Investigating the Role of Central Pain Hypersensitivity in Skeletal Muscle Neural Drive

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Participants will be required to attend two visits to Derby Medical School. Screening and eligibility assessment:- Prior to booking an appointment to attend the study, potential participants will be given the opportunity to ask questions and be pre-screened for eligibility for the study. Participation involves two study visits:- Visit 1 involves screening for eligibility, and providing informed consent. A brief history of pain condition and clinical knee assessment will be carried out. Familiarisation with the muscle testing protocol (practicing a set of muscle contractions) a questionnaire booklet will be provided at this visit. Visit 1 will last between 30 and 45 minutes. Visit 2 is the test session. Body weight and height will be taken. Pain sensitivity testing (quantitative sensory testing) will be followed by neuromuscular testing while sitting in a specially designed chair. Isometric muscle contractions will be measured using an isometric dynamometer. One muscle will be tested in the lower legs and one muscle in the upper arms (on both sides). Electrodes will be placed on a muscle at the front of the leg (tibialis anterior) and at the front of the upper arm (biceps brachii). A battery of isometric (static) muscle contractions will be performed following a force trace visual feedback on a monitor. To test whether experimental remote pain has an influence on neuromuscular functioning, a temporary pain stimulus will be applied to the arm via blood pressure cuff to a subjective level of 4/10 where '0' no pain and '10' worse pain or discomfort imaginable. A series of muscle contractions will be carried out during the remote discomfort stimulus lasting approximately 2 minutes. If discomfort becomes too much at any time the cuff will be removed immediately. Physical performance and self-reported physical functioning and disability will be measured with a simple performance measure and questionnaires respectively. A pre-test questionnaire will be used to collect relevant data, including: pain severity, duration of pain condition, duration of pain, other medical conditions, gender, ethnicity, smoking status, employment status, use of pain medications. The questionnaire also includes validated questionnaires on quality of life, central aspects of pain, disability, physical functioning, fatigue and physical activity.