Department of Physiotherapy, University of Valencia, Spain; Department of Physiotherapy, Physiotherapy in Motion. Multi-speciality Research group (PTinMOTION), University of Valencia, Spain.
Department of Physiotherapy, University of Valencia, Spain; Department of Physiotherapy, Physiotherapy in Motion. Multi-speciality Research group (PTinMOTION), University of Valencia, Spain; Departments of Human Physiology and Rehabilitation Sciences, "Pain in Motion" International Research Group, Brussels, Belgium.
J Pain. 2021 Oct;22(10):1246-1255. doi: 10.1016/j.jpain.2021.03.153. Epub 2021 Apr 20.
Exercise can reduce pain, however the effect of painful versus non-painful exercises is uncertain. The primary aim of this randomized crossover study was to compare the effect of painful versus nonpainful isometric shoulder exercises on pain intensity after exercise in individuals with rotator cuff-related shoulder pain. Secondary exploratory aims were to describe the effects on pressure pain thresholds (PPTs), conditioned pain modulation (CPM) and muscle strength. On separate days, 35 individuals performed painful isometric shoulder exercises (external rotation; 20% above pain threshold), nonpainful isometric shoulder exercises (external rotation; 20% below pain threshold), and a rest condition, in randomised order. Shoulder pain intensity, PPTs, CPM, and external rotation strength were assessed before, immediately after and 45 minutes after conditions. No significant differences were observed between painful and nonpainful exercises. Visual analogue scale scores increased immediately after both painful and non-painful exercises compared with rest (P = .047, partial ƞ = .07), but were similar to preexercise levels after 45 minutes. No changes in PPTs, CPM, or muscle strength after exercises compared with rest were observed. Painful and non-painful isometric exercises caused a moderate but short-lasting increase in shoulder pain in individuals with RCRSP. Isometric exercises had no effect on pain sensitivity and shoulder muscle strength or CPM. PERSPECTIVE: This study evaluated for the first time in individuals with rotator cuff-related shoulder pain the effects of painful versus non-painful isometric exercises on different pain-related outcome measures. Both painful and non-painful isometric exercises caused a moderate but relatively short-lasting increase in shoulder pain in individuals with rotator cuff-related shoulder pain. Trial registration number: (ClinicalTrials.gov) NCT03675399.
运动可以减轻疼痛，但疼痛与非疼痛运动的效果尚不确定。本随机交叉研究的主要目的是比较肩袖相关肩痛患者进行疼痛性与非疼痛性等长肩部运动后运动后疼痛强度的差异。次要探索性目的是描述对压力疼痛阈值（PPT）、条件性疼痛调制（CPM）和肌肉力量的影响。在不同的日子里，35 名个体以随机顺序分别进行疼痛性等长肩部运动（外旋；20%超过疼痛阈值）、无痛性等长肩部运动（外旋；20%低于疼痛阈值）和休息状态。在条件前、即刻后和 45 分钟后评估肩部疼痛强度、PPTs、CPM 和外旋力量。在疼痛性和非疼痛性运动之间未观察到显著差异。与休息相比，视觉模拟量表评分在疼痛性和非疼痛性运动后即刻均增加（P=0.047，部分η=0.07），但在 45 分钟后与运动前水平相似。与休息相比，运动后 PPTs、CPM 或肌肉力量无变化。在肩袖相关肩痛患者中，疼痛性和非疼痛性等长运动引起中度但短暂的肩部疼痛增加。等长运动对疼痛敏感性和肩部肌肉力量或 CPM 没有影响。观点：本研究首次在肩袖相关肩痛患者中评估了疼痛性与非疼痛性等长运动对不同疼痛相关结果测量的影响。疼痛性和非疼痛性等长运动均引起肩袖相关肩痛患者中度但相对短暂的肩部疼痛增加。试验注册号：（ClinicalTrials.gov）NCT03675399。
