Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences, Linköping University & Pain and Rehabilitation Centre, UHL, County Council, Linköping, Sweden.
J Rehabil Med. 2012 Jul;44(8):648-57. doi: 10.2340/16501977-1006.
Widespread deep tissue pain hyperalgesia was evaluated in women with chronic whiplash associated disorder (n = 25) and controls (n = 10) using computerized cuff pressure algometry and hypertonic saline infusion.
A pneumatic double-chamber cuff was placed around: (i) the arm and (ii) the leg. Cuff inflation rate was constant and the pain intensity was registered continuously on a visual analogue scale (VAS); thresholds of detection and tolerance were extracted. For assessment of spatial summation the protocol was repeated with a single-chamber cuff inflated around the leg. Temporal summation of pain was assessed from the leg with constant cuff pressure stimulation at 2 different pressure intensities for 10 min. Hypertonic saline was infused in the tibialis anterior muscle.
Cuff pressure pain thresholds were lower in subjects with whiplash associated disorder compared with controls (p < 0.05). Tonic pressure stimulation evoked higher maximal VAS and larger areas under the VAS curve in subjects with whiplash associated disorder compared with controls (p < 0.05). The pain threshold and tolerance were higher during single cuff than double cuff stimulation. The area under the VAS curve after intramuscular saline infusion was larger in whiplash associated disorder (p < 0.05).
The results indicated widespread hyperalgesia in chronic whiplash associated disorder and facilitated temporal summation outside the primary pain area, suggesting involvement of central sensitization.
使用计算机控制的袖带压力测痛法和高渗盐水输注法，评估慢性挥鞭样损伤相关障碍女性患者（n=25）和对照组（n=10）的广泛深部组织痛敏性疼痛。
将双腔气动袖带分别置于：（i）手臂和（ii）腿部。袖带充气速率保持恒定，疼痛强度在视觉模拟量表（VAS）上连续记录；提取检测和耐受阈值。为评估空间总和，用单腔袖带对腿部进行充气，重复该方案。用恒定袖带压力以 2 种不同压力强度对腿部进行 10 min 的连续刺激，评估疼痛的时间总和。将高渗盐水注入胫骨前肌。
与对照组相比，挥鞭样损伤相关障碍患者的袖带压痛阈值较低（p<0.05）。与对照组相比，挥鞭样损伤相关障碍患者的持续压力刺激引起更高的最大 VAS 和更大的 VAS 曲线下面积（p<0.05）。单袖带刺激时的疼痛阈值和耐受程度高于双袖带刺激。与对照组相比，挥鞭样损伤相关障碍患者肌肉内盐水输注后的 VAS 曲线下面积更大（p<0.05）。
结果表明慢性挥鞭样损伤相关障碍存在广泛的痛敏性疼痛，并在外周疼痛区域之外促进了时间总和，提示存在中枢敏化。
