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Rogerio Hirata
Aalborg University, Health Science and Technology, Faculty Member
Background/aimThe purpose of this study was to compare the isokinetic peak torque profiles from the quadriceps and hamstrings muscles during concentric and eccentric contractions in elite Brazilian soccer players across different field... more
Background/aimThe purpose of this study was to compare the isokinetic peak torque profiles from the quadriceps and hamstrings muscles during concentric and eccentric contractions in elite Brazilian soccer players across different field positions and age categories. Our hypothesis was that soccer players from different field positions are subjected to different ageing-related effects on their isokinetic peak torque.MethodsThis is a retrospective study based on professional elite-level soccer players between the years 2009 and 2019. It included 570 adult males who played for at least 5 years on first or second Brazilian divisions. Playing positions were divided as: goalkeepers, defenders, sidebacks, midfielders and forwards. Age categories were also divided as: G1 (17–20 years old), G2 (21–24 years old), G3 (25–28 years old), G4 (29–32 years old) and G5 (33 years old or more).ResultsThe results indicate a moderate effect of age (F(4545)=8.197; p<0.001; η2=0.057) and a small effect ...
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Experimental muscle pain inhibits corticomotor excitability (CE) of upper limb muscles. It is unknown if this inhibition affects overlapping muscle representations within the primary motor cortex to the same degree. This study explored CE... more
Experimental muscle pain inhibits corticomotor excitability (CE) of upper limb muscles. It is unknown if this inhibition affects overlapping muscle representations within the primary motor cortex to the same degree. This study explored CE changes of the first dorsal interosseus (FDI) and extensor carpi radialis (ECR) muscles in response to muscle pain. Participants (n=13) attended two sessions (≥48 hours in-between). Hypertonic saline was injected in the ECR (session one) or the FDI (session two) muscle. CE, assessed by transcranial magnetic stimulation (TMS) motor-evoked potentials (MEPs), was recorded at baseline, during pain, and twenty minutes postinjection together with pain intensity ratings. Pain intensity ratings did not differ between the two pain sites (p=0.19). In response to FDI muscle pain, the MEPs of the FDI muscle were reduced at 2 and 4 min postinjection (p≤0.03), but not after ECR muscle pain. No significant MEP change was detected for the ECR muscle (p=0.62). No a...
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Background and aims The effect of stretching on joint range of motion is well documented and is primarily related to changes in the tolerance to stretch, but the mechanisms underlying this change are still largely unknown. The aim of this... more
Background and aims The effect of stretching on joint range of motion is well documented and is primarily related to changes in the tolerance to stretch, but the mechanisms underlying this change are still largely unknown. The aim of this study was to investigate the influence of a remote, painful stimulus on stretch tolerance. Methods Thirty-four healthy male subjects were recruited and randomly assigned to an experimental pain group (n=17) or a control group (n=17). Passive knee extension range of motion, the activity of hamstring muscles and passive resistive torque were measured with subjects in a seated position. Three consecutive measures were performed with a 5-min interval between. A static stretch protocol was utilized in both groups to examine the effect of stretching and differences in stretch tolerance between groups. Following this, the pain-group performed a cold pressor test which is known to engage the endogenous pain inhibitory system after which measurements were r...
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Aims Muscle pain affects corticomotor areas representing the affected muscle, by changing the size of representation and reduces the corticospinal output as assessed by transcranial magnetic stimulation (TMS). Less work has been done to... more
Aims Muscle pain affects corticomotor areas representing the affected muscle, by changing the size of representation and reduces the corticospinal output as assessed by transcranial magnetic stimulation (TMS). Less work has been done to understand how pain in one muscle group may affect synergistic ipsilateral muscles distal to the pain. This study aimed to explore the effects of acute extensor carpi radialis (ECR) muscle pain on TMS motor-evoked potentials (MEPs) of the ECR and the first dorsal interosseus (FDI) muscle, which are known to strongly overlap within the corticomotor area. Methods Eight healthy volunteers (1 woman) were injected with hypertonic saline (5.8%, 0.5 mL) into the ECR muscle. Pain intensity was assessed by the visual analogue scale (VAS) every minute for 10 min. TMS was applied at 120% of ECR resting motor threshold, and MEPs were acquired from the ECR and the FDI muscles. At baseline, 10 TMS pulses were delivered. Temporal mapping of ECR and FDI MEPs over 10...
