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Deformation and pressure propagation in deep tissue during mechanical painful pressure stimulation

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Abstract

Manual palpation or pressure stimulation is often used for pain sensitivity assessment. The aim of the current study was to define a method for investigating the relation between pressure pain sensitivity and pressure propagation in soft or harder muscles. Three-dimensional finite-element computer-models were developed to simulate the tissue stress and strain distribution during pressure stimulation on the tibialis anterior and gastrocnemius muscles. Four cases were modelled representing females and males who were trained and untrained. The model geometry was based on MR images of the lower leg during pressure stimulation. Stress and strain were extracted from the models at pressure intensity levels equivalent to the pressure pain threshold. The principal strain peaked in the adipose tissue at 0.30 and 0.14 for stimulation on the gastrocnemius and tibialis anterior muscle, respectively. The principal strain in the muscle was higher for four models of the stimulation on the gastrocnemius muscle (0.22–0.30) compared with the four models of stimulation on the tibialis anterior muscle (0.11–0.14). Average pressure pain thresholds were significantly lower for the tibialis anterior compared with the gastrocnemius muscle (319 vs. 432 kPa) These data show different pressure propagation profiles in soft and hard muscle at the same pressure pain sensation level. This new approach is relevant as the clinical routine assesses all muscles equally. This results in a different exposure to pressure in relation to the muscle evaluated which may affect the outcome of the examination.

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Acknowledgments

This work was supported by a collaboration grant between the Danish Agency for Science, Technology and Innovation and the Japanese Science and Technology Agency (2009–2011).The authors would like to thank Dott. Umeda for his support during the magnetic resonance imaging procedure. The authors would like to thank the Cardiovascular Physiology Group, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Science, for their support during the modelling procedure.

Conflict of interest

The authors have no conflict to report.

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Authors and Affiliations

  1. Department of Health Science and Technology, Faculty of Medicine, Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction (SMI), Aalborg University, Fredrik Bajers Vej 7D-3, 9220, Aalborg, Denmark

    Sara Finocchietti & Thomas Graven-Nielsen

  2. Department of Neural Regulation, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan

    Ken Takahashi & Kazue Mizumura

  3. Department of Physiology, Meiji University of Integrative Medicine, Kyoto, Japan

    Kaoru Okada

  4. Department of Medical Informatics, Meiji University of Integrative Medicine, Kyoto, Japan

    Yasuharu Watanabe

  5. Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan

    Ken Takahashi

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  1. Sara Finocchietti
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  2. Ken Takahashi
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  3. Kaoru Okada
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  4. Yasuharu Watanabe
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  5. Thomas Graven-Nielsen
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  6. Kazue Mizumura
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Correspondence to Thomas Graven-Nielsen.

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Finocchietti, S., Takahashi, K., Okada, K. et al. Deformation and pressure propagation in deep tissue during mechanical painful pressure stimulation. Med Biol Eng Comput 51, 113–122 (2013). https://doi.org/10.1007/s11517-012-0974-9

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  • DOI: https://doi.org/10.1007/s11517-012-0974-9

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