Exercised-Induced Hypoalgesia Following An Elbow Flexion Low-Load Resistance Exercise with Blood Flow Restriction: A Sham-Controlled Randomized Trial in Healthy Adults

Overview

Journal Healthcare (Basel)

Specialty Health Services

Date 2022 Dec 23

PMID 36554080

Authors

Stefanos Karanasios

Alexia Sozeri

George A Koumantakis

George Gioftsos

Affiliations

Soon will be listed here.

Abstract

We aimed to evaluate the hypoalgesic effect of an elbow flexion low-load resistance exercise with blood flow restriction (LLRE-BFR) when compared to high-load resistance exercise (HLRE) with sham-BFR in healthy individuals. Forty healthy young adults (17 women), with a mean age ± SD: 26.6 ± 6.8 years, and mean body mass index ± SD: 23.6 ± 2.7 were randomly assigned to either an LLRE-BFR (30% 1 repetition maximum, RM) or an HLRE with sham-BFR group (70% of 1 RM). Blood pressure and pressure pain thresholds (PPTs) were measured pre- and post-exercise intervention. The rating of perceived exertion (RPE) was recorded after each set. There were non-significant between-group changes in PPT at the dominant biceps (-0.61, 95%CI: -1.92 to 0.68) with statistically significant reductions between pre- and post-exercise in LLRE-BFR (effect size, d = 0.88) and HLRE-BFR (effect size, d = 0.52). No within- or between-group differences were recorded in PPT at non-exercising sites of measurement. No mediating effects of changes in blood pressure or RPE on the changes in pressure pain threshold were observed. LLRE-BFR produced a similar hypoalgesic effect locally compared to HLRE and can be used as an alternative intervention to decrease pain sensitivity when HLRE is contraindicated or should be avoided.

Citing Articles

Associations of Treatment Outcome Expectations and Pain Sensitivity after Cervical Spine Manipulation in Patients with Chronic Non-Specific Neck Pain: A Cohort Study.

Paleta D, Karanasios S, Diamantopoulos N, Martzoukos N, Zampetakis N, Moutzouri M Healthcare (Basel). 2024; 12(17).

PMID: 39273728 PMC: 11395635. DOI: 10.3390/healthcare12171702.

Acute hypoalgesic, neurophysiological and perceptual responses to low-load blood flow restriction exercise and high-load resistance exercise.

Norbury R, Grant I, Woodhead A, Hughes L, Tallent J, Patterson S Exp Physiol. 2024; 109(5):672-688.

PMID: 38578259 PMC: 11061633. DOI: 10.1113/EP091705.

Blood Flow Restriction Training in Nonspecific Shoulder Pain: Study Protocol of a Crossover Randomised Controlled Trial.

Pavlou K, Savva C, Korakakis V, Pamboris G, Karagiannis C, Ploutarchou G Sports (Basel). 2023; 11(10).

PMID: 37888524 PMC: 10610701. DOI: 10.3390/sports11100197.

Wrist Extensor Training With Blood Flow Restriction for the Management of Lateral Elbow Tendinopathy: A Case Report.

Karanasios S, Lignos I, Gioftsos G Cureus. 2023; 15(2):e35468.

PMID: 36999107 PMC: 10043636. DOI: 10.7759/cureus.35468.

Low-Intensity Blood Flow Restriction Exercises Modulate Pain Sensitivity in Healthy Adults: A Systematic Review.

Karanasios S, Lignos I, Kouvaras K, Moutzouri M, Gioftsos G Healthcare (Basel). 2023; 11(5).

PMID: 36900731 PMC: 10000465. DOI: 10.3390/healthcare11050726.

References

Gajsar H, Titze C, Hasenbring M, Vaegter H . Isometric Back Exercise Has Different Effect on Pressure Pain Thresholds in Healthy Men and Women. Pain Med. 2016; 18(5):917-923. DOI: 10.1093/pm/pnw176. View

Cook S, Clark B, Ploutz-Snyder L . Effects of exercise load and blood-flow restriction on skeletal muscle function. Med Sci Sports Exerc. 2007; 39(10):1708-13. DOI: 10.1249/mss.0b013e31812383d6. View

Loenneke J, Abe T, Wilson J, Ugrinowitsch C, Bemben M . Blood flow restriction: how does it work?. Front Physiol. 2012; 3:392. PMC: 3463864. DOI: 10.3389/fphys.2012.00392. View

Vaegter H, Jones M . 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(5):e823. PMC: 7523781. DOI: 10.1097/PR9.0000000000000823. View

