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Tomschi F, Ransmann P, Schmidt A, Hilberg T. Exercise induced hypoalgesia after a high intensity functional training: a randomized controlled crossover study. BMC Sports Sci Med Rehabil 2024; 16:182. [PMID: 39198898 PMCID: PMC11351546 DOI: 10.1186/s13102-024-00969-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 08/13/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Acute physical activity often induces an acute reduction in pain sensitivity known as exercise induced hypoalgesia (EIH). The aim of this study was to investigate the effects of a high intensity functional training (HIFT) on EIH compared to a control session. METHODS 50 (age: 26.0 ± 2.7; 23 female) participants successfully conducted this study consisting of a pre-experimental test as well as a 12-minute HIFT (body-weight exercises) and a 12-minute control (supervised breathing) session in a randomized crossover design. Pre and post, pressure pain thresholds (PPT) were measured at the ankles, knees, elbows, and forehead. RESULTS The HIFT resulted in a relative maximum and average heart rate of 96.2% (± 3.6%) and 91.1% (± 4.2%), respectively, and maximum and average RPE values of 19.1 (± 1.2) and 16.2 (± 1.4), respectively. Results reveal a significant 'Intervention' × 'Time point' interaction (p < 0.001) for PPT (pooled for one average value) with hypoalgesia observed following the HIFT (p < 0.001; pre: 56.0 ± 16.8, post: 61.6 ± 19.0 [Newton]) and no change following the control (p = 0.067; pre: 56.6 ± 18.4, post: 55.3 ± 18.9 [Newton]). Further, a significant 'Time' × 'Intervention' × 'Landmark' interaction effect (p = 0.024) is observed and all landmarks showed significant hypoalgesia following HIFT (p < 0.01), except for the right elbow and forehead. Following control, no hypoalgesia was observed at any landmark. Analysing male and female participants separately, it was observed that EIH occured only in men. CONCLUSION A HIFT using bodyweight exercises reduces pain sensitivity. Hence, combining strength and aerobically demanding exercises in a short but high intensity manner, as done in HIFT, can be seen as a usable tool to induce hypoalgesia. Yet, these results were observed only in male participants, necessitating future sex-specific research. TRIAL REGISTRATION DRKS00034391, retrospectively registered on the 4th of June 2024.
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Affiliation(s)
- Fabian Tomschi
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany.
| | - Pia Ransmann
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Alexander Schmidt
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
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Liu Y, Zhang L, Wang Q, Liu H, Zhu X, Li H, Zhang H. The effects of high-intensity interval training/moderate-intensity continuous training on the inhibition of fat accumulation in rats fed a high-fat diet during training and detraining. Lipids Health Dis 2024; 23:221. [PMID: 39039573 PMCID: PMC11265190 DOI: 10.1186/s12944-024-02209-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 07/08/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Compared with moderate-intensity continuous training (MICT), high-intensity interval training (HIIT) has at least a comparable effect on inhibiting an increase in fat. However, few studies have been conducted to examine the effects of detraining on body fat in rats fed a high-fat diet. The present study aimed to compare the effects of 10 weeks of HIIT or MICT as well as 6 weeks of detraining on body fat in rats fed a high-fat diet. METHODS After being fed a high-fat diet for 8 weeks, 54 female rats were randomly assigned to six groups: (1) CON-10, sedentary control for 10 weeks; (2) MICT-10, 10 weeks of MICT; (3) HIIT-10, 10 weeks of HIIT; (4) CON-16, sedentary control for 16 weeks; (5) MICT-16, 10 weeks of MICT followed by 6 weeks of training cessation; and (6) HIIT-16, 10 weeks of HIIT followed by 6 weeks of training cessation. The training was performed 5 days/week. The subcutaneous adipose tissue (inguinal; SCAT), visceral adipose tissue (periuterine; VAT) and serum lipid profile were analysed after 10 or 16 weeks. Adipose tissue triglyceride lipase (ATGL) protein expression in VAT was assessed by western blotting. RESULTS HIIT-10 and MICT-10 prevented the increase in SCAT, VAT and serum lipid levels seen in the CON group. During the 6-week detraining period, HIIT continued to prevent the increase in adipose tissue mass observed in the CON group, whereas MICT at least maintained this inhibition. The inhibition of fat mass increase was mainly the result of preventing adipocyte hypertrophy. The HIIT-10 and HIIT-16 groups showed the highest ATGL protein expression. CONCLUSIONS HIIT has a comparable effect to MICT on inhibiting fat accumulation in female rats; however, the inhibition of SCAT and VAT increase by HIIT is superior to MICT after short-term training cessation.
