{
  "abstract": "Background: Chronic shoulder pain involves interactions between emotional and autonomic processes that shape pain perception. Movement-related pictures may contribute to autonomic modulation imbalance in musculoskeletal pain. We compared the effects of viewing shoulder movement pictures on autonomic modulation and pressure pain threshold in chronic shoulder pain with pain-free controls. Methods: This was a cross-sectional study involving 56 chronic shoulder pain and 52 pain-free controls. Participants viewed a sequence of previously validated shoulder movement pictures. Heart rate variability, blood pressure variability, baroreflex sensitivity, pressure pain threshold, and self-reported pain intensity at rest and during the movement (using a numerical pain rating scale) were assessed before, during, and after shoulder movement pictures. Results: The chronic shoulder pain group showed a reduction in parasympathetic modulation compared to the pain-free control during (high frequency-HF: p = 0.04; variance: p = 0.00) and after shoulder movement pictures (HF: p = 0.03; variance: p = 0.01). The time x group interaction was not significant in low frequency (LF) or in the LF/HF ratio and blood pressure variability. The time x group interaction was significant in the baroreflex effectiveness index (p < 0.05). The pressure pain threshold was higher in the chronic shoulder pain group after the shoulder movement pictures, with a difference between groups (p < 0.001). Numerical pain rating scale did not change in chronic shoulder pain before and after shoulder movement pictures. Conclusion: Exposure to shoulder movement pictures resulted in reduced parasympathetic modulation and lower pressure pain threshold in chronic shoulder pain.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, RibeirãoPreto, Brazil",
    "Experimental Health Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands",
    "Department of Physiotherapy, Federal Institute of Rio de Janeiro, Rio de Janeiro, Brazil",
    "School of Physical and Occupational Therapy of McGill University, Montreal, Canada",
    "Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium",
    "Health Psychology, KU Leuven, Leuven, Belgium"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Marcela C. Tozzo"
    },
    {
      "affs": [
        1
      ],
      "name": "Felipe J. J. Reis"
    },
    {
      "affs": [
        2
      ],
      "name": "Ann Meulders"
    },
    {
      "affs": [
        3
      ],
      "name": "Hugo C. D. de Souza"
    },
    {
      "affs": [
        4
      ],
      "name": "Naiara Chinellato"
    },
    {
      "affs": [
        5
      ],
      "name": "Ana Catarine Veiga"
    },
    {
      "name": "Anamaria S. de Oliveira"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4tw2tm2r8tgsz.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0350902",
  "fulltext_url": null,
  "id": "4tw2tm2r8tgsz",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0350902",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Heart Rate Variability and Autonomic Control"
    ],
    [
      "plos",
      "/Biology and life sciences/Anatomy/Musculoskeletal system/Shoulders"
    ],
    [
      "plos",
      "/Biology and life sciences/Biomechanics/Musculoskeletal mechanics"
    ],
    [
      "plos",
      "/Biology and life sciences/Neuroscience/Sensory systems/Somatosensory system/Pain sensation"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Muscle physiology/Musculoskeletal mechanics"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Sensory physiology/Somatosensory system/Pain sensation"
    ],
    [
      "plos",
      "/Biology and life sciences/Psychology/Emotions"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Musculoskeletal system/Shoulders"
    ],
    [
      "plos",
      "/Medicine and health sciences/Cardiology/Heart rate"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Pain"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Pain/Lower back pain"
    ],
    [
      "plos",
      "/Medicine and health sciences/Vascular medicine/Blood pressure"
    ],
    [
      "plos",
      "/Social sciences/Psychology/Emotions"
    ]
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  "openalex": "W7214653147",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0350902&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-28",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/4tw2tm2r8tgsz.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:37Z",
      "native_id": "10.1371/journal.pone.0350902",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0350902"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:anatomy",
      "subfield": "physiology"
    }
  ],
  "title": "Heart rate variability and pain sensitivity in people with chronic shoulder pain during passive viewing of shoulder movement pictures",
  "title_text": "Heart rate variability and pain sensitivity in people with chronic shoulder pain during passive viewing of shoulder movement pictures",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:37Z",
  "url": "https://research.draconitic.com/paper/4tw2tm2r8tgsz",
  "venue": "PLOS One",
  "versions": []
}