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  • 1. Beställ onlineKöp publikationen >>
    Dahlman, Joakim
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin.
    Psychophysiological and Performance Aspects on Motion Sickness2009Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Motion sickness is not an illness, but rather a natural autonomic response to an unfamiliar or specific stimulus. The bodily responses to motion sickness are highly individual and contextually dependent, making them difficult to predict. The initial autonomic responses are similar to the ones demonstrated when under stress. When under the influence of motion sickness, motivation and ability to perform tasks or duties are limited. However, little is known about how specific cognitive functions are affected. Furthermore, standard mitigation strategies involve medications that induce fatigue or strategies that require cognitive capabilities. Both of them may result in reduced capability to perform assigned tasks or duties. Hence, there is a need for alternative mitigation strategies.

    The aim of the thesis was to study psychophysiological and performance aspects on motion sickness. The long-term goal is to provide strategies for mitigation and prevention of motion sickness by identifying psychophysiological responses as predictors for both wellbeing and performance. This thesis comprises four studies, in which 91 participants were exposed to two different motion sickness stimuli, either an optokinetic drum or a motion platform. Before the tests, a method for extracting fixations from eye-tracking data was developed as a prerequisite for studying fixations as a possible mitigation strategy for reducing motion sickness. During exposure to stimuli that triggers motion sickness, performance was studied by testing short-term memory and encoding and retrieval. In the final study, the effects of an artificial sound horizon were studied with respect to its potential to subconsciously function as a mitigating source.

    The results of the measurements of the psychophysiological responses were in accordance with previous research, confirming the ambiguity and high individuality of the responses as well as their contextual dependencies. To study fixations, a centroid mode algorithm proved to be the best way to generate fixations from eye-movement data. In the final study, the effects of the sound horizon were compared to the effects of a non-positioned sound. In the latter condition, both fixation time and the number of fixations increased over time, whereas none of them showed a significant time effect in the sound horizon condition. The fixation time slope was significantly larger in the non-positioned sound condition compared to the sound horizon condition. Number of fixations, heart rate, and skin conductance correlated positively with subjective statements that referred to motion sickness. Among participants that were susceptible to motion sickness symptoms, short-term memory performance was negatively affected. However, no effects of motion sickness on encoding and retrieval were found, regardless of susceptibility.

    Future studies should continue focusing on autonomic responses and psychological issues of motion sickness. Factors such as motivation, expectancies, and previous experiences play a major and yet relatively unknown role within the motion sickness phenomena.

    Delarbeten
    1. Fixation identification in centroid versus start-point modes using eye-tracking data
    Öppna denna publikation i ny flik eller fönster >>Fixation identification in centroid versus start-point modes using eye-tracking data
    Visa övriga...
    2008 (Engelska)Ingår i: Perceptual and Motor Skills, ISSN 0031-5125, E-ISSN 1558-688X, Vol. 106, nr 3, s. 710-724Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Fixation-identification algorithms, needed for analyses of eye movements, may typically be separated into three categories, viz. (i) velocity-based algorithms, (ii) area-based algorithms, and (iii) dispersion-based algorithms. Dispersion-based algorithms are commonly used but this application introduces some difficulties, one being optimization. Basically, there are two modes to reach this goal of optimization, viz., the start-point mode and the centroid mode. The aim of the present study was to compare and evaluate these two dispersion-based algorithms. Manual inspections were made of 1,400 fixations in each mode. Odds ratios showed that by using the centroid mode for fixation detection, a valid fixation is 2.86 times more likely to be identified than by using the start-point mode. Moreover, the algorithm based on centroid mode dispersion showed a good interpretation speed, accuracy, robustness, and ease of implementation, as well as adequate parameter settings.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-15915 (URN)10.2466/PMS.106.3.710-724 (DOI)18712192 (PubMedID)
    Tillgänglig från: 2008-12-16 Skapad: 2008-12-16 Senast uppdaterad: 2018-03-17Bibliografiskt granskad
    2. Performance and Autonomic Responses during Motion Sickness
    Öppna denna publikation i ny flik eller fönster >>Performance and Autonomic Responses during Motion Sickness
    Visa övriga...
    2009 (Engelska)Ingår i: Human Factors, ISSN 0018-7208, E-ISSN 1547-8181, Vol. 51, nr 1, s. 56-66Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective: The aim of the study was to investigate how motion sickness, triggered by an optokinetic drum, affects short term memory performance and to explore autonomic responses to perceived motion sickness.

