de Oliveira Sato Tatiana, Hallman David M, Kristiansen Jesper, Holtermann Andreas
Physical Therapy Department, Federal University of São Carlos (UFSCar), Rodovia Washington Luís, km 235, São Carlos, SP, 13565-905, Brazil.
Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, 801-76, Gävle, SE, Sweden.
BMC Musculoskelet Disord. 2018 Nov 20;19(1):405. doi: 10.1186/s12891-018-2312-3.
The prevention and rehabilitation of multisite musculoskeletal pain would benefit from studies aiming to understand its underlying mechanism. Autonomic imbalance is a suggested mechanism for multisite pain, but hardly been studied during normal daily living. Therefore, the aim of the study is to investigate the association between multisite musculoskeletal pain and cardiac autonomic modulation during work, leisure and sleep.
This study is based on data from the "Danish Physical activity cohort with objective measurements" among 568 blue-collar workers. Pain intensity scales were dichotomized according to the median of each scale, and the number of pain sites was calculated. No site was regarded as the pain-free, one site was considered as single-site musculoskeletal pain and pain in two or more sites was regarded as multisite musculoskeletal pain. Heart rate variability (HRV) was measured by an electrocardiogram system (ActiHeart) and physical activity using accelerometers (Actigraph). Crude and adjusted linear mixed models were applied to investigate the association between groups and cardiac autonomic regulation during work, leisure and sleep.
There was no significant difference between groups and no significant interaction between groups and domains in the crude or adjusted models for any HRV index. Significant differences between domains were found in the crude and adjusted model for all indices, except SDNN; sleep time showed higher values than leisure and work time, except for LF and LF/HF, which were higher during work.
This cross-sectional study showed that multisite musculoskeletal pain is not associated with imbalanced cardiac autonomic regulation during work, leisure and sleep time.
旨在了解多部位肌肉骨骼疼痛潜在机制的研究将有助于其预防和康复。自主神经失衡是多部位疼痛的一种潜在机制,但在正常日常生活中几乎未被研究。因此,本研究的目的是调查工作、休闲和睡眠期间多部位肌肉骨骼疼痛与心脏自主神经调节之间的关联。
本研究基于“丹麦有客观测量数据的体力活动队列”中568名蓝领工人的数据。疼痛强度量表根据每个量表的中位数进行二分法划分,并计算疼痛部位的数量。无疼痛部位被视为无痛,一个部位被视为单部位肌肉骨骼疼痛,两个或更多部位的疼痛被视为多部位肌肉骨骼疼痛。心率变异性(HRV)通过心电图系统(ActiHeart)测量,体力活动通过加速度计(Actigraph)测量。应用粗线性混合模型和调整后的线性混合模型来研究工作、休闲和睡眠期间各组与心脏自主神经调节之间的关联。
在任何HRV指数的粗模型或调整模型中,各组之间均无显著差异,组与时间段之间也无显著交互作用。在除SDNN之外的所有指数的粗模型和调整模型中,发现时间段之间存在显著差异;睡眠时间的值高于休闲时间和工作时间,但LF和LF/HF除外,它们在工作期间较高。
这项横断面研究表明,多部位肌肉骨骼疼痛与工作、休闲和睡眠时间的心脏自主神经调节失衡无关。