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Affiliation(s)
- Yu Liu
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Lukai Zhang
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Qiqi Wang
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Hui Liu
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Xiangui Zhu
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Hong Li
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Haifeng Zhang
- Physical Education College, Hebei Normal University, Shijiazhuang, China.
- Hebei Provincial Key Lab of Measurement and Evaluation in Human Movement and Bio- Information, Hebei Normal University, Shijiazhuang, China.
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Hammert WB, Song JS, Yamada Y, Kataoka R, Wong V, Spitz RW, Seffrin A, Kang A, Loenneke JP. Blood flow restriction augments exercise-induced pressure pain thresholds over repetition and effort matched conditions. J Sports Sci 2024; 42:73-84. [PMID: 38412241 DOI: 10.1080/02640414.2024.2321012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024]
Abstract
We sought to determine the effects of blood flow restriction (BFR) on exercise-induced hypoalgesia, specifically using low-load (LL) resistance exercise (30% 1RM) protocols that accounted for each individual's local muscular endurance capabilities. Forty-four participants completed four conditions: (1) 70% of maximal BFR repetitions with blood flow restriction (LL+BFR exercise); (2) 70% maximal BFR repetitions without LL+BFR (LL exercise); (3) 70% maximal free flow repetitions (LL+EFFORT exercise); (4) time-matched, non-exercise control (CON). Pressure pain threshold (PPT) was measured before and after exercise. Ischaemic pain threshold and tolerance was assessed only at post. The change in upper body PPT was greater for LL+BFR exercise compared to LL exercise [difference of 0.15 (0.35) kg/cm2], LL+EFFORT exercise [difference of 0.23 (0.45) kg/cm2], and the CON condition. The change in lower body PPT was greater for LL+BFR exercise compared to LL exercise [difference of 0.40 (0.55) kg/cm2], LL+EFFORT exercise [difference of 0.36 (0.62) kg/cm2], and the CON condition. Ischaemic pain thresholds and tolerances did not change. Submaximal exercise with BFR resulted in systemic increases in PPT but had no influence on ischaemic pain sensitivity. This effect is likely unique to BFR as we did not see changes in the effort matched free flow condition.
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Affiliation(s)
- William B Hammert
- Department of Health, Exercise Science and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Jun Seob Song
- Department of Health, Exercise Science and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Yujiro Yamada
- Department of Health, Exercise Science and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Ryo Kataoka
- Department of Health, Exercise Science and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Vickie Wong
- Health and Exercise Science, Solent University, Southampton, UK
| | - Robert W Spitz
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Aldo Seffrin
- Department of Health, Exercise Science and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Anna Kang
- Department of Health, Exercise Science and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
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Aron V, Strul D, Vaegter HB, Pitance L, Armijo-Olivo S. Reliability and measurement error of exercise-induced hypoalgesia in pain-free adults and adults with musculoskeletal pain: A systematic review. Scand J Pain 2024; 24:sjpain-2023-0104. [PMID: 38619552 DOI: 10.1515/sjpain-2023-0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/18/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES We systematically reviewed the reliability and measurement error of exercise-induced hypoalgesia (EIH) in pain-free adults and in adults with musculoskeletal (MSK) pain. METHODS We searched EMBASE, PUBMED, SCOPUS, CINAHL, and PSYCINFO from inception to November 2021 (updated in February 2024). In addition, manual searches of the grey literature were conducted in March 2022, September 2023, and February 2024. The inclusion criteria were as follows: adults - pain-free and with MSK pain - a single bout of exercise (any type) combined with experimental pre-post pain tests, and assessment of the reliability and/or measurement error of EIH. Two independent reviewers selected the studies, assessed their Risk of Bias (RoB) with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) RoB tool, and graded the individual results (COSMIN modified Grading of Recommendations Assessment, Development, and Evaluation). RESULTS We included five studies involving pain-free individuals (n = 168), which were deemed to have an overall "doubtful" RoB. No study including adults with MSK pain was found. The following ranges of parameters of reliability and measurement error of EIH were reported: intraclass correlation coefficients: 0-0.61; kappa: 0.01-0.46; standard error of measurement: 30.1-105 kPa and 10.4-21%; smallest detectable changes: 83.54-291.1 kPa and 28.83-58.21%. CONCLUSIONS We concluded, with a very low level of certainty, that the reliability and measurement error of EIH is, in pain-free adults, respectively, "insufficient" and "indeterminate." Future studies should focus on people with MSK pain and could consider using tailored exercises, other test modalities than pressure pain threshold, rater/assessor blinding, and strict control of the sources of variations (e.g., participants' expectations).
