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The influence of physical activity on the nociceptive flexion reflex in healthy people

Evy Dhondt (UGent) , Lieven Danneels (UGent) , Sophie Van Oosterwijck (UGent) , Tanneke Palmans (UGent) , Johan Rijckaert (UGent) and Jessica Van Oosterwijck (UGent)
(2020) EUROPEAN JOURNAL OF PAIN. 25(4). p.774-789
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Abstract
Background The nociceptive flexion reflex (NFR) is a spinal reflex induced by painful stimuli resulting in an appropriate withdrawal response. The NFR is considered to be an objective physiological correlate of spinal nociception. Previous research has already demonstrated that physical activity (PA) can influence pain assessments. To date, no studies have directly examined the relationship between PA and spinal nociception. Hence, this study aimed to investigate whether the NFR threshold can be predicted by report-based and monitor-based measures of PA in healthy adults. Methods PA and the NFR threshold of 58 healthy adults were assessed. PA was evaluated by self-report using the International Physical Activity Questionnaire and by monitor-based accelerometry data. The NFR threshold was elicited through transcutaneous electrical stimulation of the sural nerve and quantified by the biceps femoris muscle electromyogram. Hierarchical linear regression analyses were performed to determine the relationship between PA and the NFR, while controlling for confounders. Results Monitor-based measured step count and activities of moderate- to vigorous-intensity predicted the NFR threshold accounting for 23.0% (p = .047) to 37.1% (p = .002) of the variance. Larger amounts of step counts and higher participation in moderate- to vigorous-intensity activities predicted higher NFR thresholds. Monitor-based activities of sedentary intensity predicted the NFR threshold accounting for 35.8% (p = .014) to 35.9% (p = .014) of the variance. Spending more time per day on activities of sedentary intensity predicted lower NFR thresholds. Conclusions The study provides preliminary evidence indicating that a physically active lifestyle may reduce spinal nociception in healthy adults, while a sedentary lifestyle enhances spinal nociception. Significance The present study provides preliminary evidence that the influencing effects of physical activity on pain are the result of a strong descending control and do not purely rely on supraspinal mechanisms. These study results highlight the importance of considering physical activity levels when evaluating nociceptive processing, given the prognostic value of physical activity in spinal nociception. Furthermore, this study encourages future research to examine the effects of moderate- to vigorous-intensity exercise programmes on spinal nociception in chronic pain populations.
Keywords
Anesthesiology and Pain Medicine, NOXIOUS INHIBITORY CONTROLS, PAIN MODULATION, SEDENTARY BEHAVIOR, NFR THRESHOLD, EXERCISE, RESPONSES, WOMEN, QUESTIONNAIRE, CONTRIBUTES, ASSOCIATION