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Aims Evaluate pressure pain threshold (PPT) over cervical facet joints before and after injection of experimental pain in the trapezius and multifidus muscles. Methods Fourteen healthy subjects (6 women) received randomized... more
Aims Evaluate pressure pain threshold (PPT) over cervical facet joints before and after injection of experimental pain in the trapezius and multifidus muscles. Methods Fourteen healthy subjects (6 women) received randomized ultrasound-guided injections of hypertonic saline (5.8%), in the right multifidus muscle medial to C4/C5 facet joint and in the right trapezius muscle at the midpoint between C7 spinous process and acromion. The saline-induced pain intensity was assessed on a VAS scale. Before and during saline-induced pain PPTs were assessed by pressure algometry bilaterally over C2/C3 and C5/C6 facet joints. Three-way repeated-measures ANOVA with factors PPT location, injection site, and time was used for analysis. Post-hoc analysis was done by Bonferroni. Results Saline-induced trapezius muscle pain increased PPTs over all facet joints (P < 0.05) compared with before pain. Saline-induced multifidus muscle pain increased PPTs bilaterally over C2/C3 facet joints and over the ...
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This study evaluates the complexity of force and surface electromyography (sEMG) during knee extension and flexion at low-level isometric contractions in individuals with different degrees of diabetic peripheral neuropathy (DPN). Ten... more
This study evaluates the complexity of force and surface electromyography (sEMG) during knee extension and flexion at low-level isometric contractions in individuals with different degrees of diabetic peripheral neuropathy (DPN). Ten control and 38 diabetic participants performed isometric contractions at 10%, 20%, and 30% of maximal voluntary contraction. Knee force and multichannel sEMG from vastus lateralis (VL) and biceps femoris were acquired. The SD of force and sample entropy (SaEn) of both force and sEMG were computed. Participants with moderate DPN demonstrated high force-SD and low force-SaEn. Severely affected participants showed low SaEn in VL at all force levels. DPN affects the complexity of the neuromuscular system at the knee for the extension task during low-level isometric contractions, with participants in the later stages of the disease (moderate and severe) demonstrating most of the changes. Muscle Nerve, 2017.
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Widespread pressure hyperalgesia, facilitated temporal summation of pain (TSP), and impaired conditioned pain modulation (CPM) have been found in knee osteoarthritis (KOA) patients compared with controls and these parameters have further... more
Widespread pressure hyperalgesia, facilitated temporal summation of pain (TSP), and impaired conditioned pain modulation (CPM) have been found in knee osteoarthritis (KOA) patients compared with controls and these parameters have further been suggested to be altered in the elderly. This study investigated the influence of age on pressure hyperalgesia, TSP, and CPM in patients with KOA and controls. One-hundred-thirty-three severe KOA patients and 50 age and sex-matched asymptomatic controls were assessed by cuff algometry and handheld pressure algometry. Pain sensitivity was assessed around the head of the gastrocnemius muscle to identify mild pain detection (MPDT) and tolerance (PTT) threshold. TSP was assessed by visual analogue scale (VAS) scores of the pain evoked by 10 repetitive cuff stimulations. CPM was assessed as the difference in PTT before and during cuff-induced tonic arm pain. Pressure pain thresholds (PPTs) were assessed by handheld algometry at the tibialis anterior ...
