High Intensity Exercise May Worsen Temporal Summation, But Not Conditioned Pain Modulation, in Chronic Neck Pain: A Randomised Crossover Trial
Authors List
Chen, K.K, School of Allied Health Science and Practice, University of Adelaide, South Australia, Australia
Hutchinson, M.R., School of Biomedicine, University of Adelaide, South Australia, Australia
Paul, R., Adelaide Medical School, University of Adelaide, South Australia, Australia
de Zoete, R.M.J., School of Allied Health Science and Practice, University of Adelaide, South Australia, Australia
Introduction
Physical exercise is the first treatment of choice for chronic neck pain (CNP), yet the mechanisms of effect of different exercise intensities are poorly understood. The presence of central sensitisation (CS) possibly mediates the effects of exercise on patient-reported outcomes.
Aims
To investigate the effects of high- and low-intensity exercise on measures of CS in people with CNP.
Methods
This was a randomised crossover trial (n=35 people with CNP, 63.2% female, age= 36.5±14.1 years). Participants performed a high-intensity (INVHIGH) and a low-intensity (INVLOW) aerobic exercise session in randomised order, one week apart. CS measures included conditioned pain modulation (CPM), a measure of descending pain inhibition, and temporal summation (TS), a measure of facilitatory pathways. CPM was assessed in series, using a cold pressor test as conditioning stimulus and pressure pain threshold as test stimulus, TS was assessed using PinPrick over the cervical region.
Results
After INVHIGH, there was a significant increase in CS (mean difference=0.51±1.24, p=0.02). No differences were found after INVLOW (mean difference=-0.06±1.37 p=0.80). No changes in CPM were found after INVLOW and INVHIGH.
Conclusions
High-intensity aerobic exercise had a detrimental effect on pain facilitatory pathways, whereas low-intensity exercise did not worsen outcomes. To avoid exacerbation of central sensitisation outcomes, these results suggests that low-intensity exercise might be a better option than high-intensity exercise. These findings may assist in the development of personalised approaches to exercise therapy.
References
Chen, K.K., Hutchinson, M.R., Rolan, P., & de Zoete, R.M.J. (2023, May). Effect of exercise on chronic neck pain and central sensitization: A protocol for a randomized crossover trial. Exp Physiol, 108(5), 672-682.
Chen, K.K, School of Allied Health Science and Practice, University of Adelaide, South Australia, Australia
Hutchinson, M.R., School of Biomedicine, University of Adelaide, South Australia, Australia
Paul, R., Adelaide Medical School, University of Adelaide, South Australia, Australia
de Zoete, R.M.J., School of Allied Health Science and Practice, University of Adelaide, South Australia, Australia
Introduction
Physical exercise is the first treatment of choice for chronic neck pain (CNP), yet the mechanisms of effect of different exercise intensities are poorly understood. The presence of central sensitisation (CS) possibly mediates the effects of exercise on patient-reported outcomes.
Aims
To investigate the effects of high- and low-intensity exercise on measures of CS in people with CNP.
Methods
This was a randomised crossover trial (n=35 people with CNP, 63.2% female, age= 36.5±14.1 years). Participants performed a high-intensity (INVHIGH) and a low-intensity (INVLOW) aerobic exercise session in randomised order, one week apart. CS measures included conditioned pain modulation (CPM), a measure of descending pain inhibition, and temporal summation (TS), a measure of facilitatory pathways. CPM was assessed in series, using a cold pressor test as conditioning stimulus and pressure pain threshold as test stimulus, TS was assessed using PinPrick over the cervical region.
Results
After INVHIGH, there was a significant increase in CS (mean difference=0.51±1.24, p=0.02). No differences were found after INVLOW (mean difference=-0.06±1.37 p=0.80). No changes in CPM were found after INVLOW and INVHIGH.
Conclusions
High-intensity aerobic exercise had a detrimental effect on pain facilitatory pathways, whereas low-intensity exercise did not worsen outcomes. To avoid exacerbation of central sensitisation outcomes, these results suggests that low-intensity exercise might be a better option than high-intensity exercise. These findings may assist in the development of personalised approaches to exercise therapy.
References
Chen, K.K., Hutchinson, M.R., Rolan, P., & de Zoete, R.M.J. (2023, May). Effect of exercise on chronic neck pain and central sensitization: A protocol for a randomized crossover trial. Exp Physiol, 108(5), 672-682.