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Affiliation(s)
- Vladimir Aron
- Faculty of Medicine, Institute of Neuroscience (IoNS), Université Catholique de Louvain, Brussels B-1200, Belgium
| | | | - Henrik Bjarke Vaegter
- Pain Research Group, Pain Center, Department of Anesthesiology and Intensive Care Medicine, University Hospital Odense, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Laurent Pitance
- Institute of Experimental and Clinical Research (IREC), Université Catholique de Louvain, Brussels, Belgium
- Oral and Maxillofacial Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Susan Armijo-Olivo
- Faculty of Economics and Social Sciences, Osnabrück University of Applied Sciences, Osnabrück, Germany
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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Goldfarb AH, Kraemer RR, Baiamonte BA. Endogenous Opioids and Exercise-Related Hypoalgesia: Modern Models, Measurement, and Mechanisms of Action. ADVANCES IN NEUROBIOLOGY 2024; 35:137-155. [PMID: 38874722 DOI: 10.1007/978-3-031-45493-6_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
This chapter will focus on the role exercise appears to have on activation and modulating factors within the central nervous system related to endogenous like opioids and its possible contribution to exercise-induced hypoalgesia. The implications for the exercise-mediated alterations of CNS activation factors related to opioids, specifically endorphins and enkephalins, will be presented. In this update, we discuss utilization of new technology and methods to monitor mechanisms of opioid involvement to suggest their contribution with exercise mediated hypoalgesia as well as their relationships to alterations of perceptions of pain and mood. Several special populations were included to suggest that not all individuals will respond to the exercise by mediating hypoalgesia. Factors that may confound the current understanding and suggestions from the recent literature will be presented as well as suggestions for future investigations.
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Affiliation(s)
- Allan H Goldfarb
- University of North Carolina Greensboro, Department of Kinesiology, Greensboro, NC, USA.
| | - Robert R Kraemer
- Southeastern Louisiana University, Department of Kinesiology and Health Studies, Hammond, LA, USA
| | - Brandon A Baiamonte
- Southeastern Louisiana University, Department of Psychology, Hammond, LA, USA
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Zi‐Han X, Nan A, Rui CJ, Yong‐Long Y. Modulation of pain perceptions following treadmill running with different intensities in females. Physiol Rep 2023; 11:e15831. [PMID: 37749050 PMCID: PMC10519819 DOI: 10.14814/phy2.15831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023] Open
Abstract
We aimed to compare the effects of three intensities of treadmill running on exercise-induced hypoalgesia (EIH) in healthy individuals. We anticipated that the primary and secondary changes in pain perception and modulation may differ between running intensities. Sixty-six women were randomly assigned to one of three treadmill running intensities for 35 min: 40% reserved heart rate (HRR), 55% HRR, or 70% HRR. The effects of EIH were assessed using pressure pain thresholds (PPT) and tolerance thresholds (PPTol). We measured conditional pain modulation (CPM). Compared with baseline, PPT and PPTol significantly increased in all groups during running and at the 5-10-min follow-up. The PPT and PPTol changes in the moderate- and low-intensity groups were significantly higher than those in the high-intensity group during running and 24 h after running, while the CPM responses of the high-intensity group were significantly reduced at the 24-h follow-up. Moderate- and low-intensity running may elicit significant primary and secondary (persisting over 24 h) EIH effects and increase CPM responses in females. However, high-intensity running induced only limited analgesic effects and reduced CPM responses, which may be attributed to the activation of endogenous pain modulation.
