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Table 3 Summary of the prescribed aerobic exercise and percentage improvement in pain sensitization across the studies

From: Does aerobic exercise effect pain sensitisation in individuals with musculoskeletal pain? A systematic review

Author (Year) Type Duration Frequency Intensity Number of time points Endpoint measured (units) Pre-exercise Mean (SD) PPTs/MPRsa Post-exercise Mean (SD) PPTs/MPRs/MPQ scorea Percentage change in PPTs/MPRs/MPQ scorea
Chronic musculoskeletal pain  
Randomised controlled trials  
Ote Karaca (2017) Treadmill 30 min 5 x per week for 2 weeks Submaximal – 70-85% maximum HR 2 –before and after exercise PPT sum (kg/cm2) 19.9 (6.1) 22.0 (6.3)
p=0.023
10.6% increase in mean PPTs
20.7 (5.4) 20.9 (6.7)
p=0.898
 
Repeated measures studies  
Vaegter (2016) Cycle ergometry 15 min 1 session Submaximal -50% and 75% VO2max 3 –before, immediately after and 15 min after exercise Widespread PPTs (kPa) High pain sensitivity 272.8 (158.0)
Low pain sensitivity
574.7 (362.1)
High pain sensitivity
319.1 (162.1)
290.8 (158.5)
p<0.05
Low pain sensitivity
646.3 (378.8)
563.5 (343.1) p<0.05
High pain sensitivity
17.0% increase in mean PPTs
Low pain sensitivity
12.5% increase in mean PPTs
Overall mean 14.8% increase in mean PPTs
Vaegter (2018) Cycle ergometry 15 min 1 session Submaximal -50% and 75% VO2max 3 –before, immediately after and 15 min after exercise PPTs No mean PPT values given No mean PPT values given No mean data provided
No mean PPT values given No mean PPT values given  
Chronic low back pain  
Randomised controlled trials  
Bruehl (2020) Aerobic exercise - treadmill walking/running,
stepping, elliptical, or cycling exercise as preferred by the participant
30 min with 5 min warm up and cool down 3 sessions per week for 6 weeks Submaximal- 70% and 85% HRR (RPE=14-16, hard) 2 -Before and within 10 days of final exercise session MPQ-SF (Total) Pre: 10.31(9.29) Post: 9.91(8.67) Exercise group
3.9% decrease in the MPQ-total pain measure
Control group
27.1% increase in the MPQ-total pain measure
Repeated measures studies
Meeus (2010) Cycle ergometry 6 bouts of incremental exercise –warmup and 60 s exercise phase 1 session Submaximal -20 W and increasing in steps of 10 W/minute 2 –before and immediately after exercise Mean PPTs (kg/cm3) 8.1 (3.02) 8.28 (3.49)
p=0.001
2.2% increase in mean PPTs
Hoffman (2005) Cycle ergometry 25 min 1 session Submaximal – 50-70% VO2 3 –before, immediately after and 32 min after exercise Mean pressure pain ratings (100mm VAS) 79 (12) 57 (26)
p<0.05
62 (27)
p<0.05
27.8% decrease in MPRs
Vaegter (2021) 6-minute walk test 6 min 1 session Submaximal Immediately before and after PPTs Walking pain index <2:
Lower back
586 (149-1665)
Walking pain index ≥2:
Lower back
450 (203–1,368)
No PPT values given Walking pain index <2:
Absolute change in PPT
Lower back (kPa): 38 (153)
6.6% increase
Walking pain index ≥2:
Absolute change in PPT
Lower back (kPa): -17 (112)
3.8% decrease
Sitges (2021) Treadmill walking 20 min 1 session Low–moderate intensity (65.85%±7% of maximum heart rate and 3.02±1.04 using the Borg Scale of Perceived
Exertion)
Before and after the exercise session, no further details given PPTs Gluteus medius PPTs
2.66 (1.02)
Gluteus medius PPTs
2.81 (0.97)
Exercise group
0.16 (0.55)
6.0% increase
Control group 0.12 (0.39)
4.4% increase
Gluteus medius PPTs
2.97 (1.20)
Gluteus medius PPTs
3.10 (1.24)
Neck pain  
Randomised controlled trials  
Neilsen (2010) Cycle ergometry 20 min 3 x per week for 10 weeks Submaximal -50-70% maximum HR 2 –before and after exercise Tibialis anterior and trapezius PPTs (kPa) 311 (113)
Trapezius -no significant increase
386 (107)
p<0.01
Trapezius -no significant increase
24.1% increase in mean PPTs
Kocur (2017) Nordic walking 1 h 3 x per week for 12 weeks Submaximal -40-70% HRR 2 –before and 1-2 days after last NW training session PPTs -descending trapezius, mid trapezius, lat dorsi, infraspinatus, pec major, triceps brachii and brachioradialis (kg/cm2) Descending trapezius
-1.32 (0.5)
Infraspinatus
-1.63 (0.6)
Lat dorsi
-1.66 (0.6)
Mid trap
-2.92 (0.9)
No significant increase -pecmajor, triceps brachii, brachioradialis
Descending trapezius
-1.99 (0.6)
p=0.002
Infraspinatus
-2.93 (0.8)
p=0.001
Lat dorsi
-2.21 (0.5)
p=0.02
Mid trap
-3.3 (0.8)
p=0.002
No significant increase -pec major, triceps brachii, brachioradialis
No mean data provided
Osteoarthritis  
Repeated measures studies  
Fingleton (2017) Cycle ergometry 4-10 min 1 session Submaximal - If pain at the knee joint exceeded 3/10, the participant’s workload
was reduced by 25 W
2
Before and immediately after exercise
Average PPTs of knee and forearm (kPa) Normal CPM
184.34 (58.11)
Abnormal CPM
168.87 (43.03)
Normal CPM
205.73 (76.07)
p<0.05
Abnormal CPM
152.75 (52.31)
p>0.05
11.6% increase in mean PPTs
  1. PPTs –pressure pain thresholds, MPRs – mean pain ratings. aWhere the pre and post PPTs/MPRs are split into 2 rows, the top row denotes mean pre and post PPTs in the intervention group, while the bottom row denotes mean pre and post PPTs in the control group. CPM -conditioned pain modulation; HPS –high pain sensitivity group; LPS -low kinesiophobia group; High K -high kinesiophobia group; Low K -low kinesiophobia group; HRR -heart rate reserve, VAS -visual analogue scale, MPQ(SF)Total -McGill Pain Questionnaire (Short form) total score