IMPROVEMENTS IN PREASSURE PAIN THERESHOLD AFTER AEROBIC EXERCISE FOR PATIENTS WITH CHRONIC LOW BACK PAIN

M. Oka¹, Y. Takano², D. Ogata³, K. Aoyagi⁴, R. Hishida⁵, H. Matsuse⁵

¹Himeno Hospital, Division of Rehabilitation, Fukuoka, Japan, ²International University Health and Welfare, Physical Therapy School of Health Sciences at Fukuoka, Fukuoka, Japan, ³St Mary’s Hospital, Division of Rehabilitation, Fukuoka, Japan, ⁴The University of Texas at El Paso, Doctor of Physical Therapy Program, El Paso, United States, ⁵Kurume University, Division of Rehabilitation, Fukuoka, Japan

Background: Chronic low back pain (CLBP) is one of the most representative complaints in Japan, and it is also a social issue that disturbs daily life. Inactivity and lower level of physical activity in patients with CLBP may change muscle characteristics and may be associated with pain. Recently, it is clear that pain becoming chronic is influenced by sensitization, which can be measured by pressure pain threshold (PPT). Regarding PPT, it is said that patients with CLBP have lower PPT in various parts of the body than those who are not. It is suggested that doing continuous aerobic exercise can help reduce pain and improve PPT in patients with CLBP.

Purpose: To examine changes in PPT and visual analogue scale (VAS) in patients with CLBP after long-term low-intensity aerobic exercise.

Methods: 8 patients with CLBP were included in the study. They all had CLBP and it had been persisting for more than 12 months. The PPT values were measured in 7 body parts including the low back, upper limbs, and lower limbs. Low back pain intensity was assessed by VAS. These were conducted at three times: before, after and 8weeks after intervention. During the intervention period, the participants performed bicycle ergometer exercise twice a week for 8 weeks, a total of 16 times.

Results: After the intervention, significant improvements on PPT values were observed in all parts of the 7. VAS in low back had significant improvement, too. In comparison with preintervention, PPT values in 4 parts of the body improved significantly 8 weeks after intervention.

Conclusions:_​​​​​Low-intensity aerobic exercise improved VAS in low back and PPT values in multiple parts of the body. The effect lasted for 8 weeks. As situations of sensitization is considered as one of the factors of chronic pain, we should improve the increase of pain sensitivity. Regular aerobic exercise generates analgesic effect systemically and it helps reduce pain. Through this experiment, the PPT improvements 8 weeks after intervention was observed in upper limb, lower limb, and trunk. It means the analgesic effect lasted in multiple parts of the body. Regular low-intensity bicycle ergometer exercise effectively reduced low back pain by improving PPT.

Implications: We must examine the various aspects like relationship of PPT and socialpsychology. Also, since low intensity exercise was conducted in this study, we should attempt other intensity level of exercise to evaluate the adequate level of exercise intensity for low back pain or other diseases. These would be connected with pain conditioning in Exercise therapy.

Funding acknowledgements: The present work was supported by Japan Society for the Promotion of Science,Grants-in-Aid for Scientific Research.

Keywords:
preassure pain thereshold
low back pain
aerobic exercise

Topics:
Pain & pain management
Health promotion & wellbeing/healthy ageing/physical activity
Musculoskeletal

Did this work require ethics approval? Yes

Institution: International University of Health and welfare

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

Ethics number: 18-lo-061