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Affiliation(s)
- Xu Zi‐Han
- School of Sport Medicine and RehabilitationBeijing Sport UniversityBeijingChina
| | - An Nan
- School of Sport Medicine and RehabilitationBeijing Sport UniversityBeijingChina
| | - Chang Jeremy Rui
- Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHong KongChina
| | - Yang Yong‐Long
- School of Sport Medicine and RehabilitationBeijing Sport UniversityBeijingChina
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Perceived Pain in Athletes: A Comparison between Endurance Runners and Powerlifters through a Cold Experimental Stimulation and Two Sessions of Various Physical Activation. Sports (Basel) 2022; 10:sports10120211. [PMID: 36548508 PMCID: PMC9785022 DOI: 10.3390/sports10120211] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 12/10/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Few studies in the literature have illustrated cold hypoalgesia induced by strength training. Objectives of this contribution were to compare the ratings of perceived pain in endurance running (n = 22) and powerlifting (n = 22) male athletes and controls (n = 22) at baseline and after two bouts of 40 min aerobic/strength training respectively, using the Cold Pressor Test (CPT) and simultaneously monitoring changes in blood pressure (BP), heart rate (HR), and body temperature. A two-way repeated measures ANOVA was conducted to examine the effects of training sessions in endurance runners vs. powerlifting athletes vs. controls on the intensity of perceived pain at CPT. A statistically significant two-way interaction between the group and training resulted in p < 0.001, ηp2 = 0.513. A simple main effects analysis showed that as the participants went through the strength training session, pain perception at CPT was significantly lower in powerlifters compared to runners and controls. Considering the physiological parameters, powerlifters reported significantly higher values of BP and HR. This difference was present at baseline but after training as well, and before and after CPT, despite a slight hypotensive effect. The differences reported after CPT at baseline, but very significantly after the strength activation session in the powerlifters, provide interesting insights into the hypoalgesic effect of high-intensity strength training.
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Voluntary exercise attenuates nociceptive abnormalities with no significant alterations of social interaction deficits in the BTBR mouse model of autism. Behav Brain Res 2021; 420:113727. [PMID: 34954299 DOI: 10.1016/j.bbr.2021.113727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/24/2022]
Abstract
Due to the financial burden and undesired side effects of treatment options, researchers have begun exploring alternative methods of treating autism spectrum disorder (ASD). Based on research suggesting impressive health benefits of engaging in physical activity, exercise treatment to alleviate symptoms could be a more cost effective alternative to pharmaceutical interventions. This study examined the effects of physical exercise on nociceptive responses and social interactions in an autism mouse model (BTBR T+ Itpr3tf/J). Subjects (n = 32) were separated into groups (BTBR vs B6 controls) based on the genetic strain and activity condition they were assigned. When compared to B6 controls, the BTBR mice demonstrated thermal hypoalgesia that normalized following 5 weeks of voluntary wheel running. However, exercise did not significantly attenuate social interaction deficits in BTBR mice, despite scores trending toward a positive direction. These results suggest that exercise could serve as a potential additive to other therapies for abnormal nociception in individuals with Autism Spectrum Disorder.
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Hansen S, Dalgaard RC, Mikkelsen PS, Sørensen MB, Petersen KK. Modulation of Exercise-Induced Hypoalgesia Following an Exercise Intervention in Healthy Subjects. PAIN MEDICINE 2020; 21:3556-3566. [PMID: 32984895 DOI: 10.1093/pm/pnaa212] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Exercise is recommended to promote and maintain health and as treatment for more than 25 diseases and pain conditions. Exercise-induced hypoalgesia (EIH), a measure of descending pain inhibitory control, has been found to be impaired in some chronic pain conditions, but it is currently unclear if EIH is modifiable. This study investigated whether a long-term exercise intervention could modulate EIH in healthy subjects. METHODS In 38 healthy subjects, EIH was assessed as change in pressure pain threshold (PPT) after a three-minute isometric wall squat within the first week and after approximately seven weeks of military training (MT). Further, temporal summation of pain (TSP) and Knee injury and Osteoarthritis Outcome Score (KOOS) were assessed. Physical performance capacity was assessed using the Endurance 20-m shuttle run fitness test (20MSR). Hypoalgesic (EIH > 0.0 kPa) and hyperalgesic (EIH ≤ 0.0 kPa) subgroups were defined based on baseline EIH. Change in EIH following MT was used as the primary outcome. RESULTS Increased EIH (P = 0.008), PPT (P < 0.003), and 20MSR (P < 0.001) were found following MT, with no changes in TSP and KOOS (P > 0.05). Subjects with a hyperalgesic EIH response at baseline (26% of the participants) presented significantly improved EIH following MT (P = 0.010). Finally, an association between 20MRS change and EIH change was found (r = 0.369, P = 0.023). CONCLUSIONS MT increased EIH, especially in subjects who demonstrated a hyperalgesic response at baseline. Improvement in physical performance capacity was associated with an improvement in EIH, indicating that improvement in physical performance capacity may improve central pain mechanisms.
