1Student Research Committee, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
2Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
3Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
4Neuroscience Center, Instituto de Investigaciones Cientificas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge 084301103, Panama
5Neuroscience Laboratory, NSL (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
6Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
7Academy of Health, Senses Cultural Foundation, Sacramento, CA 66006, USA
8Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Pardis, Tehran, Iran
9Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
چکیده
Background: Quantitative Electroencephalography (QEEG) is a tool helping better understand the electrical activity of the brain and a non-invasive method to assess cortical activity. To date, the brain activity of patients with chronic patellofemoral pain (PFP) has not been investigated. Objective: The current study aimed to investigate the effect of PFP on higher levels of the central nervous system by assessing the correlation between QEEG and modified excursion balance test (mSEBT) in patients with PFP. Material and Methods: Twenty-two patients with chronic PFP participated in this observational study. Their cortical electrical activity was recorded in a resting state with their eyes open, via a 32-channel QEEG. C3, C4, and Cz were considered as regions of interest. In addition to QEEG, the balance performance of the participants was evaluated via mSEBT. Results: The obtained findings revealed a negative and moderate to high correlation between theta absolute power and posteromedial direction of mSEBT in C4 (P: 0.000, r: -0.68), Cz (P: 0.001, r: -0.66), and C3 (P 0.000, r: -0.70). Additionally, a significantly close correlation is between alpha absolute power in C3 (P: 0.001, r: -0.70), C4 (P: 0.000, r: -0.71), and Cz (P: 0.000, r: -0.74) and the posteromedial direction of mSEBT. No significant correlations were between the other two directions of mSEBT, alpha, and theta. Conclusion: According to our results, balance impairment in patients with chronic PFP correlated with their QEEG neurodynamics. Moreover, our findings demonstrated the efficiency of QEEG as a neuromodulation method for patients with PFP.
Teplan M. Fundamentals of EEG measurement. Measurement Science Review. 2002;2(2):1-11.
Prichep LS, John ER, Howard B, Merkin H, Hiesiger EM. Evaluation of the pain matrix using EEG source localization: a feasibility study. Pain Med. 2011;12(8):1241-8. doi: 10.1111/j.1526-4637.2011.01191.x. PubMed PMID: 21810167.
Pinheiro ES, De Queiros FC, Montoya P, Santos CL, Do Nascimento MA, Ito CH, et al. Electroencephalographic Patterns in Chronic Pain: A Systematic Review of the Literature. PloS One. 2016;11(2):e0149085. doi: 10.1371/journal.pone.0149085. PubMed PMID: 26914356. PubMed PMCID: PMC4767709.
Apkarian AV, Hashmi JA, Baliki MN. Pain and the brain: specificity and plasticity of the brain in clinical chronic pain. 2011;152(3 Suppl):S49-64. doi: 10.1016/j.pain.2010.11.010. PubMed PMID: 21146929. PubMed PMCID: PMC3045648.
Tracey I, Bushnell MC. How neuroimaging studies have challenged us to rethink: is chronic pain a disease? J Pain. 2009;10(11):1113-20. doi: 10.1016/j.jpain.2009.09.001. PubMed PMID: 19878862.
Tse YY, Petrofsky JS, Berk L, Daher N, Lohman E, Laymon MS, et al. Postural sway and rhythmic electroencephalography analysis of cortical activation during eight balance training tasks. Med Sci Monit. 2013;19:175-86. doi: 10.12659/msm.883824. PubMed PMID: 23470794. PubMed PMCID: PMC3628716.
Saadat Z, Sinaei E, Pirouzi S, Ghofrani M, Nami M. Cortical Activity During Postural Recovery in Response to Predictable and Unpredictable Perturbations in Healthy Young and Older Adults: A Quantitative EEG Assessment. Basic Clin Neurosci. 2021;12(2):291-300. doi: 10.32598/bcn.12.2.453.1. PubMed PMID: 34925725. PubMed PMCID: PMC8672669.
Lake DA, Wofford NH. Effect of therapeutic modalities on patients with patellofemoral pain syndrome: a systematic review. Sports Health. 2011;3(2):182-9. doi: 10.1177/1941738111398583. PubMed PMID: 23016007. PubMed PMCID: PMC3445135.
Arun B, Vakkachan T, Abraham B. Comparison of dynamic postural control with and without patellofemoral pain syndrome using star excursion balance test. Journal of Medical Science and Technology. 2013;2:1-6.
Hülsdünker T, Mierau A, Neeb C, Kleinöder H, Strüder HK. Cortical processes associated with continuous balance control as revealed by EEG spectral power. Neurosci Lett. 2015;592:1-5. doi: 10.1016/j.neulet.2015.02.049. PubMed PMID: 25724275.
