疲劳性躯干屈肌运动可降低产后女性的疼痛敏感性。
Fatiguing Trunk Flexor Exercise Decreases Pain Sensitivity in Postpartum Women.
作者信息
Deering Rita, Pashibin Tatyana, Cruz Meredith, Hunter Sandra K, Hoeger Bement Marie
机构信息
Department of Physical Therapy, Marquette University, Milwaukee, WI, United States.
William S. Middleton Veterans Hospital, Madison, WI, United States.
出版信息
Front Physiol. 2019 Mar 26;10:315. doi: 10.3389/fphys.2019.00315. eCollection 2019.
BACKGROUND
Low back pain (LBP) is common in the general population and among postpartum women. Abdominal muscle exercise is often used to treat LBP, but it is unknown if fatiguing abdominal muscle exercise can produce exercise-induced hypoalgesia (EIH).
OBJECTIVES
To assess pressure pain thresholds (PPTs) at rest and following fatiguing trunk flexor exercise (EIH) in (1) nulligravid and postpartum women to evaluate the impact of pregnancy and childbirth and (2) nulligravid women and men to examine sex differences.
METHODS
Seventy healthy adults (31 postpartum women, 23 nulligravid women, 16 men) participated. Postpartum and nulligravid women were tested twice (16-18 weeks apart) to identify changes in EIH with postpartum recovery. PPTs were measured at the nailbed and superior rectus abdominis before and after exercise to investigate systemic and local EIH, respectively. Rectus abdominis muscle thickness was assessed with ultrasound.
RESULTS
Postpartum women reported lower PPTs than nulligravid women at the abdomen ( < 0.05) whereas postpartum women had lower PPTs at the nailbed during the first session only. Men reported higher nailbed PPTs ( = 0.047) and similar PPTs at the abdomen than women ( = 0.294). All groups demonstrated EIH at the abdomen ( < 0.05). Systemic EIH was absent in postpartum and nulligravid women ( > 0.05), while men demonstrated hyperalgesia. Local EIH was positively associated with muscle thickness for men and women, which was not significant at the second timepoint.
LIMITATIONS
Acute exercise response may not reflect changes that occur with exercise training.
CONCLUSION
Fatiguing trunk flexor exercise produced local EIH for all groups including postpartum and nulligravid women. Clinically, trunk exercises may be useful for acute pain relief for clinical populations that are characterized by pain and/or weakness in the abdominal region muscles in populations with abdominal pain syndromes.
背景
下腰痛(LBP)在普通人群和产后女性中都很常见。腹部肌肉锻炼常被用于治疗下腰痛,但疲劳性腹部肌肉锻炼是否能产生运动诱发的痛觉减退(EIH)尚不清楚。
目的
评估(1)未孕女性和产后女性在静息时以及进行疲劳性躯干屈肌锻炼后(EIH)的压力痛阈(PPT),以评估妊娠和分娩的影响;(2)未孕女性和男性的PPT,以检查性别差异。
方法
70名健康成年人(31名产后女性、23名未孕女性、16名男性)参与研究。产后女性和未孕女性接受两次测试(间隔16 - 18周),以确定产后恢复过程中EIH的变化。在运动前后分别测量甲床和腹直肌上部的PPT,以分别研究全身性和局部性EIH。用超声评估腹直肌厚度。
结果
产后女性腹部的PPT低于未孕女性(P < 0.05),而产后女性仅在第一次测试时甲床PPT较低。男性甲床PPT较高(P = 0.047),腹部PPT与女性相似(P = 0.294)。所有组在腹部均表现出EIH(P < 0.05)。产后女性和未孕女性无全身性EIH(P > 0.05),而男性表现为痛觉过敏。男性和女性的局部EIH与肌肉厚度呈正相关,在第二次测试时不显著。
局限性
急性运动反应可能无法反映运动训练所产生的变化。
结论
疲劳性躯干屈肌锻炼对包括产后和未孕女性在内的所有组均产生局部EIH。临床上,躯干锻炼可能有助于缓解以腹痛综合征人群腹部区域肌肉疼痛和/或无力为特征的临床人群的急性疼痛。
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