Vierck Jr C, Staud R, Price D, Cannon R, Mauderli A, Martin A . The effect of maximal exercise on temporal summation of second pain (windup) in patients with fibromyalgia syndrome. J Pain. 2003; 2(6):334-44. DOI: 10.1054/jpai.2001.25533. View

Montoya A, Hayes A . Two-condition within-participant statistical mediation analysis: A path-analytic framework. Psychol Methods. 2016; 22(1):6-27. DOI: 10.1037/met0000086. View

Hidalgo-Lozano A, Fernandez-de-Las-Penas C, Alonso-Blanco C, Ge H, Arendt-Nielsen L, Arroyo-Morales M . Muscle trigger points and pressure pain hyperalgesia in the shoulder muscles in patients with unilateral shoulder impingement: a blinded, controlled study. Exp Brain Res. 2010; 202(4):915-25. DOI: 10.1007/s00221-010-2196-4. View

Hirayama A, Saitoh Y, Kishima H, Shimokawa T, Oshino S, Hirata M . Reduction of intractable deafferentation pain by navigation-guided repetitive transcranial magnetic stimulation of the primary motor cortex. Pain. 2006; 122(1-2):22-7. DOI: 10.1016/j.pain.2005.12.001. View

Lamb K, Eston R, Corns D . Reliability of ratings of perceived exertion during progressive treadmill exercise. Br J Sports Med. 1999; 33(5):336-9. PMC: 1756195. DOI: 10.1136/bjsm.33.5.336. View

10.

Cook C, Kilduff L, Martyn Beaven C . Improving strength and power in trained athletes with 3 weeks of occlusion training. Int J Sports Physiol Perform. 2013; 9(1):166-72. DOI: 10.1123/ijspp.2013-0018. View

11.

Hughes L, Rosenblatt B, Haddad F, Gissane C, McCarthy D, Clarke T . Comparing the Effectiveness of Blood Flow Restriction and Traditional Heavy Load Resistance Training in the Post-Surgery Rehabilitation of Anterior Cruciate Ligament Reconstruction Patients: A UK National Health Service Randomised Controlled Trial. Sports Med. 2019; 49(11):1787-1805. DOI: 10.1007/s40279-019-01137-2. View

12.

Rice D, Nijs J, Kosek E, Wideman T, Hasenbring M, Koltyn K . Exercise-Induced Hypoalgesia in Pain-Free and Chronic Pain Populations: State of the Art and Future Directions. J Pain. 2019; 20(11):1249-1266. DOI: 10.1016/j.jpain.2019.03.005. View

13.

Kuppens K, Struyf F, Nijs J, Cras P, Fransen E, Hermans L . Exercise- and Stress-Induced Hypoalgesia in Musicians with and without Shoulder Pain: A Randomized Controlled Crossover Study. Pain Physician. 2016; 19(2):59-68. View

14.

Sluka K, Frey-Law L, Hoeger Bement M . Exercise-induced pain and analgesia? Underlying mechanisms and clinical translation. Pain. 2018; 159 Suppl 1:S91-S97. PMC: 6097240. DOI: 10.1097/j.pain.0000000000001235. View

15.

Vaegter H, Handberg G, Graven-Nielsen T . Similarities between exercise-induced hypoalgesia and conditioned pain modulation in humans. Pain. 2013; 155(1):158-167. DOI: 10.1016/j.pain.2013.09.023. View

16.

Skinner J, Hutsler R, BERGSTEINOVA V, Buskirk E . The validity and reliability of a rating scale of perceived exertion. Med Sci Sports. 1973; 5(2):94-6. View

17.

Koltyn K, Brellenthin A, Cook D, Sehgal N, Hillard C . Mechanisms of exercise-induced hypoalgesia. J Pain. 2014; 15(12):1294-1304. PMC: 4302052. DOI: 10.1016/j.jpain.2014.09.006. View

18.

Lemley K, Hunter S, Bement M . Conditioned pain modulation predicts exercise-induced hypoalgesia in healthy adults. Med Sci Sports Exerc. 2014; 47(1):176-84. DOI: 10.1249/MSS.0000000000000381. View

19.

Misra G, Paris T, Archer D, Coombes S . Dose-response effect of isometric force production on the perception of pain. PLoS One. 2014; 9(2):e88105. PMC: 3913768. DOI: 10.1371/journal.pone.0088105. View

20.

Sandal L, Roos E, Bogesvang S, Thorlund J . Pain trajectory and exercise-induced pain flares during 8 weeks of neuromuscular exercise in individuals with knee and hip pain. Osteoarthritis Cartilage. 2015; 24(4):589-92. DOI: 10.1016/j.joca.2015.11.002. View