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Affiliation(s)
- Simon Hansen
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | | | | | - Mathias Brandhøj Sørensen
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Kristian Kjær Petersen
- SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.,Department of Health Science and Technology, Faculty of Medicine, Center for Neuroplasticity and Pain, Aalborg University, Aalborg, Denmark
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Patterson MS, Heinrich KM, Prochnow T, Graves-Boswell T, Spadine MN. Network Analysis of the Social Environment Relative to Preference for and Tolerance of Exercise Intensity in CrossFit Gyms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8370. [PMID: 33198213 PMCID: PMC7698103 DOI: 10.3390/ijerph17228370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 11/16/2022]
Abstract
Known for its ability to improve fitness and health, high-intensity functional training (HIFT) focuses on functional movements completed at high intensities, often yielding outcomes superior to repetitive aerobic workouts. Preference for and tolerance of high-intensity exercise are associated with enjoyment of and adherence to HIFT. Similarly, the social environment present within CrossFit, a popular group-based HIFT modality, is important to the enjoyment of and adherence to HIFT. This study aimed to test whether preference and tolerance were related to social connections within CrossFit networks. Linear network autocorrelation models (LNAMs) and exponential random graph models (ERGMs) were computed on sociometric and attribute data from members of three CrossFit networks (n = 197). LNAMs showed the preference and tolerance scores of someone's social connections were associated with their own in all three gyms, and ERGMs demonstrated preference and tolerance scores were associated with the presence of social ties within all networks. This study is the first to provide evidence for a relationship between social connections and preference and tolerance. Future longitudinal research is needed to determine if the social environment may influence and optimize a person's preference of and tolerance for HIFT.
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Affiliation(s)
- Megan S. Patterson
- College of Education and Human Development, Texas A&M University, College Station, TX 77845, USA; (T.G.-B.); (M.N.S.)
| | - Katie M. Heinrich
- College of Health and Human Sciences, Kansas State University, Manhattan, KS 66506, USA;
| | - Tyler Prochnow
- Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76706, USA;
| | - Taylor Graves-Boswell
- College of Education and Human Development, Texas A&M University, College Station, TX 77845, USA; (T.G.-B.); (M.N.S.)
| | - Mandy N. Spadine
- College of Education and Human Development, Texas A&M University, College Station, TX 77845, USA; (T.G.-B.); (M.N.S.)
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Exercise-induced hypoalgesia after acute and regular exercise: experimental and clinical manifestations and possible mechanisms in individuals with and without pain. Pain Rep 2020; 5:e823. [PMID: 33062901 PMCID: PMC7523781 DOI: 10.1097/pr9.0000000000000823] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/02/2020] [Accepted: 04/21/2020] [Indexed: 01/07/2023] Open
Abstract
This review describes methodology used in the assessment of the manifestations of exercise-induced hypoalgesia in humans and previous findings in individuals with and without pain. Possible mechanisms and future directions are discussed. Exercise and physical activity is recommended treatment for a wide range of chronic pain conditions. In addition to several well-documented effects on physical and mental health, 8 to 12 weeks of exercise therapy can induce clinically relevant reductions in pain. However, exercise can also induce hypoalgesia after as little as 1 session, which is commonly referred to as exercise-induced hypoalgesia (EIH). In this review, we give a brief introduction to the methodology used in the assessment of EIH in humans followed by an overview of the findings from previous experimental studies investigating the pain response after acute and regular exercise in pain-free individuals and in individuals with different chronic pain conditions. Finally, we discuss potential mechanisms underlying the change in pain after exercise in pain-free individuals and in individuals with different chronic pain conditions, and how this may have implications for clinical exercise prescription as well as for future studies on EIH.
