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Psychophysiological reactions to experimental stress: relations to pain sensitivity, position sense and stress perception
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Stress and monotonous work contribute substantially to the development of chronic musculoskeletal disorders. Yet, the pathophysiological mechanisms underlying the process, particularly the involvement of autonomic regulation, remain unclear. It has been suggested that altered motor control resulting from distorted sensory information from fatigued muscles may be an important component in the development of musculoskeletal disorders. Animal studies have shown that sympathetic nervous system activation exerts actions in skeletal muscles, such as vasoconstriction and modulation of afferent information from muscle spindles. However, few attempts have been made to address this issue in humans. Therefore, the first aim of the thesis was to investigate the impact of repetitive computer work with and without additional stressors on muscle oxygenation and position sense in the upper extremity.

Assuming an important role of stress in the development of chronic musculoskeletal symptoms, one may expect open or latent manifestations of such symptoms in patients with non-specific stress-related illnesses. It is possible that sympathetic activation may influence pain perception, and that treatments aimed at reducing stress may also affect the pain experience. Thus, the second aim of the thesis was to evaluate the effects of a cognitive-behavioral training program and a physical activity program for patients with stress-related illnesses on autonomic reactivity, pain, and perceived health.

First, a laboratory model of computer mouse use was characterized in terms of biomechanical exposure of the wrist, and wrist position sense was determined before and after 45 minutes of continuous mouse use. Then, the effects of performing the computer mouse work under time pressure and precision demands were determined. Autonomic activity and muscle oxygenation in the upper extremity were measured during the work, and wrist position sense was assessed before and after the work. When patients with stress-related illnesses were compared to healthy individuals in autonomic reactivity to functional tests, pressure-pain thresholds, and ratings of health, indications of a relation between autonomic reactivity and symptoms of pain was found. Hence, in a subsequent evaluation of a cognitive-behavioral training program and a physical activity program for patients with stress-related illnesses, post intervention effects on autonomic reactivity to functional tests, pressure-pain thresholds, ratings of health and return-to-work were studied during a period of 12 months after the intervention.

The main findings were the following. 1) Wrist kinetics data obtained during the computer mouse work showed similarities to previously presented data for mouse-operated design tasks. 2) When time pressure and precision demands were added to the computer work, increased autonomic activity paralleled with decreased muscle oxygenation in the upper extremity was found. Wrist position sense accuracy, however, did not decrease after the work as it did when the work was performed without the additional demands. The result is intriguing, as it does not appear to be in concordance with previous animal studies. 3) Patients with stress-related illnesses showed higher autonomic reactivity to cognitive and physical laboratory tests than healthy control subjects. They also had substantially lower pressure-pain thresholds in the back, and rated poorer health and health-related behavior than the control subjects. 4) We found little difference in effect of cognitive-behavioral training and physical activity, compared to usual care, for patients with stress-related illnesses. Patients in the control group showed an improvement of about the same magnitude as in the treatment groups over the 12-month follow-up period.

The present findings indicate a non-additive relation between autonomic activity during repetitive work and position sense inaccuracy. Furthermore, patients with stress-related illnesses often reported pain in the neck, shoulders, and lower back. This was associated with lower pressure-pain thresholds in the back and a modest increase in sympathetic reactivity to physical and mental tests, which might suggest a potential use of these methods in the clinical examination and rehabilitation of patients with stress-related illnesses.

Place, publisher, year, edition, pages
2006. , 62 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1045
Keyword [en]
public health, autonomic activity, cognitive-behavioral training, muscle oxygenation, physical activity, position sense, pressure-pain thresholds, sick leave, stress
Research subject
Occupational and Environmental Medicine
Identifiers
URN: urn:nbn:se:umu:diva-879ISBN: 91-7264-146-0 (print)OAI: oai:DiVA.org:umu-879DiVA: diva2:144860
Public defence
2006-10-19, Stora föreläsningssalen, Arbetslivsinstitutet, Johan Bures väg 5, Umeå, 10:00 (English)
Opponent
Supervisors
Available from: 2006-09-28 Created: 2006-09-28 Last updated: 2009-10-06Bibliographically approved
List of papers
1. Characterization of a laboratory model of computer mouse use - applications for studying risk factors for musculoskeletal disorders.
Open this publication in new window or tab >>Characterization of a laboratory model of computer mouse use - applications for studying risk factors for musculoskeletal disorders.
2007 (English)In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 38, no 2, 213-218 p.Article in journal (Refereed) Published
Keyword
Adult, Biomechanics, Computers, Cumulative Trauma Disorders/*physiopathology, Female, Humans, Male, Muscle Fatigue/*physiology, Musculoskeletal Diseases/physiopathology, Range of Motion; Articular/physiology, Risk Factors, Sex Factors, Wrist/*physiopathology
Identifiers
urn:nbn:se:umu:diva-8340 (URN)10.1016/j.apergo.2006.03.001 (DOI)16713986 (PubMedID)
Available from: 2008-01-17 Created: 2008-01-17 Last updated: 2017-12-14Bibliographically approved
2. Effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense
Open this publication in new window or tab >>Effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense
Show others...
2005 (English)In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 94, no 1-2, 97-106 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-5363 (URN)10.1007/s00421-004-1295-y (DOI)15682326 (PubMedID)
Available from: 2006-09-28 Created: 2006-09-28 Last updated: 2017-12-14Bibliographically approved
3. Autonomic activity, pain, and perceived health in patients on sick leave due to stress-related illnesses
Open this publication in new window or tab >>Autonomic activity, pain, and perceived health in patients on sick leave due to stress-related illnesses
2005 (English)In: Integrative Physiological & Behavioral Science, ISSN 1053-881X, E-ISSN 2168-7846, Vol. 40, no 1, 3-16 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-5364 (URN)16491927 (PubMedID)
Available from: 2006-09-28 Created: 2006-09-28 Last updated: 2017-12-14Bibliographically approved
4. Evaluation of cognitive behavioural training and physical activity for patients with stress-related illnesses: a randomized controlled study.
Open this publication in new window or tab >>Evaluation of cognitive behavioural training and physical activity for patients with stress-related illnesses: a randomized controlled study.
Show others...
2007 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 5, 366-373 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-5365 (URN)10.2340/16501977-0053 (DOI)17549327 (PubMedID)
Available from: 2006-09-28 Created: 2006-09-28 Last updated: 2017-12-14Bibliographically approved

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