Laboratoire BioNR, Centre Intersectoriel en Santé Durable, Université du Québec à Chicoutimi, Saguenay, QC, Canada.
Physical Medicine and Rehabilitation Service, Department of Medicine, Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada.
PLoS One. 2024 Jul 11;19(7):e0305545. doi: 10.1371/journal.pone.0305545. eCollection 2024.
Non-invasive neurostimulation like muscle tendon vibration (VIB) and transcranial magnetic stimulation (TMS) can provide valuable insights on mechanisms underlying sensorimotor dysfunctions. However, their feasibility in the context of painful musculoskeletal disorders like shoulder impingement syndrome (SIS) remain uncertain.
The present work used a case series design including 15 participants with SIS, as well as a secondary group-based analysis comparing participants with SIS to 15 healthy counterparts. Proprioceptive processing was tested by VIB-induced kinesthetic illusions of shoulder abduction, and TMS tested corticospinal excitability of the upper trapezius. Detailed individual data were collected, including any technical challenges and feasibility issues encountered.
VIB was in general well-tolerated and elicited a perceptible kinesthetic illusion in 13 participants with SIS and 14 controls. TMS presented with several challenges related to discomfort, fear-related behaviors, technical problems and high motor thresholds, especially in participants with SIS. It was only possible to collect all TMS measures in 5 participants with SIS (for both the painful and non/less-painful sides), in 7 controls on their dominant side and 10 controls on the non-dominant side. The only significant group-based analysis was a lower illusion speed/amplitude on the painful versus non-painful side in persons with SIS (p = 0.035).
Our study provides preliminary data on challenges encountered with TMS and VIB of trunk/proximal muscle in persons with SIS and healthy counterparts. It might help future studies to better address those challenges beforehand and improve the overall feasibility and impact of neurostimulation tools in musculoskeletal disorders.
非侵入性神经刺激，如肌肉肌腱振动（VIB）和经颅磁刺激（TMS），可以为感觉运动功能障碍的机制提供有价值的见解。然而，它们在肩峰下撞击综合征（SIS）等疼痛性肌肉骨骼疾病中的可行性仍不确定。
本研究采用病例系列设计，包括 15 名 SIS 患者，以及基于组的二次分析，将 SIS 患者与 15 名健康对照者进行比较。通过 VIB 诱导的肩部外展运动觉错觉来测试本体感受加工，通过 TMS 测试上斜方肌的皮质脊髓兴奋性。收集了详细的个体数据，包括遇到的任何技术挑战和可行性问题。
VIB 通常耐受性良好，在 13 名 SIS 患者和 14 名对照组中引起了可感知的运动错觉。TMS 遇到了与不适、恐惧相关行为、技术问题和高运动阈值相关的几个挑战，尤其是在 SIS 患者中。仅在 5 名 SIS 患者（疼痛侧和非/轻痛侧）、7 名对照组的优势侧和 10 名对照组的非优势侧收集到了所有 TMS 测量值。唯一具有统计学意义的组间分析是 SIS 患者疼痛侧与非疼痛侧的错觉速度/幅度较低（p = 0.035）。
本研究提供了关于 TMS 和 VIB 对 SIS 患者和健康对照者躯干/近端肌肉的挑战的初步数据。它可能有助于未来的研究在神经刺激工具应用于肌肉骨骼疾病之前更好地解决这些挑战，提高神经刺激工具的整体可行性和影响力。