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Limits of stability (LOS) have extensive clinical and rehabilitational value yet no standard consensus on measuring LOS exists. LOS measured using a leaning or a circling protocol is commonly used in research and clinical settings,... more
Limits of stability (LOS) have extensive clinical and rehabilitational value yet no standard consensus on measuring LOS exists. LOS measured using a leaning or a circling protocol is commonly used in research and clinical settings, however differences in protocols and reliability problems exist. This study measured LOS using a four-way-leaning test and a circular-leaning test to test which showed larger LOS measurements. Furthermore, number of adaptation trials needed for consistent results was assessed. Limits of stability were measured using a force plate (Metitur Good Balance System(®)) sampling at 50Hz. Thirty healthy subjects completed 30 trials assessing LOS alternating between four-way-leaning test and circular-leaning test. A main effect of methods (ANOVA:F(1,28)=45.86, P&amp;amp;amp;amp;amp;amp;lt;0.01) with the four-way-leaning test showing larger values than the circular-leaning test (NK, P&amp;amp;amp;amp;amp;amp;lt;0.01). An interaction between method×directions was found (ANOVA:F(3, 84)=24.87, P&amp;amp;amp;amp;amp;amp;lt;0.01). The four-way-leaning test showed larger LOS in anterior (NK, P&amp;amp;amp;amp;amp;amp;lt;0.05), right (NK, P&amp;amp;amp;amp;amp;amp;lt;0.01) and left direction (NK, P&amp;amp;amp;amp;amp;amp;lt;0.01). Analysis of LOS for the four-way-leaning test showed a difference between trials (ANOVA:F(14,392)=7.81, P&amp;amp;amp;amp;amp;amp;lt;0.01). Differences were found between trial 1 and 7 (NK, P&amp;amp;amp;amp;amp;amp;lt;0.03), trial 6 and 8 (NK, P&amp;amp;amp;amp;amp;amp;lt;0.02) and trial 7 and 15 (NK, P&amp;amp;amp;amp;amp;amp;lt;0.02). Four-way-leaning test showed high correlation (ICC&amp;amp;amp;amp;amp;amp;gt;0.87) between first and second trial for all directions. Four-way-leaning test yields larger LOS in anterior, right and left direction making it more reliable when measuring LOS. A learning effect was found up to the 8th trial, which suggests using 8 adaptation trials before reliable LOS is measured.
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ABSTRACT Introduction Longstanding groin injuries are a challenging area of sports medicine. Before we move forward in management we must first better understand the structures that form this region. This includes the gross anatomy and... more
ABSTRACT Introduction Longstanding groin injuries are a challenging area of sports medicine. Before we move forward in management we must first better understand the structures that form this region. This includes the gross anatomy and its function as well as the cells that underpin this function. The adductor longus has a fibrocartilage enthesis proximally. However, this enthesis is complex with a confluence of structures that interact including bone, enthesis and tendon. This interaction is likely to be critical in future advances in diagnosis and treatment methods. This presentation will explore the anatomy and histology of this area and discuss its relevance to the clinician. Current literature will also be synthesised with emerging data in EMG, quantitative sensory testing and the effect pain has on these measures.
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ABSTRACT Background / aim: Experimental pain models of induced short duration pain allow the pain provocation tests to be evaluated in healthy individuals. This study was aimed at establishing the best clinical test(s) to identify... more
ABSTRACT Background / aim: Experimental pain models of induced short duration pain allow the pain provocation tests to be evaluated in healthy individuals. This study was aimed at establishing the best clinical test(s) to identify adductor longus tendon experimental pain. Methods: Experimental pain was induced in 15 healthy, physically-active, male participants, by hypertonic saline injection (1 mL, 5.8%) into the proximal adductor longus tendon (AL). A painful control injection into the rectus femoris muscle (RF) (hypertonic saline; 1mL, 5.8%) and an AL non-painful control (isotonic saline; 1 mL, 0.9%) were utilised. Six clinical tests were examined (adduction in 0°, 45° and 90° hip flexion; crunch, ipsi- and contralateral oblique crunch). Increased pain provocation of the clinical tests under AL experimental pain was recorded as a true positive. Positive (+LR) and negative likelihood ratios (-LR) were calculated for individual and combination of tests. Results: Hip Adduction in 0° flexion had the greatest +LR (controlled with RF-pain; +LR=2.8, 95%CI 1.09-7.32) and 45° (controlled with RF-pain; -LR=0.0, 95%CI 0.00-1.90) and 90° (RF-pain and AL-isotonic control conditions; -LR=0.0, 95%CI 0.00-0.94) having the lowest -LR. Pain provocation with any two of three adduction tests had the highest +LR of the combinations (AL isotonic control condition; +LR=2.41, 95%CI 1.31-4.44). Conclusion: The 0° hip adduction test is best to detect adductor longus tendon pain and the 45° or 90° hip adduction test is best to rule out adductor longus tendon pain. A test battery is not diagnostically superior to the 0° test alone. Validation in clinical populations is warranted.