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12
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Holden S, Lyng K, Graven-Nielsen T, Riel H, Olesen JL, Larsen LH, Rathleff MS. Isometric exercise and pain in patellar tendinopathy: A randomized crossover trial. J Sci Med Sport 2020; 23:208-214. [DOI: 10.1016/j.jsams.2019.09.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/18/2019] [Accepted: 09/21/2019] [Indexed: 11/15/2022]
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13
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Schmitt A, Wallat D, Stangier C, Martin JA, Schlesinger‐Irsch U, Boecker H. Effects of fitness level and exercise intensity on pain and mood responses. Eur J Pain 2019; 24:568-579. [DOI: 10.1002/ejp.1508] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 11/11/2019] [Accepted: 11/15/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Angelika Schmitt
- Functional Neuroimaging Group Department of Radiology University Hospital Bonn Bonn Germany
| | - Diana Wallat
- Functional Neuroimaging Group Department of Radiology University Hospital Bonn Bonn Germany
| | | | - Jason Anthony Martin
- Functional Neuroimaging Group Department of Radiology University Hospital Bonn Bonn Germany
| | | | - Henning Boecker
- Functional Neuroimaging Group Department of Radiology University Hospital Bonn Bonn Germany
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Attention-deficit/hyperactivity disorder medication does not alter exercise-induced hypoalgesia following an acute bout of dynamic circuit resistance exercise. Biol Sport 2019; 35:321-327. [PMID: 30765916 PMCID: PMC6358524 DOI: 10.5114/biolsport.2018.77837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/14/2018] [Accepted: 04/18/2018] [Indexed: 02/07/2023] Open
Abstract
The primary goal of this study was to investigate the effects of attention-deficit/hyperactivity disorder (ADHD) medications on exercise-induced hypoalgesia (EIH), heart rate, and perceived exertion. Thirty college-age students (10 Controls, 10 ADHD diagnosis, and 10 ADHD diagnosis with medications) completed 2 sessions: 1) a maximal testing session and 2) an experimental session consisting of 3 consecutive dynamic resistance exercise circuits comprised of 12 repetitions of 9 exercises at 60% of 1-repetition maximum using a 1:1 work to rest ratio. All participants, regardless of condition (Controls vs. ADHD without medications vs. ADHD with medications), displayed EIH accompanied by an increase in blood lactate, heart rate, and perceived exertion for the duration of the exercise bout. Therefore, the effects of resistance exercise are not altered by ADHD diagnosis or psychostimulant medication use for ADHD. These findings are intriguing given the known ergogenic and hypoalgesic effects of caffeine, a less potent stimulant.
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Rhon DI, Snodgrass SJ, Cleland JA, Greenlee TA, Sissel CD, Cook CE. Comparison of Downstream Health Care Utilization, Costs, and Long-Term Opioid Use: Physical Therapist Management Versus Opioid Therapy Management After Arthroscopic Hip Surgery. Phys Ther 2018; 98:348-356. [PMID: 29669080 DOI: 10.1093/ptj/pzy019] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 02/06/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND Physical therapy and opioid prescriptions are common after hip surgery, but are sometimes delayed or not used. OBJECTIVE The objective of this study was to compare downstream health care utilization and opioid use following hip surgery for different patterns of physical therapy and prescription opioids. DESIGN The design of this study was an observational cohort. METHODS Health care utilization was abstracted from the Military Health System Data Repository for patients who were 18 to 50 years old and were undergoing arthroscopic hip surgery between 2004 and 2013. Patients were grouped into those receiving an isolated treatment (only opioids or only physical therapy) and those receiving both treatments on the basis of timing (opioid first or physical therapy first). Outcomes included overall health care visits and costs, hip-related visits and costs, additional surgeries, and opioid prescriptions. RESULTS Of 1870 total patients, 76.8% (n = 1437) received physical therapy, 71.6% (n = 1339) received prescription opioids, and 1073 (56.1%) received both physical therapy and opioids. Because 24 patients received both opioids and physical therapy on the same day, they were eventually removed the final timing-of-care analysis. Adjusted hip-related mean costs were the same in both groups receiving isolated treatments (${\$}$11,628 vs ${\$}$11,579), but the group receiving only physical therapy had significantly lower overall total health care mean costs (${\$}$18,185 vs ${\$}$23,842) and fewer patients requiring another hip surgery. For patients receiving both treatments, mean hip-related downstream costs were significantly higher in the group receiving opioids first than in the group receiving physical therapy first (${\$}$18,806 vs ${\$}$16,955) and resulted in greater opioid use (7.83 vs 4.14 prescriptions), greater total days' supply of opioids (90.17 vs 44.30 days), and a higher percentage of patients with chronic opioid use (69.5% vs 53.2%). LIMITATIONS Claims data were limited by the accuracy of coding, and observational data limit inferences of causality. CONCLUSIONS Physical therapy first was associated with lower hip-related downstream costs and lower opioid use than opioids first; physical therapy instead of opioids was associated with less total downstream health care utilization. These results need to be validated in prospective controlled trials.
