Mendez-Rebolledo Guillermo, Orozco-Chavez Ignacio, Salazar-Méndez Joaquín, Morales-Verdugo Juan, Martinez-Valdes Eduardo
Laboratorio de Investigación Somatosensorial y Motora, Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile.
Departamento de Ciencias del Movimiento Humano, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile.
Front Hum Neurosci. 2025 Jul 10;19:1603807. doi: 10.3389/fnhum.2025.1603807. eCollection 2025.
Musculoskeletal dysfunctions can significantly impair quality of life due to persistent pain and neuromuscular adaptations. While regional activation patterns in healthy muscles are well-documented, the effects of clinical and experimental pain on these patterns remain inconsistent. Accordingly, this study systematically evaluates the scientific evidence on alterations in the spatial distribution of muscle activity, quantified by shifts in the center of activity of high-density surface electromyography (HD-sEMG) signals, under experimental and clinical pain conditions.
A comprehensive database search was conducted from inception to June 6, 2025. The review included studies that evaluated the spatial distribution of muscle activity with HD-sEMG, analyzing two-dimensional shifts in the center of activity among individuals with clinical or experimentally induced pain. Methodological quality was assessed using the adapted Newcastle-Ottawa Scale, and evidence certainty was evaluated with the GRADE approach. A random-effects model was employed in the meta-analysis to account for variability across studies.
Twenty studies involving 562 participants (231 control, 266 clinical pain, and 65 experimental pain) were included. The meta-analysis revealed a statistically significant shift in the center of activity in individuals with clinical pain compared with asymptomatic controls (SMD = 0.49; 95% CI = 0.15 to 1.84; = 0.004), particularly those with chronic low back pain, with a low effect size (SMD = 0.43; 95% CI = 0.03 to 0.83; = 0.04), indicating altered spatial distribution of muscle activity. A meta-analysis for experimental pain was not feasible due to limited data.
These findings underscore that clinical pain is associated with altered spatial distribution of muscle activity and emphasize the need for standardized methodologies and further research across diverse populations to enhance pain management and rehabilitation strategies.
This study was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42024534320), https://www.crd.york.ac.uk/PROSPERO/view/CRD42024534320.
肌肉骨骼功能障碍会因持续疼痛和神经肌肉适应性改变而严重损害生活质量。虽然健康肌肉的区域激活模式已有充分记录，但临床和实验性疼痛对这些模式的影响仍不一致。因此，本研究系统地评估了在实验性和临床性疼痛条件下，通过高密度表面肌电图（HD-sEMG）信号活动中心的变化来量化肌肉活动空间分布改变的科学证据。
从数据库建立至2025年6月6日进行了全面的检索。该综述纳入了使用HD-sEMG评估肌肉活动空间分布的研究，分析了临床或实验性疼痛个体中活动中心的二维变化。使用改编的纽卡斯尔-渥太华量表评估方法学质量，并采用GRADE方法评估证据确定性。荟萃分析采用随机效应模型来考虑研究间的变异性。
纳入了20项研究，共562名参与者（231名对照、266名临床疼痛患者和65名实验性疼痛患者）。荟萃分析显示，与无症状对照组相比，临床疼痛个体的活动中心有统计学意义的偏移（标准化均数差[SMD]=0.49；95%置信区间[CI]=0.15至1.84；P=0.004），特别是慢性下腰痛患者，效应量较低（SMD=0.43；95%CI=0.03至0.83；P=0.04），表明肌肉活动的空间分布发生了改变。由于数据有限，实验性疼痛的荟萃分析不可行。
这些发现强调临床疼痛与肌肉活动空间分布改变有关，并强调需要标准化方法以及在不同人群中进行进一步研究，以加强疼痛管理和康复策略。
本研究已在国际前瞻性系统评价注册库（PROSPERO）（标识符CRD42024534320）中进行前瞻性注册，网址为https://www.crd.york.ac.uk/PROSPERO/view/CRD42024534320。