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Background and aims Spine stability is affected in low back (LB) pain and potentially by muscle fatigue and soreness. This study assessed motor control responses to unexpected surface perturbations during stance during experimental LB... more
Background and aims Spine stability is affected in low back (LB) pain and potentially by muscle fatigue and soreness. This study assessed motor control responses to unexpected surface perturbations during stance during experimental LB muscle pain combined with fatigue and muscle soreness. Methods Nineteen healthy participants were examined day 1-3 before and after bilateral injections of hypertonic saline into m. longissimus. Pain intensity was scored on a visual analogue scale (VAS). Day 2 included injections during post-exercise LB muscle fatigue and day 3 during delayed onset back muscle soreness (DOMS). Twenty perturbations were conducted randomly with tilts in sagittal and frontal plane or displacements in the frontal plane. Bilateral electromyography (EMG) was recorded from 12 trunk muscles. The root-mean-square (RMS-EMG) was extracted. Changes (DeltaRMS) and absolute changes (DeltaRMSabs) in the RMS-EMG from the baseline of the day were calculated and averaged among back and ...
Background / aim: Experimental pain models of induced short duration pain allow the pain provocation tests to be evaluated in healthy individuals. This study was aimed at establishing the best clinical test(s) to identify adductor longus... more
Background / aim: Experimental pain models of induced short duration pain allow the pain provocation tests to be evaluated in healthy individuals. This study was aimed at establishing the best clinical test(s) to identify adductor longus tendon experimental pain. Methods: Experimental pain was induced in 15 healthy, physically-active, male participants, by hypertonic saline injection (1 mL, 5.8%) into the proximal adductor longus tendon (AL). A painful control injection into the rectus femoris muscle (RF) (hypertonic saline; 1mL, 5.8%) and an AL non-painful control (isotonic saline; 1 mL, 0.9%) were utilised. Six clinical tests were examined (adduction in 0°, 45° and 90° hip flexion; crunch, ipsi- and contralateral oblique crunch). Increased pain provocation of the clinical tests under AL experimental pain was recorded as a true positive. Positive (+LR) and negative likelihood ratios (-LR) were calculated for individual and combination of tests. Results: Hip Adduction in 0° flexion ...
Background / aim: Little attention has been given to symptomology in longstanding groin pain. This study aims to establish the pain distribution in experimentally-induced groin pain. Methods: Experimental pain was induced by hypertonic... more
Background / aim: Little attention has been given to symptomology in longstanding groin pain. This study aims to establish the pain distribution in experimentally-induced groin pain. Methods: Experimental pain was induced by hypertonic saline injection (1 mL, 5.8%) into the proximal adductor longus tendon (AL) or rectus femoris muscle (RF) of 15 healthy, physically active, male participants. An injection of isotonic saline (1 mL, 0.9%) was used as control. Muscle pain intensity (scored on a visual analogue scale; VAS area-under-curve, VAS peak) and pain distribution (body chart) were assessed. Bodily areas were broken into regions with frequencies reported relative to the “Groin Triangle” (formed by the lines between the pubic tubercle, anterior superior iliac spine (ASIS), and mid-distance point between the ASIS and superior patella pole). Results: The hypertonic saline injected into the AL tendon produced significantly higher VAS peaks and VAS areas when compared with isotonic sal...