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Affiliation(s)
- Daniel I Rhon
- Baylor University Doctoral Physical Therapy Program, 3630 Stanley Road, Bldg 2841, Suite 2301, San Antonio, TX 78234. Dr Rhon is a board-certified orthopaedic clinical specialist and a fellow of the American Academy of Orthopedic Manual Therapists
| | - Suzanne J Snodgrass
- Discipline of Physiotherapy, School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Joshua A Cleland
- Physical Therapy Department, Franklin Pierce College, Concord, New Hampshire. Dr Cleland is a board-certified orthopaedic clinical specialist and a fellow of the American Academy of Orthopedic Manual Therapists
| | - Tina A Greenlee
- US Army Brooke Army Medical Center, Center for the Intrepid, Fort Sam Houston, Texas
| | | | - Chad E Cook
- Doctor of Physical Therapy Division, Duke University, Durham, North Carolina. Dr Cook is a board-certified orthopaedic clinical specialist and a fellow of the American Academy of Orthopedic Manual Physical Therapists
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16
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Lee VY, Booy R, Skinner R, Edwards KM. The effect of exercise on vaccine-related pain, anxiety and fear during HPV vaccinations in adolescents. Vaccine 2018; 36:3254-3259. [PMID: 29709446 DOI: 10.1016/j.vaccine.2018.04.069] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 01/21/2023]
Abstract
INTRODUCTION With increased school-based vaccinations for improved coverage rates and practicality, the World Health Organization (WHO) recently endorsed research to identify possible interventions to reduce vaccine-related pain in mass clinical and school-based settings. In particular, the lack of research in adolescents indicate a particular need in this population. Acute exercise has analgesic effects and has been used as a behavioural adjuvant to vaccination. Here, we examine the effect of exercise on vaccine-related pain, anxiety and fear in adolescents, during a school-based program for HPV vaccinations. METHODS 116 students (Female: 61, Male: 55) aged 11-13 years were randomly allocated to either an Exercise (n = 60) or Control (n = 56) group. All participants completed demographic and Trait-anxiety questionnaires prior to receiving the vaccine according to usual care. The Exercise group also performed upper body exercise for 15 min prior to receiving the vaccine. Immediately after the vaccine administration, all participants reported on pain, anxiety and fear at the time of receiving the vaccine. RESULTS Female adolescents in the Exercise group reported significantly less pain (3.64; 95% CI, 2.98-4.30) than Controls (4.58; 95% CI, 3.96-5.19; p = 0.04). Further, females reported greater pain and anxiety than males in the Control group but not the Exercise group. CONCLUSION This study supports the use of exercise prior to vaccine administration, especially in female adolescents who are particularly vulnerable to negative experiences during vaccination procedures. Furthermore, the ease of application, as well as the benefit of exercise, provides support for the use of simple exercise prior to vaccination in mass vaccination settings. Clinical trial registry: ANZCTR, ACTRN12614001185651.
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Affiliation(s)
- V Y Lee
- The University of Sydney, Faculty of Health Sciences & Charles Perkins Centre, Sydney, Australia.
| | - R Booy
- The University of Sydney, National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Sydney, Australia
| | - R Skinner
- University of Sydney, Dept of Paediatrics & Adolescent Health, Children's Hospital at Westmead, Australia
| | - K M Edwards
- The University of Sydney, Faculty of Health Sciences & Charles Perkins Centre, Sydney, Australia
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