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