César Fernández de las Peñas

Referred Pain From the Trochlear Region in Tension‐Type Headache: A Myofascial Trigger Point From the Superior Oblique Muscle

Background.—Tension‐type headache (TTH) is a prototypical headache in which myofascial trigger points (MTrPs) can play an important role. To our knowledge, MTrPs in the muscle tissues of the trochlear region, ie, the superior oblique muscle (SOM), have not been previously mentioned, and a referred pain pattern from this region has never been reported.

Differences in pressure pain sensitivity of elite male soccer players on artificial turf and natural grass

The aim of this study was to compare topographical pressure pain sensitivity maps of the lower extremity in elite footballers (soccer) playing on artificial turf or natural grass. A total of 16 football players (mean age ± SD: 22 ± 2 years) for artificial turf and 13 football players (age: 22 ± 3 years) for natural grass participated. Pressure pain thresholds (PPTs) were measured bilaterally over 23 locations of the lower extremity to assess deep structure sensitivity to mechanical pain. The analysis of variance detected significant differences in PPT between groups and measurement points (P < 0.001). Football players playing on natural grass exhibited lower PPT as compared to those playing on artificial turf (P < 0.05). In addition, PPT over vastus medialis muscle had the lowest value (most sensitive) (P < 0.01); whereas PPT over the rectus femoris was the highest one (least sensitive). This study showed the ability of PPT maps to reveal heterogeneous distribution of mechanical sensitivity in relation to turf type. The decreased mechanical sensitivity to pain among football players playing on artificial turf compared with natural grass points most likely towards a favourable trait of such turf type. Further studies are needed to confirm these findings.

C0051 Ultrasound imaging and health related to quality of life in patients with chronic plantar heel pain

Background Chronic plantar heel pain (CPHP) is the most common cause of heel pain in adults. Pain is described as burning, aching, lancinating, worsening when the patient takes his/her first steps after waking up or after a prolonged rest period. The aim of this study was to determine the differences and relationship between in ultrasound imaging and health-related quality of life (QoL) between individuals with CPHP and healthy controls. Methods Sixteen patients, 10 males and 6 females (mean age: 45±11 years) with CPHP and 16 age- and gender-matched healthy controls (mean age: 45±11 years) were recruited. Plantar fascia thickness was bilaterally assessed via ultrasound imaging on the calcaneus bone and fascia (1 cm from calcaneus). Further, health-related QoL was assessed using the Foot Health Status Questionnaire (FHSQ). Results The analysis of variance showed significant differences between both groups and sides, for ultrasound imagining on the calcaneus (group: F=57.528, p<0.001; side: F=11.092, p<0.001) and fascia (group: F=41.280, p<0.001; side: F=7.246, p=0.009): individuals with CPHP had a greater plantar fascia thickness than healthy controls at the both points. A significant interaction between side and group for ultrasound imaging of the calcaneus (F=16.491, p<0.001) and the fascia (F=3.784, p=0.046) was also observed: plantar fascia thickness over the calcaneus and fascia was significantly higher on the affected side as compared with the non-affected side and both sides in healthy controls. The analysis also revealed patients reported significantly lower scores on foot pain, foot function, general foot health, general health, physical activity and social capacity domains (p<0.003) of the QoL questionnaire. No significant differences existed between groups on the domains of shoes and vigour (p>0.05). Significant negative correlations between plantar fascia thickness over the calcaneus and foot function (r=−0.537; p=0.032), shoes (r=−0.619; p=0.01) and physical activity (r=−0.509; p=0.044) domains were observed: the greater the plantar fascia thickness, the lower the QoL in these domains. Conclusions Our findings revealed greater thickness of the plantar fascia in the affected foot and deterioration of foot and general health domains in patients with CPHP. Higher thickness of the plantar fascia was associated with worse foot function, shoes and physical activity subscales.

Immediate Changes in Resting and Contracted Thickness of Transversus Abdominis After Dry Needling of Lumbar Multifidus in Healthy Participants: A Randomized Controlled Crossover Trial

Objective The purpose of this study was to investigate changes in resting and/or contraction thickness of the transversus abdominis (TrA) muscle after dry needling (DN) of the lumbar multifidus (LM) in asymptomatic participants. Methods A randomized controlled laboratory trial with crossover design was performed. Forty‐seven healthy individuals who had not experienced low back pain in the previous 6 months were randomly assigned to receive DN to the LM or a sham‐DN intervention. Participants received both interventions separated at least 7 days apart. They were instructed on how to perform a concentric contraction of TrA. Resting and contraction thicknesses of the TrA were obtained through real‐time ultrasound measurements before and immediately after each intervention by an assessor blinded to the intervention received. Data from 4 individuals had to be excluded because of poor image quality. Results Two‐way analysis of variance revealed a significant contraction with treatment interaction (F[1,42] = 11.489; P = .002). Simple main effects using paired‐samples t tests and a Bonferroni post hoc analysis revealed differences in contracted states of the TrA for DN vs sham‐DN (P = .009) and between contracted and resting states for the DN group (P = .001): after DN, TrA thickness at rest exhibited a mean decrease of 0.03 cm and a mean increase of 0.05 cm during contraction. Conclusion This study suggests that application of DN to LM was accompanied by a decreased resting thickness and an increased contraction thickness of the TrA in asymptomatic participants.