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Dentistry Journal May 2024implementing appropriate pharmacological and non-pharmacological interventions to alleviate pain related to routine dental procedures in paediatric patients could... (Review)
Review
OBJECTIVE
implementing appropriate pharmacological and non-pharmacological interventions to alleviate pain related to routine dental procedures in paediatric patients could enhance children's ability to manage dental care. The aim of this review was to investigate the effectiveness of and provide recommendations for interventions that can be used to reduce intra-operative and post-operative pain associated with routine paediatric dental procedures.
METHODS
A systematic review of randomised controlled clinical trials (RCT) was conducted. Multiple electronic databases were systematically searched. The Cochrane risk-of-bias tool for RCTs was used to evaluate the quality of the included studies. A meta-analysis was performed to determine the effectiveness of the interventions using the Cohen's d standardised mean differences (SMD) and 95% confidence intervals (CIs) for continuous outcomes. The GRADE tool was used to assess the certainty of evidence to make recommendations.
RESULTS
The review included forty-five RCTs comprising 3093 children. Thirty-seven RCTs were included in the meta-analysis, which showed the effectiveness of behavioural interventions (SMD = -0.50, 95% CI -0.83 to -0.18), mechanoreceptor and thermal receptor stimulation (SMD = -1.38, 95% CI -2.02 to -0.73) for intra-operative pain, and pre-emptive oral analgesics (SMD = -0.77, 95% CI -1.21 to -0.33) for reducing post-operative pain in children receiving routine dental care.
CONCLUSION
The GRADE results for these interventions were strong recommendation (IB) for their use, based on moderate evidence and their benefits far outweighing the harm, and they can be delivered readily with minimal training to reduce the pain experience of paediatric patients.
PubMed: 38920864
DOI: 10.3390/dj12060163 -
Journal of Neuroengineering and... Mar 2024The regulation of gait is critical to many activities of everyday life. When walking, somatosensory information obtained from mechanoreceptors throughout body is... (Review)
Review
BACKGROUND
The regulation of gait is critical to many activities of everyday life. When walking, somatosensory information obtained from mechanoreceptors throughout body is delivered to numerous supraspinal networks and used to execute the appropriate motion to meet ever-changing environmental and task demands. Aging and age-related conditions oftentimes alter the supraspinal sensorimotor control of walking, including the responsiveness of the cortical brain regions to the sensorimotor inputs obtained from the peripheral nervous system, resulting in diminished mobility in the older adult population. It is thus important to explicitly characterize such supraspinal sensorimotor elements of walking, providing knowledge informing novel rehabilitative targets. The past efforts majorly relied upon mental imagery or virtual reality to study the supraspinal control of walking. Recent efforts have been made to develop magnetic resonance imaging (MRI)-compatible devices simulating specific somatosensory and/or motor aspects of walking. However, there exists large variance in the design and functionality of these devices, and as such inconsistent functional MRI (fMRI) observations.
METHODS
We have therefore completed a systematic review to summarize current achievements in the development of these MRI-compatible devices and synthesize available imaging results emanating from studies that have utilized these devices.
RESULTS
The device design, study protocol and neuroimaging observations of 26 studies using 13 types of devices were extracted. Three of these devices can provide somatosensory stimuli, eight motor stimuli, and two both types of stimuli. Our review demonstrated that using these devices, fMRI data of brain activation can be successfully obtained when participants remain motionless and experience sensorimotor stimulation during fMRI acquisition. The activation in multiple cortical (e.g., primary sensorimotor cortex) and subcortical (e.g., cerebellum) regions has been each linked to these types of walking-related sensorimotor stimuli.
CONCLUSION
The observations of these publications suggest the promise of implementing these devices to characterize the supraspinal sensorimotor control of walking. Still, the evidence level of these neuroimaging observations was still low due to small sample size and varied study protocols, which thus needs to be confirmed via studies with more rigorous design.
Topics: Humans; Aged; Walking; Magnetic Resonance Imaging; Gait; Neuroimaging; Aging
PubMed: 38443983
DOI: 10.1186/s12984-024-01323-y -
Frontiers in Human Neuroscience 2023Mechanical vibration is an effective way for externally activating Ia primary endings of the muscle spindles and skin mechanoreceptors. Despite its popularity in...
OBJECTIVE
Mechanical vibration is an effective way for externally activating Ia primary endings of the muscle spindles and skin mechanoreceptors. Despite its popularity in proprioception and postural control studies, there is still no review covering the wide variety of vibration parameters or locations used in studies. The main purpose of this scoping review was thus to give an overview of general vibration parameters and to identify, if available, the rationale for justifying methodological choices concerning vibration parameters.
