A psychophysical study comparing massage to conditioned pain modulation: A single blind randomized controlled trial in healthy participants

INTRODUCTION

Pain-inducing massage results in greater pain inhibition than pain free massage, suggesting a mechanism dependent on conditioned pain modulation (CPM). The purpose of this study was to test the hypothesis that pain inducing massage produces similar magnitude of reduction in pain sensitivity as a cold pressor task and that baseline conditioned pain modulation efficiency predicts pain inducing massage related hypoalgesia.

METHODS

Sixty healthy participants were randomly assigned to receive either pain inducing massage to the neck, cold pressor task to the hand, or pain free massage to the neck. Participants also underwent pre and immediate post-intervention quantitative sensory testing. A repeated measures ANCOVA determined between group differences in pain sensitivity changes.

RESULTS

Pain inducing massage used as a conditioning stimulus resulted in comparable experimental pain sensitivity changes as a cold pressor task (p > 0.05). Pain intensity during the intervention demonstrated a weak correlation (r = 0.20, p = 0.12) with changes in pain sensitivity at a remote site. Individuals with an efficient CPM at baseline who received the pain inducing massage displayed greater increases in pressure pain threshold compared to individuals with a less efficient CPM indicating the potential benefit of treatment stratification by mechanism.

CONCLUSION

Although pain inducing massage resulted in less self-reported pain than a cold pressor task, both resulted in similar magnitude of the CPM response, suggesting shared underlying mechanisms. Understanding mechanisms of interventions can move us closer to mechanistic based treatments for pain which is consistent with a personalized medicine approach to care.

Improving Active Gaming's Energy Expenditure in Healthy Adults Using Structured Playing Instructions for the Nintendo Wii and Xbox Kinect

Naugle, KE, Carey, C, Ohlman, T, Godza, M, Mikesky, A, and Naugle, KM. Improving active gaming's energy expenditure in healthy adults using structured playing instructions for the Nintendo Wii and Xbox Kinect. J Strength Cond Res 33(2): 549-558, 2019-Professionals work constantly to increase energy expenditure and improve cardiovascular outcomes. A newer form of physical activity used to improve cardiovascular outcomes and increase energy expenditure while also providing entertainment is active gaming. The purpose was to determine energy expenditure and enjoyment levels during participation in different games played with a directed set of instructions designed to enhance movement. Twenty-one adults completed 6 sessions (1 familiarization and 5 experimental) on separate days. During 4 of the experimental sessions, participants played 1 of 4 active games for two 15-minute periods. Two active games were from Xbox Kinect and 2 were from Nintendo Wii. During the first period, participants played at a self-selected level of activity. During the second period, participants were given specific instructions for play during both active and down times within games. Participants wore a portable gas analyzer to measure energy expenditure. Resting energy expenditure was measured during session 6. Outcome measures were analyzed with 4 Game × 2 Period repeated-measures analyses of variance. Energy expenditure, measured in metabolic equivalents (METS), was greatest while playing Kinect Fighter Within. METS, enjoyment levels, and percentage of time spent in whole-body activity were greater during the period with specific instructions compared to the self-selected levels of activity, regardless of active game. When played at a self-selected level of activity, energy expenditure during the active games was similar to that of light physical activity. However, energy expenditure improved during the second period of game play showing that specific instructions created energy expenditure of moderate intensity.