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Lack of endogenous pain inhibition during exercise in people with chronic whiplash: an experimental study

Jessica Van Oosterwijck UGent, Jo Nijs, Mira Meeus UGent, Michel Van Loo and Lorna Paul (2012) MEDICINE AND SCIENCE IN SPORTS AND EXERCISE. 44(5). p.S602-S602
abstract
Evidence for altered central pain processing and central sensitization in chronic whiplash associated disorders (CWAD) is accumulating. Dysfunctional descending inhibitory action is one of the major characteristics of central sensitization and has been studied during exercise in some chronic pain conditions but no data regarding the response of people with CWAD to exercise are available. PURPOSE: To examine the efficacy of the endogenous pain inhibitory systems during exercise and exercise response in CWAD patients during two different types of exercise. METHODS: Twenty-two women with CWAD and 22 healthy sedentary controls performed a submaximal and a self-paced, physiologically limited exercise test on a cycle ergometer on two separate occasions. The exercise tests were undertaken with cardiorespiratory monitoring. Before and after the exercise bouts, subjects filled out questionnaires to assess health status, and underwent pain pressure threshold (PPT) measurements. Throughout the study, subjects’ activity levels were assessed using accelerometry in order to monitor potential influences of daily activity levels. Possible changes in any of the outcome measures in response to exercise were compared between the two groups, and between the two types of exercise, using repeated measures ANOVA. RESULTS: In CWAD PPTs decreased following submaximal exercise, whereas they increased in healthy subjects. The same effect was established in response to the self-paced, physiologically limited exercise, with exception of the PPTs measured at the calf which increased. A worsening of the CWAD symptom complex was reported post-exercise. Fewer symptoms were reported in response to the self-paced, physiologically limited exercise. In addition, no differences in submaximal exercise capacity or daily physical activity were observed between people with CWAD and controls. CONCLUSIONS: The present study is the first to examine and suggest an impaired descending endogenous pain inhibition during exercise in CWAD patients, and hence provides additional evidence for the presence of central sensitization in CWAD. Submaximal exercise triggers post-exertional malaise, while a self-paced and physiologically limited exercise will trigger less ‘severe’ symptoms, and therefore seems more appropriate for CWAD patients.
Please use this url to cite or link to this publication:
author
organization
year
type
conference
publication status
published
subject
keyword
exercise test, pain threshold, algometry, post-exertional malaise, whiplash injuries, sensitization
in
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
Med. Sci. Sports Exerc.
volume
44
issue
5
article_number
abstract 3080
pages
S602 - S602
conference name
ACSM's 59th annual meeting ; 3rd World congress on Exercise is Medicine®
conference location
San Francisco, CA, USA
conference start
2012-05-29
conference end
2012-06-02
JCR category
SPORT SCIENCES
JCR impact factor
4.475 (2012)
JCR rank
4/84 (2012)
JCR quartile
1 (2012)
ISSN
0195-9131
language
English
UGent publication?
yes
classification
C3
id
2139055
handle
http://hdl.handle.net/1854/LU-2139055
date created
2012-06-11 14:16:42
date last changed
2012-06-26 13:31:56
@inproceedings{2139055,
  abstract     = {Evidence for altered central pain processing and central sensitization in chronic whiplash associated disorders (CWAD) is accumulating. Dysfunctional descending inhibitory action is one of the major characteristics of central sensitization and has been studied during exercise in some chronic pain conditions but no data regarding the response of people with CWAD to exercise are available. 
PURPOSE: To examine the efficacy of the endogenous pain inhibitory systems during exercise and exercise response in CWAD patients during  two different types of exercise. 
METHODS: Twenty-two women with CWAD and 22 healthy sedentary controls performed a submaximal and a self-paced, physiologically limited exercise test on a cycle ergometer on two separate occasions. The exercise tests were undertaken with cardiorespiratory monitoring. Before and after the exercise bouts, subjects filled out questionnaires to assess health status, and underwent pain pressure threshold (PPT) measurements. Throughout the study, subjects{\textquoteright} activity levels were assessed using accelerometry in order to monitor potential influences of daily activity levels. Possible changes in any of the outcome measures in response to exercise were compared between the two groups, and between the two types of exercise, using repeated measures ANOVA. 
RESULTS: In CWAD PPTs decreased following submaximal exercise, whereas they increased in healthy subjects. The same effect was established in response to the self-paced, physiologically limited exercise, with exception of the PPTs measured at the calf which increased. A worsening of the CWAD symptom complex was reported post-exercise. Fewer symptoms were reported in response to the self-paced, physiologically limited exercise. In addition, no differences in submaximal exercise capacity or daily physical activity were observed between people with CWAD and controls. 
CONCLUSIONS: The present study is the first to examine and suggest an impaired descending endogenous pain inhibition during exercise in CWAD patients, and hence provides additional evidence for the presence of central sensitization in CWAD. Submaximal exercise triggers post-exertional malaise, while a self-paced and physiologically limited exercise will trigger less {\textquoteleft}severe{\textquoteright} symptoms, and therefore seems more appropriate for CWAD patients.},
  articleno    = {abstract 3080},
  author       = {Van Oosterwijck, Jessica and Nijs, Jo and Meeus, Mira and Van Loo, Michel and Paul, Lorna},
  booktitle    = {MEDICINE AND SCIENCE IN SPORTS AND EXERCISE},
  issn         = {0195-9131},
  keyword      = {exercise test,pain threshold,algometry,post-exertional malaise,whiplash injuries,sensitization},
  language     = {eng},
  location     = {San Francisco, CA, USA},
  number       = {5},
  pages        = {abstract 3080:S602--abstract 3080:S602},
  title        = {Lack of endogenous pain inhibition during exercise in people with chronic whiplash: an experimental study},
  volume       = {44},
  year         = {2012},
}

Chicago
Van Oosterwijck, Jessica, Jo Nijs, Mira Meeus, Michel Van Loo, and Lorna Paul. 2012. “Lack of Endogenous Pain Inhibition During Exercise in People with Chronic Whiplash: An Experimental Study.” In Medicine and Science in Sports and Exercise, 44:S602–S602.
APA
Van Oosterwijck, J., Nijs, J., Meeus, M., Van Loo, M., & Paul, L. (2012). Lack of endogenous pain inhibition during exercise in people with chronic whiplash: an experimental study. MEDICINE AND SCIENCE IN SPORTS AND EXERCISE (Vol. 44, pp. S602–S602). Presented at the ACSM’s 59th annual meeting ; 3rd World congress on Exercise is Medicine®.
Vancouver
1.
Van Oosterwijck J, Nijs J, Meeus M, Van Loo M, Paul L. Lack of endogenous pain inhibition during exercise in people with chronic whiplash: an experimental study. MEDICINE AND SCIENCE IN SPORTS AND EXERCISE. 2012. p. S602–S602.
MLA
Van Oosterwijck, Jessica, Jo Nijs, Mira Meeus, et al. “Lack of Endogenous Pain Inhibition During Exercise in People with Chronic Whiplash: An Experimental Study.” Medicine and Science in Sports and Exercise. Vol. 44. 2012. S602–S602. Print.