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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
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BMC Musculoskeletal Disorders

ISSN: 1471-2474

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