    Background: Previous research has found motion sickness to decrease performance, but it is not known how short term memory in particular is affected.

    Method: Thirty-eight healthy participants performed a listening span test while seated in a rotating optokinetic drum. Measurements of motion sickness, performance, heart rate, skin conductance, blood volume pulse, and pupil size were performed simultaneously throughout the experiment.

    Results: A total of 16 participants terminated the trial due to severe nausea, while the other 22 endured the full 25 minutes. Perceived motion sickness increased over time in both groups, but less among those who endured the trial. Short term memory performance decreased towards the end for those who terminated, while it increased for the other group. Results from the measured autonomic responses were ambiguous.

    Conclusion: The present study concludes that performance, measured as short term memory, declines as perceived motion sickness progresses.

    Application: This research has potential implications for command and control personnel in risk of developing motion sickness.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-15916 (URN)10.1177/0018720809332848 (DOI)
    Tillgänglig från: 2008-12-16 Skapad: 2008-12-16 Senast uppdaterad: 2017-12-14Bibliografiskt granskad
    3. Effects of Motion Sickness on Encoding and Retrieval
    Öppna denna publikation i ny flik eller fönster >>Effects of Motion Sickness on Encoding and Retrieval
    Visa övriga...
    2010 (Engelska)Artikel i tidskrift (Refereegranskat) Submitted
    Abstract [en]

    Objective: In this study, possible effects of motion sickness on encoding and retrieval of words were investigated.

    Background: The impact of motion sickness on human performance has been studied with regards to psychomotor functions and over learned skills, as well as to novel situations requiring encoding and retrieval skills through the use of short term memory. In this study, possible effects of motion sickness on encoding and retrieval of words were investigated.

    Method: Forty healthy participants, half of them males, performed a continuous recognition task (CRT) during exposure to a motion sickness triggering optokinetic drum. The CRT was employed as a measurement of performance and consisted of encoding and retrieval of words. The task consisted of three consecutive phases 1) encoding of familiar words; 2) encoding and retrieval of words under the influence of motion sickness; 3) retrieval of words after exposure.

    Results: Data analysis revealed no significant differences in the ability to encode or retrieve words during motion sickness compared with a control condition. In addition, there were no significant correlations between the level of motion sickness and performance of the CRT.

    Conclusion: The results indicate that encoding and retrieval of words are not affected by moderate levels of motion sickness. Application: This research has implications for operational settings where professionals experience moderate levels of motion sickness.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-15917 (URN)
    Tillgänglig från: 2008-12-16 Skapad: 2008-12-16 Senast uppdaterad: 2018-03-17Bibliografiskt granskad
    4. Could sound be used as a strategy for reducing symptoms of perceived motion sickness?
    Öppna denna publikation i ny flik eller fönster >>Could sound be used as a strategy for reducing symptoms of perceived motion sickness?
    2008 (Engelska)Ingår i: Journal of NeuroEngineering and Rehabilitation, ISSN 1743-0003, E-ISSN 1743-0003, Vol. 5, nr 35Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background: Working while exposed to motions, physically and psychologically affects a person. Traditionally, motion sickness symptom reduction has implied use of medication, which can lead to detrimental effects on performance. Non-pharmaceutical strategies, in turn, often require cognitive and perceptual attention. Hence, for people working in high demand environments where it is impossible to reallocate focus of attention, other strategies are called upon. The aim of the study was to investigate possible impact of a mitigation strategy on perceived motion sickness and psychophysiological responses, based on an artificial sound horizon compared with a non-positioned sound source.

