Effect of experimental and clinical pain on the spatial distribution of muscle activity: a systematic review and meta-analysis

IntroductionMusculoskeletal dysfunctions can significantly impair quality of life due to persistent pain and neuromuscular adaptations. While regional activation patterns in healthy muscles are well-documented, the effects of clinical and experimental pain on these patterns remain inconsistent. Acco...

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Main Authors: Guillermo Mendez-Rebolledo, Ignacio Orozco-Chavez, Joaquín Salazar-Méndez, Juan Morales-Verdugo, Eduardo Martinez-Valdes
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Human Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnhum.2025.1603807/full
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author Guillermo Mendez-Rebolledo
Ignacio Orozco-Chavez
Joaquín Salazar-Méndez
Juan Morales-Verdugo
Eduardo Martinez-Valdes
author_facet Guillermo Mendez-Rebolledo
Ignacio Orozco-Chavez
Joaquín Salazar-Méndez
Juan Morales-Verdugo
Eduardo Martinez-Valdes
author_sort Guillermo Mendez-Rebolledo
collection DOAJ
description IntroductionMusculoskeletal dysfunctions can significantly impair quality of life due to persistent pain and neuromuscular adaptations. While regional activation patterns in healthy muscles are well-documented, the effects of clinical and experimental pain on these patterns remain inconsistent. Accordingly, this study systematically evaluates the scientific evidence on alterations in the spatial distribution of muscle activity, quantified by shifts in the center of activity of high-density surface electromyography (HD-sEMG) signals, under experimental and clinical pain conditions.MethodsA comprehensive database search was conducted from inception to June 6, 2025. The review included studies that evaluated the spatial distribution of muscle activity with HD-sEMG, analyzing two-dimensional shifts in the center of activity among individuals with clinical or experimentally induced pain. Methodological quality was assessed using the adapted Newcastle-Ottawa Scale, and evidence certainty was evaluated with the GRADE approach. A random-effects model was employed in the meta-analysis to account for variability across studies.ResultsTwenty studies involving 562 participants (231 control, 266 clinical pain, and 65 experimental pain) were included. The meta-analysis revealed a statistically significant shift in the center of activity in individuals with clinical pain compared with asymptomatic controls (SMD = 0.49; 95% CI = 0.15 to 1.84; p = 0.004), particularly those with chronic low back pain, with a low effect size (SMD = 0.43; 95% CI = 0.03 to 0.83; p = 0.04), indicating altered spatial distribution of muscle activity. A meta-analysis for experimental pain was not feasible due to limited data.ConclusionsThese findings underscore that clinical pain is associated with altered spatial distribution of muscle activity and emphasize the need for standardized methodologies and further research across diverse populations to enhance pain management and rehabilitation strategies.Systematic review registrationThis study was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42024534320), https://www.crd.york.ac.uk/PROSPERO/view/CRD42024534320.
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spelling doaj-art-7cd212a93e544370a3f1be8002b2190c2025-08-20T02:36:18ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612025-07-011910.3389/fnhum.2025.16038071603807Effect of experimental and clinical pain on the spatial distribution of muscle activity: a systematic review and meta-analysisGuillermo Mendez-Rebolledo0Ignacio Orozco-Chavez1Joaquín Salazar-Méndez2Juan Morales-Verdugo3Eduardo Martinez-Valdes4Laboratorio de Investigación Somatosensorial y Motora, Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, ChileDepartamento de Ciencias del Movimiento Humano, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, ChileLaboratorio de Investigación Somatosensorial y Motora, Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, ChileDepartamento de Ciencias Preclínicas, Facultad de Medicina, Universidad Católica del Maule, Talca, ChileSchool of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United KingdomIntroductionMusculoskeletal dysfunctions can significantly impair quality of life due to persistent pain and neuromuscular adaptations. While regional activation patterns in healthy muscles are well-documented, the effects of clinical and experimental pain on these patterns remain inconsistent. Accordingly, this study systematically evaluates the scientific evidence on alterations in the spatial distribution of muscle activity, quantified by shifts in the center of activity of high-density surface electromyography (HD-sEMG) signals, under experimental and clinical pain conditions.MethodsA comprehensive database search was conducted from inception to June 6, 2025. The review included studies that evaluated the spatial distribution of muscle activity with HD-sEMG, analyzing two-dimensional shifts in the center of activity among individuals with clinical or experimentally induced pain. Methodological quality was assessed using the adapted Newcastle-Ottawa Scale, and evidence certainty was evaluated with the GRADE approach. A random-effects model was employed in the meta-analysis to account for variability across studies.ResultsTwenty studies involving 562 participants (231 control, 266 clinical pain, and 65 experimental pain) were included. The meta-analysis revealed a statistically significant shift in the center of activity in individuals with clinical pain compared with asymptomatic controls (SMD = 0.49; 95% CI = 0.15 to 1.84; p = 0.004), particularly those with chronic low back pain, with a low effect size (SMD = 0.43; 95% CI = 0.03 to 0.83; p = 0.04), indicating altered spatial distribution of muscle activity. A meta-analysis for experimental pain was not feasible due to limited data.ConclusionsThese findings underscore that clinical pain is associated with altered spatial distribution of muscle activity and emphasize the need for standardized methodologies and further research across diverse populations to enhance pain management and rehabilitation strategies.Systematic review registrationThis study was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42024534320), https://www.crd.york.ac.uk/PROSPERO/view/CRD42024534320.https://www.frontiersin.org/articles/10.3389/fnhum.2025.1603807/fullclinical painexperimental painregional muscle activityelectromyographyhigh density surface electromyographyneuromuscular adaptation
spellingShingle Guillermo Mendez-Rebolledo
Ignacio Orozco-Chavez
Joaquín Salazar-Méndez
Juan Morales-Verdugo
Eduardo Martinez-Valdes
Effect of experimental and clinical pain on the spatial distribution of muscle activity: a systematic review and meta-analysis
Frontiers in Human Neuroscience
clinical pain
experimental pain
regional muscle activity
electromyography
high density surface electromyography
neuromuscular adaptation
title Effect of experimental and clinical pain on the spatial distribution of muscle activity: a systematic review and meta-analysis
title_full Effect of experimental and clinical pain on the spatial distribution of muscle activity: a systematic review and meta-analysis
title_fullStr Effect of experimental and clinical pain on the spatial distribution of muscle activity: a systematic review and meta-analysis
title_full_unstemmed Effect of experimental and clinical pain on the spatial distribution of muscle activity: a systematic review and meta-analysis
title_short Effect of experimental and clinical pain on the spatial distribution of muscle activity: a systematic review and meta-analysis
title_sort effect of experimental and clinical pain on the spatial distribution of muscle activity a systematic review and meta analysis
topic clinical pain
experimental pain
regional muscle activity
electromyography
high density surface electromyography
neuromuscular adaptation
url https://www.frontiersin.org/articles/10.3389/fnhum.2025.1603807/full
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