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MLA
Dhondt, Evy, et al. “The Influence of Physical Activity on the Nociceptive Flexion Reflex in Healthy People.” EUROPEAN JOURNAL OF PAIN, vol. 25, no. 4, 2020, pp. 774–89, doi:10.1002/ejp.1708.
APA
Dhondt, E., Danneels, L., Van Oosterwijck, S., Palmans, T., Rijckaert, J., & Van Oosterwijck, J. (2020). The influence of physical activity on the nociceptive flexion reflex in healthy people. EUROPEAN JOURNAL OF PAIN, 25(4), 774–789. https://doi.org/10.1002/ejp.1708
Chicago author-date
Dhondt, Evy, Lieven Danneels, Sophie Van Oosterwijck, Tanneke Palmans, Johan Rijckaert, and Jessica Van Oosterwijck. 2020. “The Influence of Physical Activity on the Nociceptive Flexion Reflex in Healthy People.” EUROPEAN JOURNAL OF PAIN 25 (4): 774–89. https://doi.org/10.1002/ejp.1708.
Chicago author-date (all authors)
Dhondt, Evy, Lieven Danneels, Sophie Van Oosterwijck, Tanneke Palmans, Johan Rijckaert, and Jessica Van Oosterwijck. 2020. “The Influence of Physical Activity on the Nociceptive Flexion Reflex in Healthy People.” EUROPEAN JOURNAL OF PAIN 25 (4): 774–789. doi:10.1002/ejp.1708.
Vancouver
1.
Dhondt E, Danneels L, Van Oosterwijck S, Palmans T, Rijckaert J, Van Oosterwijck J. The influence of physical activity on the nociceptive flexion reflex in healthy people. EUROPEAN JOURNAL OF PAIN. 2020;25(4):774–89.
IEEE
[1]
E. Dhondt, L. Danneels, S. Van Oosterwijck, T. Palmans, J. Rijckaert, and J. Van Oosterwijck, “The influence of physical activity on the nociceptive flexion reflex in healthy people,” EUROPEAN JOURNAL OF PAIN, vol. 25, no. 4, pp. 774–789, 2020.
@article{8688992,
  abstract     = {{Background The nociceptive flexion reflex (NFR) is a spinal reflex induced by painful stimuli resulting in an appropriate withdrawal response. The NFR is considered to be an objective physiological correlate of spinal nociception. Previous research has already demonstrated that physical activity (PA) can influence pain assessments. To date, no studies have directly examined the relationship between PA and spinal nociception. Hence, this study aimed to investigate whether the NFR threshold can be predicted by report-based and monitor-based measures of PA in healthy adults.

Methods PA and the NFR threshold of 58 healthy adults were assessed. PA was evaluated by self-report using the International Physical Activity Questionnaire and by monitor-based accelerometry data. The NFR threshold was elicited through transcutaneous electrical stimulation of the sural nerve and quantified by the biceps femoris muscle electromyogram. Hierarchical linear regression analyses were performed to determine the relationship between PA and the NFR, while controlling for confounders.

Results Monitor-based measured step count and activities of moderate- to vigorous-intensity predicted the NFR threshold accounting for 23.0% (p = .047) to 37.1% (p = .002) of the variance. Larger amounts of step counts and higher participation in moderate- to vigorous-intensity activities predicted higher NFR thresholds. Monitor-based activities of sedentary intensity predicted the NFR threshold accounting for 35.8% (p = .014) to 35.9% (p = .014) of the variance. Spending more time per day on activities of sedentary intensity predicted lower NFR thresholds.

Conclusions The study provides preliminary evidence indicating that a physically active lifestyle may reduce spinal nociception in healthy adults, while a sedentary lifestyle enhances spinal nociception.

Significance The present study provides preliminary evidence that the influencing effects of physical activity on pain are the result of a strong descending control and do not purely rely on supraspinal mechanisms. These study results highlight the importance of considering physical activity levels when evaluating nociceptive processing, given the prognostic value of physical activity in spinal nociception. Furthermore, this study encourages future research to examine the effects of moderate- to vigorous-intensity exercise programmes on spinal nociception in chronic pain populations.}},
  author       = {{Dhondt, Evy and Danneels, Lieven and Van Oosterwijck, Sophie and Palmans, Tanneke and Rijckaert, Johan and Van Oosterwijck, Jessica}},
  issn         = {{1090-3801}},
  journal      = {{EUROPEAN JOURNAL OF PAIN}},
  keywords     = {{Anesthesiology and Pain Medicine,NOXIOUS INHIBITORY CONTROLS,PAIN MODULATION,SEDENTARY BEHAVIOR,NFR THRESHOLD,EXERCISE,RESPONSES,WOMEN,QUESTIONNAIRE,CONTRIBUTES,ASSOCIATION}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{774--789}},
  title        = {{The influence of physical activity on the nociceptive flexion reflex in healthy people}},
  url          = {{http://dx.doi.org/10.1002/ejp.1708}},
  volume       = {{25}},
  year         = {{2020}},
}

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