    Method: Twenty-three healthy subjects were seated on a motion platform in an artificial sound horizon or in non-positioned sound, in random order with one week interval between the trials. Perceived motion sickness (Mal), maximum duration of exposure (ST), skin conductance, blood volume pulse, temperature, respiration rate, eye movements and heart rate were measured continuously throughout the trials.

    Results: Mal scores increased over time in both sound conditions, but the artificial sound horizon, applied as a mitigation strategy for perceived motion sickness, showed no significant effect on Mal scores or ST. The number of fixations increased with time in the non-positioned sound condition. Moreover, fixation time was longer in the nonpositioned sound condition compared with sound horizon, indicating that the subjects used more time to fixate and, hence, assumingly made fewer saccades.

    Conclusion: A subliminally presented artificial sound horizon did not significantly affect perceived motion sickness, psychophysiological variables or the time the subjects endured the motion sickness triggering stimuli. The number of fixations and fixation times increased over time in the non-positioned sound condition.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-15918 (URN)10.1186/1743-0003-5-35 (DOI)
    Tillgänglig från: 2009-03-02 Skapad: 2008-12-16 Senast uppdaterad: 2018-03-17Bibliografiskt granskad
  • 2.
    Dahlman, Joakim
    et al.
    Swedish Defense Research Agency, Linköping.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Forsman, Fredrik
    Chalmers University of Technology, Göteborg.
    Perceived motion sickness and effects on performance following naval transportation2012Ingår i: Journal of human performance in extreme environments, ISSN 1529-5168, Vol. 10, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The present study focused on the relationship between previous experiences of, and rated susceptibility to, motion sickness and its correlation to subjective measurements and actual performance. Performance was measured in terms of shooting precision among 23 participants from the Swedish amphibious corps after transportation in a small amphibious boat, while sealed off with no reference to the outside world. Self-rating questionnaires were collected regarding perceived performance and presence of motion sickness. The physiological status perceived by each participant was related to factors that generally indicate early stages of motion sickness, which also were correlated to deficits in performance. It was further shown that participants who believed that their performance could be affected by motion sickness also performed less well.

  • 3.
    Dahlman, Joakim
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Sjörs, Anna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Ledin, Torbjörn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Öronkliniken US.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Habiliteringen: Barn- och ungdomshabiliteringen, LSS Råd och stöd.
    Could sound be used as a strategy for reducing symptoms of perceived motion sickness?2008Ingår i: Journal of NeuroEngineering and Rehabilitation, ISSN 1743-0003, E-ISSN 1743-0003, Vol. 5, nr 35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Working while exposed to motions, physically and psychologically affects a person. Traditionally, motion sickness symptom reduction has implied use of medication, which can lead to detrimental effects on performance. Non-pharmaceutical strategies, in turn, often require cognitive and perceptual attention. Hence, for people working in high demand environments where it is impossible to reallocate focus of attention, other strategies are called upon. The aim of the study was to investigate possible impact of a mitigation strategy on perceived motion sickness and psychophysiological responses, based on an artificial sound horizon compared with a non-positioned sound source.

    Method: Twenty-three healthy subjects were seated on a motion platform in an artificial sound horizon or in non-positioned sound, in random order with one week interval between the trials. Perceived motion sickness (Mal), maximum duration of exposure (ST), skin conductance, blood volume pulse, temperature, respiration rate, eye movements and heart rate were measured continuously throughout the trials.

    Results: Mal scores increased over time in both sound conditions, but the artificial sound horizon, applied as a mitigation strategy for perceived motion sickness, showed no significant effect on Mal scores or ST. The number of fixations increased with time in the non-positioned sound condition. Moreover, fixation time was longer in the nonpositioned sound condition compared with sound horizon, indicating that the subjects used more time to fixate and, hence, assumingly made fewer saccades.

