Pacheco-Barrios Kevin, Carolyna Gianlorenço Anna, Machado Roberto, Queiroga Marcos, Zeng Huiyan, Shaikh Emad, Yang Yiling, Nogueira Beatriz, Castelo-Branco Luis, Fregni Felipe
Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, USA.
Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud. Lima, Peru.
Princ Pract Clin Res. 2020 Sep 7;6(3):11-28. doi: 10.21801/ppcrj.2020.63.2. Epub 2020 Sep 16.
The use of exercise is a potential treatment option to modulate pain (exercise-induced hypoalgesia). The pain threshold (PT) response is a measure of pain sensitivity that may be a useful marker to assess the effect of physical exercise on pain modulation.
The aim of this systematic review and meta-analysis is to evaluate the PT response to exercise in healthy subjects.
We searched in MEDLINE, EMBASE, Web of Science, Lilacs, and Scopus using a search strategy with the following search terms: "exercise" OR "physical activity" AND "Pain Threshold" from inception to December 2nd, 2019. As criteria for inclusion of appropriate studies: randomized controlled trials or quasi-experimental studies that enrolled healthy subjects; performed an exercise intervention; assessed PT. Hedge's effect sizes of PT response and their 95% confidence intervals were calculated, and random-effects meta-analyses were performed.
For the final analysis, thirty-six studies were included (n=1326). From this we found a significant and homogenous increase in PT in healthy subjects (ES=0.19, 95% CI= 0.11 to 0.27, I2=7.5%). According to subgroup analysis the effect was higher in studies: with women (ES=0.36); performing strength exercise (ES=0.34), and with moderate intensity (ES=0.27), and no differences by age were found. Confirmed by the meta-regression analysis.
This meta-analysis provides evidence of small to moderate effects of exercise on PT in healthy subjects, being even higher for moderate strength exercise and in women. These results support the idea of modulation of the endogenous pain system due to exercise and highlight the need of clinical translation to chronic pain population.
运动的使用是调节疼痛（运动诱发的痛觉减退）的一种潜在治疗选择。痛阈（PT）反应是疼痛敏感性的一种度量，可能是评估体育锻炼对疼痛调节效果的有用指标。
本系统评价和荟萃分析的目的是评估健康受试者对运动的PT反应。
我们使用包含以下检索词的检索策略在MEDLINE、EMBASE、科学网、Lilacs和Scopus中进行检索：“运动”或“体育活动”以及“痛阈”，检索时间从数据库建立至2019年12月2日。纳入适当研究的标准为：纳入健康受试者的随机对照试验或准实验研究；进行运动干预；评估PT。计算PT反应的Hedge效应量及其95%置信区间，并进行随机效应荟萃分析。
最终分析纳入了36项研究（n = 1326）。由此我们发现健康受试者的PT有显著且同质的增加（ES = 0.19，95%CI = 0.11至0.27，I² = 7.5%）。根据亚组分析，在以下研究中效应更高：女性参与的研究（ES = 0.36）；进行力量训练的研究（ES = 0.34），以及中等强度的研究（ES = 0.27），未发现年龄差异。经荟萃回归分析证实。
本荟萃分析提供了证据，表明运动对健康受试者的PT有小到中等程度的影响，中等强度运动和女性的影响更大。这些结果支持了运动对内源性疼痛系统进行调节的观点，并强调了向慢性疼痛人群进行临床转化的必要性。
