Meeus Mira, Hermans Linda, Ickmans Kelly, Struyf Filip, Van Cauwenbergh Deborah, Bronckaerts Laura, De Clerck Luc S, Moorken Greta, Hans Guy, Grosemans Sofie, Nijs Jo
Departments of Human Physiology and Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; "Pain in Motion" Research Group.
Pain Pract. 2015 Feb;15(2):98-106. doi: 10.1111/papr.12181. Epub 2014 Feb 17.
Temporal summation (TS) of pain, conditioned pain modulation (CPM), and exercise-induced analgesia (EIA) are often investigated in chronic pain populations as an indicator for enhanced pain facilitation and impaired endogenous pain inhibition, respectively, but interactions are not yet clear both in healthy controls and in chronic pain patients. Therefore, the present double-blind randomized placebo-controlled study evaluates pains cores, TS, and CPM in response to exercise in healthy controls, patients with chronic fatigue syndrome and comorbid fibromyalgia (CFS/FM), and patients with rheumatoid arthritis (RA), both under placebo and paracetamol condition.
Fifty-three female volunteers - of which 19 patients with CFS/FM, 16 patients with RA, and 18 healthy controls - underwent a submaximal exercise test on a bicycle ergometer on 2 different occasions (paracetamol vs. placebo), with an interval of 7 days. Before and after exercise, participants rated pain intensity during TS and CPM.
Patients with rheumatoid arthritis showed decreased TS after exercise, both after paracetamol and placebo (P < 0.05). In patients with CFS/FM, results were less univocal. A nonsignificant decrease in TS was only observed after taking paracetamol. CPM responses to exercise are inconclusive, but seem to worsen after exercise. No adverse effects were seen.
This study evaluates pain scores, TS, and CPM in response to submaximal exercise in 2 different chronic pain populations and healthy controls. In patients with RA, exercise had positive effects on TS, suggesting normal EIA. In patients with CFS/FM, these positive effects were only observed after paracetamol and results were inconsistent.
疼痛的时间总和（TS）、条件性疼痛调制（CPM）和运动诱导镇痛（EIA）常用于慢性疼痛人群的研究，分别作为疼痛易化增强和内源性疼痛抑制受损的指标，但在健康对照者和慢性疼痛患者中，它们之间的相互作用尚不清楚。因此，本双盲随机安慰剂对照研究评估了在安慰剂和对乙酰氨基酚条件下，健康对照者、慢性疲劳综合征合并纤维肌痛（CFS/FM）患者以及类风湿关节炎（RA）患者运动后的疼痛评分、TS和CPM。
53名女性志愿者——其中19名CFS/FM患者、16名RA患者和18名健康对照者——在2个不同时间（对乙酰氨基酚组与安慰剂组）在自行车测力计上进行次最大运动试验，间隔7天。运动前后，参与者对TS和CPM期间的疼痛强度进行评分。
类风湿关节炎患者运动后TS降低，对乙酰氨基酚组和安慰剂组均如此（P<0.05）。在CFS/FM患者中，结果不太明确。仅在服用对乙酰氨基酚后观察到TS有不显著的降低。CPM对运动的反应尚无定论，但运动后似乎有所恶化。未观察到不良反应。
本研究评估了2种不同慢性疼痛人群和健康对照者在次最大运动后的疼痛评分、TS和CPM。在RA患者中，运动对TS有积极影响，提示EIA正常。在CFS/FM患者中，这些积极影响仅在服用对乙酰氨基酚后观察到，且结果不一致。
