Rasmussen Anna Houmøller, Petersen Lærke Kjeldgaard, Kaasgaard Sperling Mette, Bertelsen Maria Møller, Rathleff Michael Skovdal, Petersen Kristian Kjær-Staal
Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
Department of Clinical Medicine, Center for General Practice, Aalborg University, Aalborg, Denmark.
Scand J Pain. 2023 Sep 12;23(4):751-758. doi: 10.1515/sjpain-2023-0039. Print 2023 Oct 26.
Studies suggest that a range of pain mechanisms, such as poor quality of sleep, perceived stress, pain catastrophizing or pain sensitivity, are likely to enhance clinical pain. Animal studies suggest that these pain mechanisms can be modulated by increasing physical activity, but human data are needed to support this hypothesis. This exploratory study aimed to investigate the changes in pain mechanisms after a simple self-directed walking program of 8-weeks. Additionally, this exploratory study investigated the interaction between changes over time in assessments of poor quality of sleep, perceived stress, pain catastrophizing or pain sensitivity and how these changes interacted with each other.
This prospective cohort study included 30 healthy subjects who were assessed at baseline and 4- and 8-weeks after initiating the walking program (30 min walking/day for 8 weeks). Self-report outcomes included: Pain Catastrophizing Scale (PCS), the Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index. Pressure pain thresholds, temporal summation of pain and conditioned pain modulation (CPM) were assessed using cuff algometry.
Twenty-four subjects completed all the visits (age: 42.2, SD: 14.9, 16 females). PCS and PSS significantly decreased at the 8-week's visit compared to baseline (p<0.05). No significant differences were seen for an improvement in quality of sleep (p=0.071) and pain sensitivity (p>0.075) when comparing the 8-week's visit to the baseline visit. Changes in pain mechanisms comparing baseline and 8-weeks data were calculated and regression analyses found that an improvement in PCS was associated with an improvement in CPM (R=0.197, p=0.017) and that a higher adherence to the walking program was associated with a larger improvement in PCS (R=0.216, p=0.013).
The current exploratory study indicates that a simple self-directed walking program of 8-weeks can improve pain catastrophizing thoughts, perceived stress. Higher adherence to the walking program were associated with an improvement in pain catastrophizing and an improvement in pain catastrophizing was associated with an increase in conditioned pain modulation.
研究表明，一系列疼痛机制，如睡眠质量差、感知压力、疼痛灾难化或疼痛敏感性，可能会加重临床疼痛。动物研究表明，这些疼痛机制可通过增加体力活动来调节，但需要人体数据来支持这一假设。这项探索性研究旨在调查为期8周的简单自主步行计划后疼痛机制的变化。此外，这项探索性研究还调查了睡眠质量差、感知压力、疼痛灾难化或疼痛敏感性评估随时间的变化之间的相互作用，以及这些变化如何相互影响。
这项前瞻性队列研究纳入了30名健康受试者，在基线时以及开始步行计划（每天步行30分钟，共8周）后的4周和8周进行评估。自我报告的结果包括：疼痛灾难化量表（PCS）、感知压力量表（PSS）和匹兹堡睡眠质量指数。使用袖带测痛法评估压力痛阈值、疼痛的时间总和以及条件性疼痛调制（CPM）。
24名受试者完成了所有访视（年龄：42.2，标准差：14.9；16名女性）。与基线相比，在第8周访视时，PCS和PSS显著降低（p<0.05）。将第8周访视与基线访视相比，睡眠质量（p=0.071）和疼痛敏感性（p>0.075）的改善无显著差异。计算了比较基线和8周数据时疼痛机制的变化，回归分析发现，PCS的改善与CPM的改善相关（R=0.197，p=0.017），并且对步行计划的更高依从性与PCS的更大改善相关（R=0.216，p=0.013）。
当前的探索性研究表明，为期8周的简单自主步行计划可改善疼痛灾难化思维和感知压力。对步行计划的更高依从性与疼痛灾难化的改善相关，而疼痛灾难化的改善与条件性疼痛调制的增加相关。