Home-exercise is commonly prescribed for rehabilitation of the shoulder following injury. There is a lack of technology available to monitor if the patient performs the exercises as prescribed. The purpose of this study was to investigate... more
Home-exercise is commonly prescribed for rehabilitation of the shoulder following injury. There is a lack of technology available to monitor if the patient performs the exercises as prescribed. The purpose of this study was to investigate the validity of using three dimensional (3D) gyroscope data recorded with the Bandcizer™ sensor to differentiate between three elastic band exercises performed in the shoulder joint: abduction, flexion, and external rotation. Concurrent validity study. This study was performed over two phases. In the first phase, 20 subjects performed three sets of 10 of shoulder abduction, external rotation and flexion exercises with a Thera-Band mounted with a Bandcizer, while supervised by a physical therapist. The Bandcizer has an inbuilt three-dimensional gyroscope, capable of measuring angular rotation. Gyroscope data were analyzed in Matlab, and a one-way ANOVA was used to test for significant differences between each of the three exercises. An algorithm was...
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Anticipatory postural adjustments (APAs) are motor responses generated to stabilize balance prior to voluntary movement. This study investigated how infrapatellar fat pad pain induces reorganization of APAs during reaction time tasks. It... more
Anticipatory postural adjustments (APAs) are motor responses generated to stabilize balance prior to voluntary movement. This study investigated how infrapatellar fat pad pain induces reorganization of APAs during reaction time tasks. It has been hypothesized that knee pain may cause insufficient APAs, thereby impairing the balance. While standing, 12 healthy men performed two reaction time tasks (shoulder flexion of the dominant side and bilateral heel lift, respectively) before, during and after experimental infrapatellar fat pad pain induced in the dominant side by injections of hypertonic saline. Isotonic saline was injected as control. The reaction time task performance was assessed by peak angle and peak angular velocity. Timing and intensity of the postural muscle activity were recorded by surface electromyography. The reaction time task performance was not significantly affected by experimental pain. The onset of muscle activity in vastus medialis, vastus lateralis and tibia...
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Clinical neck pain affects pain sensitivity and coordination of neck muscles, but the impact on the shoulder muscles is unclear. This study investigated the effect of experimental neck pain on the activity of the axioscapular muscles... more
Clinical neck pain affects pain sensitivity and coordination of neck muscles, but the impact on the shoulder muscles is unclear. This study investigated the effect of experimental neck pain on the activity of the axioscapular muscles during arm movements and changes in pain sensitivity. Experimental neck pain was induced in 24 healthy volunteers by injecting hypertonic saline into the splenius capitis. Isotonic saline was injected as control. Before, during, and after injections, electromyography was recorded bilaterally from 8 muscles during standardized arm movements (140° scapular plane elevation), and the root mean square amplitude was extracted. Likewise, pressure pain thresholds were assessed bilaterally on 3 sites. The root mean square electromyography was decreased for the ipsilateral upper trapezius (P < .01) and increased for the ipsilateral middle deltoid (P < .03) during upward movements. The root mean square electromyography was reduced for the ipsilateral upper t...
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The Active Straight Leg Raise (ASLR) test is widely used clinically to assess severity of lumbopelvic pain due to decreased stability of the sacroiliac joint (SIJ). This study aimed to bypass the influence of decreased SIJ stability on... more
The Active Straight Leg Raise (ASLR) test is widely used clinically to assess severity of lumbopelvic pain due to decreased stability of the sacroiliac joint (SIJ). This study aimed to bypass the influence of decreased SIJ stability on the ASLR test by investigating the effect of experimental pelvic pain and hyperalgesia on the outcome of the ASLR test. Thirty-four healthy subjects participated in this randomized crossover study. Pelvic pain was induced by injecting hypertonic saline into the long posterior sacroiliac ligament. Isotonic saline was injected on the contralateral side as control. Pain intensity was assessed on an electronic visual analogue scale (VAS). The Likert scores of difficulty performing the ASLR test and simultaneous electromyography (EMG) of trunk and thigh muscles were recorded before, during and post-pain. Pressure pain thresholds (PPTs) were assessed bilaterally in the pelvic area and lower limb. Compared with the control condition and baseline, hypertonic ...