METHODS
Three databases (Pubmed, CINHAL, and SPORTDiscus) were searched from inception to July 2022. Included articles were to focus on the study of muscle spindles and skin mechanoreceptors vibration in humans and assess postural control. Following inclusion, data regarding demographic information, populations, vibration parameters and rationale were extracted and summarized.
RESULTS
One hundred forty-seven articles were included, mostly targeting lower extremities ( = 137) and adults ( = 126). The parameters used varied widely but were most often around 80 Hz, at an amplitude of 1 mm for 10-20 s. Regarding rationales, nearly 50% of the studies did not include any, whereas those including one mainly cited the same two studies, without elaborating specifically on the parameter's choice.
CONCLUSION
This scoping review provided a comprehensive description of the population recruited and parameters used for vibration protocols in current studies with humans. Despite many studies, there remain important gaps of knowledge that needs to be filled, especially for vibration amplitude and duration parameters in various populations.
PubMed: 38234593
DOI: 10.3389/fnhum.2023.1307639 -
Journal of Clinical Medicine Oct 2023Osteoarthritis (OA) is one of the most common chronic diseases in the world. It is frequently accompanied by high levels of persistent pain, as well as substantial... (Review)
Review
PURPOSE
Osteoarthritis (OA) is one of the most common chronic diseases in the world. It is frequently accompanied by high levels of persistent pain, as well as substantial impairments in function and functional capacity. This review aims to systematically analyze the changes in proprioception and related mechanoreceptors in OA patients.
METHODS
Studies from September 2013 to September 2023 were identified by conducting searches on the PubMed, Web of Science, and Scopus electronic databases following the PRISMA statement. One reviewer independently assessed and screened the literature, extracted the data, and graded the studies. The body of evidence underwent an evaluation and grading process using the ROBINS-I tool, which was specifically designed to assess the risk of bias in non-randomized studies of interventions. Results were summarized using descriptive methods.
RESULTS
A search through 37 studies yielded 14 clinical studies that were ultimately included. The primary focus of the studies was on the knee joint, particularly the posterior cruciate ligament (PCL). The studies found that PCL in OA patients had impaired proprioceptive accuracy, possibly due to changes in mechanoreceptors (Ruffini, Pacini, and Golgi Mazzoni corpuscles). This suggests that dysfunctional articular mechanoreceptors, especially in severe cases of OA, may contribute to reduced proprioception. Dynamic stabilometry also identified significant proprioceptive deficits in patients with knee articular cartilage lesions, underscoring the impact of such lesions on knee proprioception.
CONCLUSIONS
Literature data have shown that proprioceptive accuracy may play an important role in OA, particularly in the knee PCL and cartilage. However, the role of proprioception and related mechanoreceptors needs to be further clarified. Future studies focusing on the relationship between proprioception, OA disease, and symptoms, considering age and gender differences, and exploring OA joints other than the knee should be conducted to improve clinical and surgical outcomes in cases where proprioception and mechanoreceptors are impaired in OA patients.
PubMed: 37892761
DOI: 10.3390/jcm12206623 -
Brain and Behavior Nov 2023Humans use discriminative touch to perceive texture through dynamic interactions with surfaces, activating low-threshold mechanoreceptors in the skin. It was largely... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Humans use discriminative touch to perceive texture through dynamic interactions with surfaces, activating low-threshold mechanoreceptors in the skin. It was largely assumed that texture was processed in primary somatosensory regions in the brain; however, imaging studies indicate heterogeneous patterns of brain activity associated with texture processing.
METHODS
To address this, we conducted a coordinate-based activation likelihood estimation meta-analysis of 13 functional magnetic resonance imaging studies (comprising 15 experiments contributing 228 participants and 275 foci) selected by a systematic review.
RESULTS
Concordant activations for texture perception occurred in the left primary somatosensory and motor regions, with bilateral activations in the secondary somatosensory, posterior insula, and premotor and supplementary motor cortices. We also evaluated differences between studies that compared touch processing to non-haptic control (e.g., rest or visual control) or those that used haptic control (e.g., shape or orientation perception) to specifically investigate texture encoding. Studies employing a haptic control revealed concordance for texture processing only in the left secondary somatosensory cortex. Contrast analyses demonstrated greater concordance of activations in the left primary somatosensory regions and inferior parietal cortex for studies with a non-haptic control, compared to experiments accounting for other haptic aspects.
CONCLUSION
These findings suggest that texture processing may recruit higher order integrative structures, and the secondary somatosensory cortex may play a key role in encoding textural properties. The present study provides unique insight into the neural correlates of texture-related processing by assessing the influence of non-textural haptic elements and identifies opportunities for a future research design to understand the neural processing of texture.
Topics: Humans; Brain Mapping; Likelihood Functions; Magnetic Resonance Imaging; Touch Perception
PubMed: 37749852
DOI: 10.1002/brb3.3264