Knauf Matthew T, Koltyn Kelli F
Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin.
Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin.
J Pain. 2014 Jun;15(6):656-63. doi: 10.1016/j.jpain.2014.02.008. Epub 2014 Mar 13.
The purpose of this study was to examine exercise-induced pain modulation in diabetic adults with painful diabetic neuropathy (PDN) compared to diabetic adults without PDN. Eighteen adults diagnosed with type 2 diabetes with and without PDN (mean age of 49 years) completed 2 sessions. During the familiarization session, participants completed questionnaires, were familiarized with the pain testing protocols, and completed maximal isometric contractions. During the exercise session, experimental pain testing was completed before and following exercise consisting of 3 minutes of isometric exercise performed at 25% maximal voluntary contraction. Ratings of perceived exertion and muscle pain were assessed every 30 seconds during exercise. Results indicated that ratings of perceived exertion and muscle pain during exercise were significantly higher (P < .05) for diabetic adults with PDN versus diabetic adults without PDN. Diabetic adults with PDN did not experience changes in thermal pain ratings following exercise, whereas diabetic adults without PDN reported significantly lower pain ratings following exercise. It is concluded that diabetic adults with PDN experienced high levels of muscle pain during exercise and a lack of exercise-induced hypoalgesia following exercise, in comparison to diabetic adults without PDN, who experienced lower levels of muscle pain during exercise and a hypoalgesic response following exercise.
Very little research has been conducted examining the impact of exercise on pain modulation in diabetic adults with PDN. This study provides support that adults with PDN exhibit exercise-induced endogenous pain modulatory system dysfunction.
本研究的目的是比较患有疼痛性糖尿病神经病变（PDN）的糖尿病成年人与未患PDN的糖尿病成年人运动诱发的疼痛调节情况。18名被诊断为2型糖尿病且有或无PDN的成年人（平均年龄49岁）完成了两个阶段的测试。在熟悉阶段，参与者完成问卷调查，熟悉疼痛测试方案，并完成最大等长收缩。在运动阶段，在由最大自主收缩25%进行的3分钟等长运动前后完成实验性疼痛测试。在运动过程中每30秒评估一次主观用力感觉和肌肉疼痛程度。结果表明，与未患PDN的糖尿病成年人相比，患PDN的糖尿病成年人在运动过程中的主观用力感觉和肌肉疼痛程度显著更高（P < 0.05）。患PDN的糖尿病成年人运动后热痛评分没有变化，而未患PDN的糖尿病成年人运动后疼痛评分显著降低。结论是，与未患PDN的糖尿病成年人相比，患PDN的糖尿病成年人在运动过程中经历高水平的肌肉疼痛，且运动后缺乏运动诱发的痛觉减退，而未患PDN的糖尿病成年人在运动过程中经历较低水平的肌肉疼痛，且运动后有痛觉减退反应。
关于运动对患有PDN的糖尿病成年人疼痛调节影响的研究非常少。本研究支持患有PDN的成年人表现出运动诱发的内源性疼痛调节系统功能障碍。