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ABSTRACT Introduction Longstanding groin injuries are a challenging area of sports medicine. Before we move forward in management we must first better understand the structures that form this region. This includes the gross anatomy and... more
ABSTRACT Introduction Longstanding groin injuries are a challenging area of sports medicine. Before we move forward in management we must first better understand the structures that form this region. This includes the gross anatomy and its function as well as the cells that underpin this function. The adductor longus has a fibrocartilage enthesis proximally. However, this enthesis is complex with a confluence of structures that interact including bone, enthesis and tendon. This interaction is likely to be critical in future advances in diagnosis and treatment methods. This presentation will explore the anatomy and histology of this area and discuss its relevance to the clinician. Current literature will also be synthesised with emerging data in EMG, quantitative sensory testing and the effect pain has on these measures.
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Automated movements adjusting postural control may be hampered during musculoskeletal pain leaving a risk of incomplete control of balance. This study investigated the effect of experimental muscle pain on anticipatory postural... more
Automated movements adjusting postural control may be hampered during musculoskeletal pain leaving a risk of incomplete control of balance. This study investigated the effect of experimental muscle pain on anticipatory postural adjustments by reaction task movements. While standing, nine healthy males performed two reaction time tasks (shoulder flexion of dominant side and bilateral heel lift) before, during and after experimental muscle pain. On two different days experimental pain was induced in the m. vastus medialis (VM) or the m. tibialis anterior (TA) of the dominant side by injections of hypertonic saline (1ml, 5.8%). Isotonic saline (1ml, 0.9%) was used as control injection. Electromyography (EMG) was recorded from 13 muscles. EMG onset, EMG amplitude, and kinematic parameters (shoulder and ankle joint) were extracted. During shoulder flexion and VM pain the onset of the ipsilateral biceps femoris was significantly faster than baseline and post injection sessions. During heels lift in the VM and TA pain conditions the onset of the contralateral TA was significantly faster than baseline and post injection sessions in bilateral side. VM pain significantly reduced m. quadriceps femoris activity and TA pain significantly reduced ipsilateral VM activity and TA activity during bilateral heel lift. The EMG reaction time was delayed in bilateral soleus muscles during heels lift with VM and TA pain. The faster onset of postural muscle activity during anticipatory postural adjustments may suggest a compensatory function to maintain postural control whereas the reduced postural muscle activity during APAs may indicate a pain adaptation strategy to avoid secondary damage.
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The objective of this study was to examine the effect of experimental knee-related pain on postural control. Twelve healthy subjects stood as quietly as possible on a movable force platform (that measured the centre of pressure and... more
The objective of this study was to examine the effect of experimental knee-related pain on postural control. Twelve healthy subjects stood as quietly as possible on a movable force platform (that measured the centre of pressure and provided fast perturbations) before, during, and after experimental knee-related pain. Lower limb electromyographic (EMG) activity and joint angles were measured. Experimental pain was induced by injecting hypertonic saline into the infrapatellar fat pad (unilateral and bilateral) and isotonic saline was used for control sessions. Compared with the baseline and control sessions, unilateral and bilateral knee-related pain during quiet standing evoked (1) an increased sway displacement in the anterior–posterior direction (P < 0.05), (2) larger knee flexion (P < 0.05), and (3) larger EMG changes. Bilateral pain also induced (1) larger medial–lateral sway displacement and speed (P < 0.05) and (2) larger left hip flexion (P < 0.05). During forward perturbations, subjects leaned forward during both painful conditions when compared with baseline (P < 0.05). The additional impairment by bilateral pain suggests that the non-painful limb in unilateral pain conditions compensates for the impaired postural control. These results show that knee-related pain impairs postural stability during quiet standing, indicating the vulnerability of patients with knee pain to falls. This measure could potentially help clinicians who seek to assess how pain responses may contribute to patient’s postural control and stability during quiet standing.