pain mechanisms of tendinopathies are not completely understood. Currently, little is known whether, or to which degree, somatosensory changes within the nervous system may contribute to the pain in tendinopathies. We conducted a patient controlled study in which we used the standardized QST protocol developed by the German Research Network on Neuropathic Pain. This protocol consists of seven different tests that measures 13 somatosensory parameters and can be seen as the gold standard to measure somatosensory function. Twelve athletes with clinically diagnosed chronic patellar tendinopathy (PT) mean duration 30 months (range 6-120) and 20 controls were included in the study. In two of the 13 QST parameters namely Mechanical Pain Threshold (P < 0.05) and Vibration Disappearance Threshold (P < 0.5) injured athletes were significantly more sensitive for the applied stimuli. None of the athletes had signs of Dynamic Mechanical Allodynia. Reduced mechanical pain thresholds or pinprick allodynia reflects the involvement of central sensitization upon the myelinated (Aδ-fibre) nociceptive input. From this explorative study, we conclude that sensitization may play a prominent role in the pain during and after sports activity in patella tendinopathy patients.
运动中肌腱病的患病率很高。肌腱病的病因和疼痛机制尚未完全了解。目前，对于神经系统内的躯体感觉变化是否以及在多大程度上可能导致肌腱病的疼痛，知之甚少。我们进行了一项患者对照研究，使用了由德国神经性疼痛研究网络开发的标准化 QST 方案。该方案由七种不同的测试组成，可测量 13 种躯体感觉参数，可视为测量躯体感觉功能的金标准。12 名患有临床诊断的慢性髌腱病（PT）的运动员（平均病程 30 个月，范围 6-120 个月）和 20 名对照者纳入了该研究。在 13 个 QST 参数中的两个参数中，即机械疼痛阈值（P < 0.05）和振动消失阈值（P < 0.5），受伤运动员对所施加的刺激更为敏感。没有运动员出现动态机械性痛觉过敏的迹象。机械性疼痛阈值降低或刺痛性痛觉过敏反映了在髓鞘（Aδ-纤维）伤害性传入时中枢敏化的参与。从这项探索性研究中，我们得出结论，敏化可能在髌腱病患者运动期间和运动后疼痛中起重要作用。
