• Pâmela M Bandeira, ReisFelipe J JFJJPostgraduate Program in Medicine (Cardiology).Department of Physical Therapy, Federal Institute of Rio de Janeiro (IFRJ).Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Educati, Fernanda D N Muniz, Anna C S Chaves, Orlando Fernandes, and Tiago Arruda-Sanchez.
• Postgraduate Program in Medicine (Cardiology).
• Clin J Pain. 2021 Aug 1; 37 (8): 591597591-597.

ObjectiveInvestigation if emotional reactivity by measuring heart rate variability (HRV) and pressure pain sensitivity during a passive visualization task in participants with chronic low back pain (CLBP).Materials And MethodsThis case-control study was composed of 47 participants with CLBP and 47 asymptomatic participants. Both groups were submitted to a passive visualization task using 27 pictures from PHODA (Photograph Series of Daily Activities). HRV frequency domains were measured before, during, and after the task. Pressure pain threshold and pain intensity were also measured before and after the task.ResultsThe adjusted mean difference was statistically significant for HRV frequency domains during the visualization task, including low frequency [-5.92; 95% confidence interval (CI)=-9.60 to -2.23], high frequency (-0.71; 95% CI=-1.02 to -0.39), and low-frequency/high-frequency ratio (8.82; 95% CI=5.19 to 12.45). Pressure pain threshold decreased after the task in the CLBP group in all body sites, and pain intensity increased (-0.8; 95% CI=-1.16 to -0.39).DiscussionAversive environmental stimuli, such as visual cues, may generate defensive physiological reactions. HRV can provide a measure that reflects the perceptions of threat and safety in the environment. Participants with CLBP presented changes in sympathovagal balance during passive visualization of pictures of daily activities, higher pain sensitivity, and high pain intensity when they were exposed to a passive visualization task using pictures of daily living that may arouse fears of harm.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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