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Baehr LA, Frey-Law LA, Finley M. Quantitative Sensory Changes Related to Physical Activity in Adult Populations: A Scoping Review. Am J Phys Med Rehabil 2022; 101:708-713. [PMID: 34508062 DOI: 10.1097/phm.0000000000001883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Exercise-induced hypoalgesia related to physical activity produces sensory adaptations, but its mechanism remains unclear. Quantitative sensory testing is an effective measurement tool to identify sensory changes, but the extent of evidence linking quantitative sensory testing and physical activity has not been explored. The purpose of this scoping review is to synthesize the evidence on using quantitative sensory testing to evaluate psychophysical changes related to physical activity in adult populations. The researchers developed a comprehensive search strategy with a Health Sciences Librarian using the Arksey and O'Malley Methodological framework. Four databases (Medline [PubMed], CINAHL, Web of Science, and Embase) were searched for peer-reviewed primary research. After 2790 articles were evaluated, 196 studies were included for final review. More than half of studies used randomized controlled trial design (50.5%), followed by quasi-experimental (24.0%) and observational (25.5%) strategies. Healthy adults (42.9%) and individuals with chronic health conditions (20.9%) were examined most frequently. Aerobic (27.6%) and strength (21.4%) physical activity types were most commonly studied. Static quantitative sensory testing measures of pressure pain threshold (84%) were used most frequently. The findings of this scoping review demonstrate available evidence for quantitative sensory testing as a measurement tool of neuromodulation related to physical activity in adult populations. A systematic review is warranted to examine outcomes and recommendations.
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Affiliation(s)
- Laura A Baehr
- From the Physical Therapy and Rehabilitation Sciences Department, Drexel University, Philadelphia, Pennsylvania (LAB, MF); and Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa (LAF-L)
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Fleckenstein J, Neuberger EWI, Bormuth P, Comes F, Schneider A, Banzer W, Fischer L, Simon P. Investigation of the Sympathetic Regulation in Delayed Onset Muscle Soreness: Results of an RCT. Front Physiol 2021; 12:697335. [PMID: 34603072 PMCID: PMC8481669 DOI: 10.3389/fphys.2021.697335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Sports-related pain and injury is directly linked to tissue inflammation, thus involving the autonomic nervous system (ANS). In the present experimental study, we disable the sympathetic part of the ANS by applying a stellate ganglion block (SGB) in an experimental model of delayed onset muscle soreness (DOMS) of the biceps muscle. We included 45 healthy participants (female 11, male 34, age 24.16 ± 6.67 years [range 18-53], BMI 23.22 ± 2.09 kg/m2) who were equally randomized to receive either (i) an SGB prior to exercise-induced DOMS (preventive), (ii) sham intervention in addition to DOMS (control/sham), or (iii) SGB after the induction of DOMS (rehabilitative). The aim of the study was to determine whether and to what extent sympathetically maintained pain (SMP) is involved in DOMS processing. Focusing on the muscular area with the greatest eccentric load (biceps distal fifth), a significant time × group interaction on the pressure pain threshold was observed between preventive SGB and sham (p = 0.034). There was a significant effect on pain at motion (p = 0.048), with post hoc statistical difference at 48 h (preventive SGB Δ1.09 ± 0.82 cm VAS vs. sham Δ2.05 ± 1.51 cm VAS; p = 0.04). DOMS mediated an increase in venous cfDNA -as a potential molecular/inflammatory marker of DOMS- within the first 24 h after eccentric exercise (time effect p = 0.018), with a peak at 20 and 60 min. After 60 min, cfDNA levels were significantly decreased comparing preventive SGB to sham (unpaired t-test p = 0.008). At both times, 20 and 60 min, cfDNA significantly correlated with observed changes in PPT. The 20-min increase was more sensitive, as it tended toward significance at 48 h (r = 0.44; p = 0.1) and predicted the early decrease of PPT following preventive stellate blocks at 24 h (r = 0.53; p = 0.04). Our study reveals the broad impact of the ANS on DOMS and exercise-induced pain. For the first time, we have obtained insights into the sympathetic regulation of pain and inflammation following exercise overload. As this study is of a translational pilot character, further research is encouraged to confirm and specify our observations.
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Affiliation(s)
- Johannes Fleckenstein
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Elmo W. I. Neuberger
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sports Sciences, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp Bormuth
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Fabio Comes
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
- Department of Orthopedics, Orthopedic University Hospital Friedrichsheim gGmbH, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Angelika Schneider
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
- Institute of Occupational, Social and Environmental Medicine, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Winfried Banzer
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
- Institute of Occupational, Social and Environmental Medicine, Goethe-Universität Frankfurt am Main, Frankfurt am Main, Germany
| | - Lorenz Fischer
- Professor em. Interventional Pain Management, Neural Therapy, General Internal Medicine, University of Bern, Bern, Switzerland
| | - Perikles Simon
- Department of Sports Medicine, Rehabilitation and Disease Prevention, Institute of Sports Sciences, Johannes Gutenberg University Mainz, Mainz, Germany
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