Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
School of Medical Sciences, University of New South Wales, Sydney, Australia.
Eur J Pain. 2019 Aug;23(7):1329-1339. doi: 10.1002/ejp.1400. Epub 2019 May 14.
Exercise is prescribed for people with Parkinson's disease to address motor and non-motor impairments, including pain. Exercise-induced hypoalgesia (i.e., an immediate reduction in pain sensitivity following exercise) is reported in the general population; however, the immediate response of pain sensitivity to exercise in people with Parkinson's disease is unknown. The purpose of this study was to investigate if exercise-induced hypoalgesia is present following isometric and aerobic exercise in people with Parkinson's disease, and if so, if it varies with the dose of aerobic exercise.
Thirty people with idiopathic Parkinson's disease and pain-free age-matched controls completed two observational studies evaluating the response to: (a) right arm isometric exercise; and (b) treadmill walking at low and moderate intensities. Pressure pain thresholds were measured over biceps brachii and quadriceps muscles immediately before and after exercise, with increased thresholds after exercise indicating exercise-induced hypoalgesia.
Pressure pain thresholds increased in the Parkinson's disease group at all tested sites following all exercise bouts (e.g., isometric exercise, right bicep 29%; aerobic exercise, quadriceps, moderate intensity 8.9%, low intensity 7.1% (p ≤ 0.008)), with no effect of aerobic exercise dose (p = 0.159). Similar results were found in the control group.
Overall, people with Parkinson's disease experienced an exercise-induced hypoalgesia response similar to that of the control group, the extent of which did not vary between mild and moderate doses of aerobic exercise. Further research is warranted to investigate potential longer term benefits from exercise in the management of pain in this population.
Isometric and aerobic exercise reduces pain sensitivity in people with Parkinson's disease. As exercise is important for people with Parkinson's disease, these results provide assurance that people with Parkinson's disease and pain can exercise without an immediate increase in pain sensitivity. The reduction in pain sensitivity with both modes and with low and moderate intensities of aerobic exercise suggests that people with Parkinson's disease can safely choose the mode and intensity of exercise that best suits their needs.
运动被推荐给帕金森病患者，以改善运动和非运动障碍，包括疼痛。运动诱导的痛觉减退（即运动后即刻降低疼痛敏感性）在普通人群中已有报道；然而，帕金森病患者的疼痛敏感性对运动的即时反应尚不清楚。本研究旨在探讨帕金森病患者进行等长和有氧运动后是否存在运动诱导的痛觉减退，如果存在，其是否随有氧运动剂量的不同而变化。
30 名特发性帕金森病患者和年龄匹配的无痛对照组完成了两项观察性研究，评估了以下两种情况的反应：（a）右臂等长运动；（b）在低强度和中等强度下进行跑步机步行。在运动前后立即测量肱二头肌和股四头肌的压力疼痛阈值，运动后阈值增加表明存在运动诱导的痛觉减退。
帕金森病组在所有测试部位的压力疼痛阈值在所有运动后均增加（例如，等长运动，右二头肌 29%；有氧运动，股四头肌，中等强度 8.9%，低强度 7.1%（p≤0.008）），而有氧运动剂量无影响（p=0.159）。对照组也得到了类似的结果。
总体而言，帕金森病患者经历了与对照组相似的运动诱导的痛觉减退反应，其程度在轻度和中度有氧运动剂量之间没有差异。需要进一步研究以调查该人群运动在疼痛管理中的潜在长期益处。
等长和有氧运动降低了帕金森病患者的疼痛敏感性。由于运动对帕金森病患者很重要，这些结果保证了患有帕金森病和疼痛的患者可以在不增加疼痛敏感性的情况下进行运动。两种模式以及低强度和中等强度有氧运动都能降低疼痛敏感性，这表明帕金森病患者可以安全地选择最适合自己需求的运动模式和强度。