Hülsdünker T, Mierau A, Strüder HK. Higher Balance Task Demands are Associated with an Increase in Individual Alpha Peak Frequency. Front Hum Neurosci. 2015;9:695. doi: 10.3389/fnhum.2015.00695. PubMed PMID: 26779005. PubMed PMCID: PMC4702132.
Edwards AE, Guven O, Furman MD, Arshad Q, Bronstein AM. Electroencephalographic Correlates of Continuous Postural Tasks of Increasing Difficulty. Neuroscience. 2018;395:35-48. doi: 10.1016/j.neuroscience.2018.10.040. PubMed PMID: 30391529.
Del Percio C, Brancucci A, Bergami F, Marzano N, Fiore A, Di Ciolo E, et al. Cortical alpha rhythms are correlated with body sway during quiet open-eyes standing in athletes: a high-resolution EEG study. 2007;36(3):822-9. doi: 10.1016/j.neuroimage.2007.02.054. PubMed PMID: 17478102.
Slobounov S, Sebastianelli W, Hallett M. Residual brain dysfunction observed one year post-mild traumatic brain injury: combined EEG and balance study. Clin Neurophysiol. 2012;123(9):1755-61. doi: 10.1016/j.clinph.2011.12.022. PubMed PMID: 22361265. PubMed PMCID: PMC3513284.
Sigmund KJ, Bement MKH, Earl-Boehm JE. Exploring the Pain in Patellofemoral Pain: A Systematic Review and Meta-Analysis Examining Signs of Central Sensitization. J Athl Train. 2021;56(8):887-901. doi: 10.4085/1062-6050-0190.20. PubMed PMID: 33238005. PubMed PMCID: PMC8359717.
Oldfield RC. The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971;9(1):97-113. doi: 10.1016/0028-3932(71)90067-4. PubMed PMID: 5146491.
Peterson SM, Rios E, Ferris DP. Transient visual perturbations boost short-term balance learning in virtual reality by modulating electrocortical activity. Journal of Neurophysiology. 2018;120(4):1998-2010. doi: 10.1152/jn.00292.2018. PubMed PMID: 30044183. PubMed PMCID: PMC7054635.
Crossley K, Bennell K, Green S, Cowan S, McConnell J. Physical therapy for patellofemoral pain: a randomized, double-blinded, placebo-controlled trial. Am J Sports Med. 2002;30(6):857-65. doi: 10.1177/03635465020300061701. PubMed PMID: 12435653.
Alnahdi AH, Alderaa AA, Aldali AZ, Alsobayel H. Reference values for the Y Balance Test and the lower extremity functional scale in young healthy adults. J Phys Ther Sci. 2015;27(12):3917-21. doi: 10.1589/jpts.27.3917. PubMed PMID: 26834380. PubMed PMCID: PMC4713819.
Motealleh A, Barzegar A, Abbasi L. The immediate effect of lumbopelvic manipulation on knee pain, knee position sense, and balance in patients with patellofemoral pain: A randomized controlled trial. J Bodyw Mov Ther. 2020;24(3):71-7. doi: 10.1016/j.jbmt.2020.01.006. PubMed PMID: 32826011.
Kisner C, Colby LA. Therapeutic exercise: foundations and techniques 6th edition. FA Davis Company; 2012.
Gebel A, Lehmann T. Balance task difficulty affects postural sway and cortical activity in healthy adolescents. Exp Brain Res. 2020;238(5):1323-33. doi: 10.1007/s00221-020-05810-1. PubMed PMID: 32328673. PMCID: PMC7237405.
Hertel J, Braham RA, Hale SA, Olmsted-Kramer LC. Simplifying the star excursion balance test: analyses of subjects with and without chronic ankle instability. J Orthop Sports Phys Ther. 2006;36(3):131-7. doi: 10.2519/jospt.2006.36.3.131. PubMed PMID: 16596889.
Coughlan GF, Fullam K, Delahunt E, Gissane C, Caulfield BM. A comparison between performance on selected directions of the star excursion balance test and the Y balance test. J Athl Train. 2012;47(4):366-71. doi: 10.4085/1062-6050-47.4.03. PubMed PMID: 22889651. PubMed PMCID: PMC3396295.
Jagger K, Frazier A, Aron A, Harper B. Scoring performance variations between the Y-balance test, a modified Y-balance test, and the modified star excursion balance test. Int J Sports Phys Ther. 2020;15(1):34-41. PubMed PMID: 32089956. PubMed PMCID: PMC7015020.