    Conclusion: A subliminally presented artificial sound horizon did not significantly affect perceived motion sickness, psychophysiological variables or the time the subjects endured the motion sickness triggering stimuli. The number of fixations and fixation times increased over time in the non-positioned sound condition.

  • 4.
    Dahlman, Joakim
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Sjörs, Anna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Lindström, Johan
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Öronkliniken US.
    Ledin, Torbjörn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Öronkliniken US.
    Falkmer, Torbjörn
    Jönköping University, Jönköping Sweden.
    Performance and Autonomic Responses during Motion Sickness2009Ingår i: Human Factors, ISSN 0018-7208, E-ISSN 1547-8181, Vol. 51, nr 1, s. 56-66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of the study was to investigate how motion sickness, triggered by an optokinetic drum, affects short term memory performance and to explore autonomic responses to perceived motion sickness.

    Background: Previous research has found motion sickness to decrease performance, but it is not known how short term memory in particular is affected.

    Method: Thirty-eight healthy participants performed a listening span test while seated in a rotating optokinetic drum. Measurements of motion sickness, performance, heart rate, skin conductance, blood volume pulse, and pupil size were performed simultaneously throughout the experiment.

    Results: A total of 16 participants terminated the trial due to severe nausea, while the other 22 endured the full 25 minutes. Perceived motion sickness increased over time in both groups, but less among those who endured the trial. Short term memory performance decreased towards the end for those who terminated, while it increased for the other group. Results from the measured autonomic responses were ambiguous.

    Conclusion: The present study concludes that performance, measured as short term memory, declines as perceived motion sickness progresses.

    Application: This research has potential implications for command and control personnel in risk of developing motion sickness.

  • 5.
    Dahlman, Joakim
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Sjörs, Anna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Lundgren, Pontus
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Rehabiliteringsmedicinska kliniken US.
    Ledin, Torbjörn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Öronkliniken US.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Habiliteringen: Barn- och ungdomshabiliteringen, LSS Råd och stöd.
    Effects of Motion Sickness on Encoding and Retrieval2010Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: In this study, possible effects of motion sickness on encoding and retrieval of words were investigated.

    Background: The impact of motion sickness on human performance has been studied with regards to psychomotor functions and over learned skills, as well as to novel situations requiring encoding and retrieval skills through the use of short term memory. In this study, possible effects of motion sickness on encoding and retrieval of words were investigated.

    Method: Forty healthy participants, half of them males, performed a continuous recognition task (CRT) during exposure to a motion sickness triggering optokinetic drum. The CRT was employed as a measurement of performance and consisted of encoding and retrieval of words. The task consisted of three consecutive phases 1) encoding of familiar words; 2) encoding and retrieval of words under the influence of motion sickness; 3) retrieval of words after exposure.

    Results: Data analysis revealed no significant differences in the ability to encode or retrieve words during motion sickness compared with a control condition. In addition, there were no significant correlations between the level of motion sickness and performance of the CRT.

    Conclusion: The results indicate that encoding and retrieval of words are not affected by moderate levels of motion sickness. Application: This research has implications for operational settings where professionals experience moderate levels of motion sickness.

