Department of General Internal Medicine and Psychosomatics, Medical Hospital, University of Heidelberg, Germany Mannheimer Institute of Public Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
Pain. 2012 Jun;153(6):1253-1262. doi: 10.1016/j.pain.2012.03.005.
This study systematically reviewed differences in pain perception between athletes and normally active controls. We screened MEDLINE, Sport-Discus, EMBASE, Web of Science, PsycINFO, PSYNDEX, and the citations of original studies and systematic reviews. All studies on experimentally induced pain that compared pain perception between athletes and normally active controls were eligible. The main outcome measures were pain tolerance and pain threshold. Effects are described as standardized mean differences and were pooled using random-effects models. Fifteen studies including 899 subjects met the inclusion criteria. Twelve of these studies assessed pain tolerance, and 9 studies examined pain threshold. A meta-analysis of these studies revealed that athletes possessed higher pain tolerance compared to normally active controls (effect size calculated as Hedges' g=0.87, 95% confidence interval [CI(95)] 0.53-1.21; P<0.00001), whereas available data on pain threshold were less uniform (Hedges' g=0.69, CI(95) 0.16-1.21; P=0.01). After exclusion of studies with high risk of bias, differences between groups in pain threshold were not significant any longer. Our data suggest that regular physical activity is associated with specific alterations in pain perception. Psychological and biological factors that may be responsible for these alterations are discussed.
本研究系统地综述了运动员和正常活动对照者之间疼痛感知的差异。我们筛选了 MEDLINE、Sport-Discus、EMBASE、Web of Science、PsycINFO、PSYNDEX 和原始研究及系统评价的参考文献。所有比较运动员和正常活动对照者之间疼痛感知的实验性诱发疼痛研究都符合纳入标准。主要结局指标为疼痛耐受力和疼痛阈值。效应以标准化均数差来描述，并使用随机效应模型进行汇总。15 项研究共纳入 899 名受试者。其中 12 项研究评估了疼痛耐受力，9 项研究检查了疼痛阈值。对这些研究的荟萃分析显示，与正常活动对照者相比，运动员具有更高的疼痛耐受力（效应大小计算为 Hedges' g=0.87，95%置信区间 [CI(95)] 0.53-1.21；P<0.00001），而关于疼痛阈值的现有数据则不太一致（Hedges' g=0.69，CI(95) 0.16-1.21；P=0.01）。在排除了高偏倚风险的研究后，两组间的疼痛阈值差异不再显著。我们的数据表明，经常进行体育活动与疼痛感知的特定改变有关。讨论了可能导致这些改变的心理和生物学因素。
