Smith Ashley, Ritchie Carrie, Pedler Ashley, McCamley Kaitlin, Roberts Kathryn, Sterling Michele
Recover Injury Research Centre, NHMRC Centre of Research Excellence in Road Traffic Injury, Menzies Health Institute Queensland, Griffith University, Parklands Dr, Southport, Qld 4122, Australia.
Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Qld 4072, Australia.
Scand J Pain. 2017 Apr;15:14-21. doi: 10.1016/j.sjpain.2016.11.007. Epub 2016 Dec 6.
Reduced pain sensitivity following exercise is termed exercise induced hypoalgesia (EIH). Preliminary evidence suggests that impairment of EIH is evident in individuals with whiplash associated disorders (WAD) following submaximal aerobic exercise. This study aimed to compare EIH responses to isometric and aerobic exercise in patients with chronic WAD and healthy controls and investigate relationships between EIH, conditioned pain modulation (CPM) and psychological factors in patients with chronic WAD.
A cross sectional pre-post study investigated the effect of a single session of submaximal aerobic cycling exercise and a single session of isometric timed wall squat exercise on EIH in a group of participants with chronic WAD (n=21) and a group of asymptomatic control participants (n=19). Bivariate analyses between EIH and baseline measures of CPM and psychological features (fear of movement, pain catastrophization and posttraumatic stress symptoms) were also investigated.
The isometric wall squat exercise but not the aerobic cycling exercise resulted in EIH in both groups (P<.023) with no between-group differences (P>.55) demonstrated for either exercise. There were no significant associations measured between EIH (for either exercise performed), and CPM, or any of the psychological variables.
This study showed that individuals with chronic WAD and mild to moderate pain and disability, and no evidence of dysfunctional CPM, demonstrated reduced pain sensitivity, both in the cervical spine and over the tibialis anterior following an isometric, timed wall squat exercise. Cycling exercise did not increase pain sensitivity.
Individuals with chronic WAD and mild to moderate levels of neck pain and disability may experience less pain sensitivity both locally and remotely following an exercise program directed at non-painful muscles performing isometric exercises. Individuals cycling for 30min at 75% of age-predicted heart rate maximum do not experience increased pain sensitivity.
运动后疼痛敏感性降低被称为运动诱导性痛觉减退（EIH）。初步证据表明，在进行次最大强度有氧运动后，挥鞭样损伤相关疾病（WAD）患者的EIH受损明显。本研究旨在比较慢性WAD患者和健康对照者对等长运动和有氧运动的EIH反应，并研究慢性WAD患者中EIH、条件性疼痛调制（CPM）和心理因素之间的关系。
一项横断面前后对照研究，调查了一组慢性WAD患者（n=21）和一组无症状对照参与者（n=19）进行单次次最大强度有氧自行车运动和单次等长时间靠墙蹲起运动对EIH的影响。还研究了EIH与CPM及心理特征（运动恐惧、疼痛灾难化和创伤后应激症状）基线测量值之间的双变量分析。
两组中，等长时间靠墙蹲起运动而非有氧自行车运动导致了EIH（P<.023），两种运动均未显示出组间差异（P>.55）。在EIH（针对所进行的任何一种运动）与CPM或任何心理变量之间未测得显著相关性。
本研究表明，患有慢性WAD且有轻至中度疼痛和功能障碍、且无CPM功能障碍证据的个体，在进行等长时间靠墙蹲起运动后，颈椎和胫骨前肌的疼痛敏感性均降低。骑自行车运动并未增加疼痛敏感性。
患有慢性WAD且有轻至中度颈部疼痛和功能障碍的个体，在针对非疼痛肌肉进行等长运动的锻炼计划后，局部和远处的疼痛敏感性可能会降低。以年龄预测心率最大值的75%进行30分钟骑行的个体不会出现疼痛敏感性增加。