  • 6.
    Falkmer, Torbjörn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Habiliteringen: Barn- och ungdomshabiliteringen, LSS Råd och stöd.
    Dahlman, Joakim
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Tekniska högskolan.
    Dukic, Tania
    Swedish National Road and Transport, Research Institute, VTI, Gothenburg, Sweden.
    Bjällmark, Anna
    School for Technique and Health, KTH, Stockholm, Sweden.
    Larsson, Matilda
    School for Technique and Health, KTH, Stockholm, Sweden.
    Fixation identification in centroid versus start-point modes using eye-tracking data2008Ingår i: Perceptual and Motor Skills, ISSN 0031-5125, E-ISSN 1558-688X, Vol. 106, nr 3, s. 710-724Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Fixation-identification algorithms, needed for analyses of eye movements, may typically be separated into three categories, viz. (i) velocity-based algorithms, (ii) area-based algorithms, and (iii) dispersion-based algorithms. Dispersion-based algorithms are commonly used but this application introduces some difficulties, one being optimization. Basically, there are two modes to reach this goal of optimization, viz., the start-point mode and the centroid mode. The aim of the present study was to compare and evaluate these two dispersion-based algorithms. Manual inspections were made of 1,400 fixations in each mode. Odds ratios showed that by using the centroid mode for fixation detection, a valid fixation is 2.86 times more likely to be identified than by using the start-point mode. Moreover, the algorithm based on centroid mode dispersion showed a good interpretation speed, accuracy, robustness, and ease of implementation, as well as adequate parameter settings.

  • 7.
    Falkmer, Torbjörn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Habiliteringen: Barn- och ungdomshabiliteringen, LSS Råd och stöd.
    Dahlman, Joakim
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin.
    Hasewinkel, Håkan
    FOI, Linköping.
    Sjörs, Anna
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin.
    Ökad körsäkerhet och snabbare målidentifiering genom blickregistrering2006Rapport (Övrigt vetenskapligt)
  • 8.
    Lützhöft,, Margareta
    et al.
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Industriell arbetsvetenskap. Linköpings universitet, Tekniska högskolan.
    Dahlman, Joakim
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    The human factor in accident analysis: the Kronprins Harald case2002Ingår i: Nordic Navigation, 2002, Vol. 1, nr 2Konferensbidrag (Refereegranskat)
  • 9.
    Sjors, Anna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Larsson, Britt
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    Dahlman, Joakim
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Falkmer, Torbjorn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Habiliteringen: Barn- och ungdomshabiliteringen, LSS Råd och stöd.
    Gerdle, Bjorn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    Physiological responses to low-force work and psychosocial stress in women with chronic trapezius myalgia2009Ingår i: BMC MUSCULOSKELETAL DISORDERS, ISSN 1471-2474, Vol. 10, nr 63Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Repetitive and stressful work tasks have been linked to the development of pain in the trapezius muscle, although the underlying mechanisms still remain unclear. In earlier studies, it has been hypothesized that chronic muscle pain conditions are associated with imbalance in the autonomic nervous system, predominantly expressed as an increased sympathetic activity. This study investigates whether women with chronic trapezius myalgia show higher muscle activity and increased sympathetic tone at baseline and during repetitive low-force work and psychosocial stress, compared with pain-free controls. Methods: Eighteen women with chronic trapezius myalgia (MYA) and 30 healthy female controls (CON) were studied during baseline rest, 100 min of repetitive low-force work, 20 min of psychosocial stress (Trier Social Stress Test, TSST), and 80 min recovery. The subjects rated their pain intensity, stress and energy level every 20 min throughout the experiment. Muscle activity was measured by surface electromyography in the trapezius muscle (EMGtrap) and deltoid muscle (EMGdelt). Autonomic reactivity was measured through heart rate (HR), skin conductance (SCL), blood pressure (MAP) and respiration rate (Resp). Results: At baseline, EMGtrap, stress ratings, and HR were higher in MYA than in CON. Energy ratings, EMGdelt, SCL, MAP and Resp were, however, similar in the two groups. Significant main group effects were found for pain intensity, stress ratings and EMGtrap. Deltoid muscle activity and autonomic responses were almost identical in MYA and CON during work, stress and recovery. In MYA only, pain intensity and stress ratings increased towards the end of the repetitive work. Conclusion: We found increased muscle activity during uninstructed rest in the painful muscle of a group of women with trapezius myalgia. The present study could not confirm the hypothesis that chronic trapezius myalgia is associated with increased sympathetic activity. The suggestion of autonomic imbalance in patients with chronic local or regional musculoskeletal pain needs to be further investigated.

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