Exercise-Induced Hypoalgesia in Patients with Chronic Whiplash-Associated Disorders: Differences Between Subgroups Based on the Central Sensitization Inventory

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Jan 23

PMID 38256616

Authors

Erwin Hendriks

Iris Coppieters

Lennard Voogt

Wilfried Cools

Kelly Ickmans

Affiliations

Soon will be listed here.

Abstract

Background: Physical exercise is an important element in the rehabilitation of chronic whiplash-associated disorders, with the physiological process underlying pain reduction called exercise-induced hypoalgesia. In chronic whiplash-associated disorders, exercise-induced hypoalgesia appears impaired, and the research suggests a relationship with symptoms of dysfunctional nociceptive processing, such as central sensitization. This study improves our understanding of exercise-induced hypoalgesia in chronic whiplash-associated disorders by examining the differences between the extent of exercise-induced hypoalgesia in subgroups based on scores on the central sensitization inventory (CSI).

Methods: Data were collected from 135 participants with chronic whiplash-associated disorders who completed a set of questionnaires. Pain pressure thresholds and temporal summations were assessed before and after a submaximal aerobic bicycle exercise test.

Results: We observed no interaction effect between exercise-induced hypoalgesia and the CSI scores for both pain pressure threshold and temporal summation. No overall statistical effect was measured in the analysis of the effect of time. The pain pressure threshold significantly related to the CSI. The temporal summation showed no correlation.

Conclusions: During this study, we did not find evidence for a difference in the presence of exercise-induced hypoalgesia when the subgroups were created based on the central sensitization cluster calculator. Limited evidence was found for the influence of CSI scores on the delta pain pressure threshold.

References

Mayer T, Neblett R, Cohen H, Howard K, Choi Y, Williams M . The development and psychometric validation of the central sensitization inventory. Pain Pract. 2011; 12(4):276-85. PMC: 3248986. DOI: 10.1111/j.1533-2500.2011.00493.x. View

Bement M, Dicapo J, Rasiarmos R, Hunter S . Dose response of isometric contractions on pain perception in healthy adults. Med Sci Sports Exerc. 2008; 40(11):1880-9. DOI: 10.1249/MSS.0b013e31817eeecc. View

Mucke M, Cuhls H, Radbruch L, Baron R, Maier C, Tolle T . Quantitative sensory testing (QST). English version. Schmerz. 2016; 35(Suppl 3):153-160. DOI: 10.1007/s00482-015-0093-2. View

Harris S, Sterling M, Farrell S, Pedler A, Smith A . The influence of isometric exercise on endogenous pain modulation: comparing exercise-induced hypoalgesia and offset analgesia in young, active adults. Scand J Pain. 2018; 18(3):513-523. DOI: 10.1515/sjpain-2017-0177. View

Van Oosterwijck J, Marusic U, De Wandele I, Paul L, Meeus M, Moorkens G . The Role of Autonomic Function in Exercise-induced Endogenous Analgesia: A Case-control Study in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Healthy People. Pain Physician. 2017; 20(3):E389-E399. View

Brellenthin A, Crombie K, Cook D, Sehgal N, Koltyn K . Psychosocial Influences on Exercise-Induced Hypoalgesia. Pain Med. 2016; 18(3):538-550. PMC: 8491610. DOI: 10.1093/pm/pnw275. View

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

Kregel J, Vuijk P, Descheemaeker F, Keizer D, van der Noord R, Nijs J . The Dutch Central Sensitization Inventory (CSI): Factor Analysis, Discriminative Power, and Test-Retest Reliability. Clin J Pain. 2015; 32(7):624-30. DOI: 10.1097/AJP.0000000000000306. View

Hays R, Morales L . The RAND-36 measure of health-related quality of life. Ann Med. 2001; 33(5):350-7. DOI: 10.3109/07853890109002089. View

10.

Cathcart S, Winefield A, Rolan P, Lushington K . Reliability of temporal summation and diffuse noxious inhibitory control. Pain Res Manag. 2009; 14(6):433-8. PMC: 2807770. DOI: 10.1155/2009/523098. View

11.

Tomschi F, Lieverkus D, Hilberg T . Exercise-induced hypoalgesia (EIH) in response to different exercise intensities. Eur J Appl Physiol. 2022; 122(10):2213-2222. PMC: 9463310. DOI: 10.1007/s00421-022-04997-1. View

12.

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

13.

Van Oosterwijck J, Nijs J, Meeus M, Van Loo M, Paul L . Lack of endogenous pain inhibition during exercise in people with chronic whiplash associated disorders: an experimental study. J Pain. 2012; 13(3):242-54. DOI: 10.1016/j.jpain.2011.11.006. View

14.

Coppieters I, De Pauw R, Kregel J, Malfliet A, Goubert D, Lenoir D . Differences Between Women With Traumatic and Idiopathic Chronic Neck Pain and Women Without Neck Pain: Interrelationships Among Disability, Cognitive Deficits, and Central Sensitization. Phys Ther. 2017; 97(3):338-353. DOI: 10.2522/ptj.20160259. View

15.

Alsouhibani A, Vaegter H, Hoeger Bement M . Systemic Exercise-Induced Hypoalgesia Following Isometric Exercise Reduces Conditioned Pain Modulation. Pain Med. 2018; 20(1):180-190. PMC: 7868957. DOI: 10.1093/pm/pny057. View

16.

Adams L, Turk D . Psychosocial factors and central sensitivity syndromes. Curr Rheumatol Rev. 2015; 11(2):96-108. PMC: 4728142. DOI: 10.2174/1573397111666150619095330. View

17.

Koltyn K . Exercise-induced hypoalgesia and intensity of exercise. Sports Med. 2002; 32(8):477-87. DOI: 10.2165/00007256-200232080-00001. View

18.

Staffe A, Bech M, Clemmensen S, Nielsen H, Larsen D, Petersen K . Total sleep deprivation increases pain sensitivity, impairs conditioned pain modulation and facilitates temporal summation of pain in healthy participants. PLoS One. 2019; 14(12):e0225849. PMC: 6892491. DOI: 10.1371/journal.pone.0225849. View

19.

Wewege M, Jones M . Exercise-Induced Hypoalgesia in Healthy Individuals and People With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis. J Pain. 2020; 22(1):21-31. DOI: 10.1016/j.jpain.2020.04.003. View

20.

Meeus M, Ickmans K, De Clerck L, Moorkens G, Hans G, Grosemans S . Serotonergic descending inhibition in chronic pain: design, preliminary results and early cessation of a randomized controlled trial. In Vivo. 2011; 25(6):1019-25. View