THE EFFECT OF AEROBIC EXERCISE ON PRESSURE PAIN THRESHOLDS IN PEOPLE WITH CHRONIC LOW BACK PAIN

Y. Takano¹, N. Hamachi², K. Matsuda², T. Shimoda², R. Okoba², T. Shimoi², R. Hshida³, H. Matsuse³, K. Aoyagi⁴

¹International University Health and Welfare, Department of Physical Therapy School of Health at Fukuoka, Fukuoka, Japan, ²International University Health and Welfare, Department of Physical Therapy School of Health Sciences at Fukuoka, Fukuoka, Japan, ³Kurume University, Division of Rehabilitation, Fukuoka, Japan, ⁴The University of Texas at El Paso, Doctor of Physical Therapy Program, El Paso, United States

Background: It is known that chronic low back pain (CLBP) patient are tend to have sensitivity of pain compared to healthy subjects. Recently, it is clear that pain becoming chronic is influenced by central sensitization (CP), which can be measured by pressure pain threshold (PPT). Exercise has been reported as a viable therapy in reducing all forms of chronic pain. However, there is limited report on CLBP.

Purpose: The purpose of this study is to determine the analgesic effect of aerobic exercise for young participants with CLBP as well as health young adult.

Methods: Five young adults with CLBP group and six health young adults (Control group) ( aged average 20.5 years old) were participated in this study. Cardiopulmonary exercise test was performed to measure the maximal oxygen uptake (PeakVO2). The Peak VO2 was used to determine the aerobic exercise load. The PPT were assessed before and after bicycle ergometer exercise of 5 minutes warm-up, 20 minutes at 50% maximal oxygen uptake (Vo₂max) and 5 minutes cool-down. The speed of revolution was maintained at 50 to 60 revolutions per minute. The PPT in 7 places over the body were measured, including left gastrocnemius, spine at the level of Jacoby line, spine at the level of the middle of inferior and superior angle of scapula, left index fingernail, left second metacarpal bone (metacarpal bone of the index finger), first dorsal interosseous muscle of the foot and toenail of left hallux. The exact Wilcoxon signed rank test was used to evaluate change from the baseline in each group. The Research Ethics of the International University Health and Welfare (18-Io-061).

Results: No negative effect was found after aerobic exercise in CLBP group. Compared to the control group, the CLBP group had established lower pre-exercise PPT overall. For CLBP group, there were significant increases in post-exercise PPT in spine at the level of Jacoby line (which is the pain area), index fingernail, spine at the level of the middle of inferior and superior angle of scapula and first dorsal interosseous muscle of the foot. For the control group, significant increase in post-exercise PPT was only found in spine at the level of the middle of inferior and superior angle of scapula.

Conclusions: The PPT in participants with CLBP are tended to be lower than those in healthy participants. Because the change in CS of brain as well as spinal cord reduces PPT in other parts of the body away from low back. It is known that the exercise-induced analgesia is produced by activating pain inhibitory system. However, the relation between PPT and intensity and duration of exercise remains unknown. In this study, aerobic exercise at moderate level increases PPT in pain area as well as in other parts of the body.

Implications: Aerobic exercise might be an effective treatment for CLBP participants that provide improvements in their sensitization of pain. Therefore, CLBP of Exercise prescription should be made individually for the sensitivity of pain.

Funding acknowledgements: The study was supported in part by the Japanese Society for the Promotion of Science Grant-in-Aid for scientific research (19K11392)

Keywords:
Low back pain
Pressure Pain threshold
Aerobics exercise

Topics:
Pain & pain management
Musculoskeletal: spine

Did this work require ethics approval? Yes

Institution: International University Health and Welfare

Committee: The Research Ethics of the International University Health and Welfare

Ethics number: 18-Io-061