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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

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CiteScore 2017: 0.84

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1877-8879
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Volume 18, Issue 3

The influence of isometric exercise on endogenous pain modulation: comparing exercise-induced hypoalgesia and offset analgesia in young, active adults

Samuel Harris / Michele Sterling
  • RECOVER Injury Research Centre, NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Brisbane, Australia
  • Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
  • Other articles by this author:
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/ Scott F. Farrell
  • RECOVER Injury Research Centre, NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Brisbane, Australia
  • Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Ashley Pedler
  • RECOVER Injury Research Centre, NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Brisbane, Australia
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  • De Gruyter OnlineGoogle Scholar
/ Ashley D. Smith
  • Corresponding author
  • School of Allied Health Sciences, Griffith University, 58 Parklands Dr, Southport, Gold Coast, QLD 4215, Australia, Phone: +1 403 281 7264
  • Email
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Published Online: 2018-03-30 | DOI: https://doi.org/10.1515/sjpain-2017-0177

Abstract

Background and aims

Impairment of endogenous analgesia has been associated with the development, maintenance and persistence of pain. Endogenous analgesia can be evaluated using exercise-induced hypoalgesia (EIH) and offset analgesia (OffA) paradigms, which measure temporal filtering of sensory information. It is not clear if these paradigms are underpinned by common mechanisms, as EIH and OffA have not previously been directly compared. A further understanding of the processes responsible for these clinically relevant phenomena may have future diagnostic and therapeutic utility in management of individuals with persistent pain conditions. The primary aim of this study was to investigate if there is a correlation between the magnitudes of EIH and OffA. The secondary aim of the study was to examine whether exercise influences OffA.

Methods

Thirty-six healthy, pain-free participants were recruited. EIH was evaluated using pressure pain thresholds (PPT) and pain ratings to suprathreshold pressure stimuli over tibialis anterior and the cervical spine. OffA evaluation utilised a three-step protocol, whereby individualised heat pain thermal stimuli [Numerical Rating Scale (NRS)=50/100] were applied (T1), before increasing 1 °C (T2), followed by 1 °C reduction (T3). The magnitude of OffA was calculated as the percentage reduction in the NRS from T2 to T3. PPT/suprathreshold pain ratings and OffA measures were recorded, before and after 5 min of isometric quadriceps exercise performed at 20–25% maximum voluntary contraction (MVC); and following a 15 min rest period. Data were analysed using repeated measures (RM) ANCOVA and correlational analyses.

Results

There was no correlation between EIH measures (PPTs or pain ratings to suprathreshold pressure stimuli over tibialis anterior or the cervical spine) and OffA (p>0.11 for all). OffA was induced and not modulated by exercise (p=0.28).

Conclusions

Five minutes of 20–25% MVC lower limb isometric exercise provided non-pharmacological pain modulation in young, active adults. Magnitude of EIH was not correlated with that of OffA, and exercise did not influence magnitude of OffA.

Implications

These results suggest that in young, pain-free individuals, separate testing of these two paradigms is required to comprehensively evaluate efficacy of endogenous analgesia. If these results are replicated in patient populations, alternative or complementary methods to exercise interventions may be required to modulate impaired OffA.

Keywords: exercise-induced hypoalgesia; offset analgesia; isometric exercise; endogenous analgesia; temporal filtering; pain sensitivity

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About the article

Received: 2017-12-04

Revised: 2018-03-05

Accepted: 2018-03-06

Published Online: 2018-03-30

Published in Print: 2018-07-26


Authors’ statements

Research funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflict of interest: The authors do not have any conflicts of interest to declare.

Informed consent: All participants provided informed written consent prior to completing baseline questionnaires and resting physical measures.

Ethical approval: Ethical clearance for this study was granted by Griffith University Human Research Ethics Committee (#: 2016/307).


Citation Information: Scandinavian Journal of Pain, Volume 18, Issue 3, Pages 513–523, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1515/sjpain-2017-0177.

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