PDF(Pubmed)
Abstract：
BACKGROUND: Various exercises can attenuate pain perception in healthy individuals and may interact with the descending pain modulation in the central nervous system. However, the analgesic effects of exercise in patients with myofascial pain can be disrupted by the pathological changes during chronic pain conditions. Thus, the exercises targeted on the facilitation of the sensory-motor interaction may have a positive impact on the restoration of the descending pain modulation and the analgesia effects.
OBJECTIVE: This paper estimates the effect of proprioceptive neuromuscular facilitation (PNF) and resistance training on exercise-induced hypoalgesia (EIH) and conditioned pain modulation (CPM) among patients with myofascial pain syndrome.
METHODS: A total of 76 female patients with myofascial pain syndrome (aged 18-30 years), with the pain in the upper trapezius and a visual analog scale score of greater than 30/100 mm, were enrolled in the study. Participants were randomly assigned into 3 intervention groups, including isometric (n=18, 24%), isotonic (n=19, 25%), and PNF (n=20, 26%) exercises, as well as 1 control group (n=19, 25%) with no intervention. Pressure pain threshold and the CPM responses at the myofascial trigger point, arm, and leg sites were assessed before and after the exercise session. The effective EIH response was reflected in the improvement of pressure pain thresholds.
RESULTS: There was an increase in pressure pain thresholds and CPM responses at trigger point (P<.001 and P<.001), arm (P<.001 and P<.001), and leg sites (P<.001 and P=.03) in participants who performed PNF and isotonic exercise, while the isometric exercise only increased pressure pain thresholds at leg sites (P=.03). Compared with the control group, both the isotonic (P=.02) and PNF (P<.001) groups showed greater EIH responses at the trigger points. In comparison to the control group, only the PNF exercise (P=.01) significantly improved pressure pain thresholds and CPM responses at arm and leg sites compared to the control group.
CONCLUSIONS: PNF, isotonic, and isometric exercises could lead to local and global EIH effects. The improvement in CPM response following PNF and isotonic exercises suggested that the EIH mechanisms of different resistance exercises may be attributed to the enhancement of the endogenous pain modulation via the motor-sensory interaction from the additional eccentric and dynamic muscle contraction.
BACKGROUND: Chinese Clinical Trial Registry ChiCtr202111090819166165; https://tinyurl.com/2ab93p7n.
OBJECTIVE: This paper estimates the effect of proprioceptive neuromuscular facilitation (PNF) and resistance training on exercise-induced hypoalgesia (EIH) and conditioned pain modulation (CPM) among patients with myofascial pain syndrome.
METHODS: A total of 76 female patients with myofascial pain syndrome (aged 18-30 years), with the pain in the upper trapezius and a visual analog scale score of greater than 30/100 mm, were enrolled in the study. Participants were randomly assigned into 3 intervention groups, including isometric (n=18, 24%), isotonic (n=19, 25%), and PNF (n=20, 26%) exercises, as well as 1 control group (n=19, 25%) with no intervention. Pressure pain threshold and the CPM responses at the myofascial trigger point, arm, and leg sites were assessed before and after the exercise session. The effective EIH response was reflected in the improvement of pressure pain thresholds.
RESULTS: There was an increase in pressure pain thresholds and CPM responses at trigger point (P<.001 and P<.001), arm (P<.001 and P<.001), and leg sites (P<.001 and P=.03) in participants who performed PNF and isotonic exercise, while the isometric exercise only increased pressure pain thresholds at leg sites (P=.03). Compared with the control group, both the isotonic (P=.02) and PNF (P<.001) groups showed greater EIH responses at the trigger points. In comparison to the control group, only the PNF exercise (P=.01) significantly improved pressure pain thresholds and CPM responses at arm and leg sites compared to the control group.
CONCLUSIONS: PNF, isotonic, and isometric exercises could lead to local and global EIH effects. The improvement in CPM response following PNF and isotonic exercises suggested that the EIH mechanisms of different resistance exercises may be attributed to the enhancement of the endogenous pain modulation via the motor-sensory interaction from the additional eccentric and dynamic muscle contraction.
BACKGROUND: Chinese Clinical Trial Registry ChiCtr202111090819166165; https://tinyurl.com/2ab93p7n.
摘要：
背景：各种锻炼可以减弱健康个体的疼痛感知，并可能与中枢神经系统中下降的疼痛调节相互作用。然而,运动对肌筋膜疼痛患者的镇痛作用可被慢性疼痛期间的病理变化所破坏。因此，以促进感觉-运动相互作用为目标的运动可能对疼痛调节下降和镇痛效果的恢复产生积极影响.
目的：本文评估了本体感觉神经肌肉促进（PNF）和抗阻训练对肌筋膜疼痛综合征患者运动诱发的痛觉减退（EIH）和条件性疼痛调节（CPM）的影响。
方法：共76例女性肌筋膜疼痛综合征患者（年龄18-30岁），上斜方肌疼痛，视觉模拟量表评分大于30/100mm，参加了这项研究。参与者被随机分为3个干预组，包括等距(n=18，24%)，等渗(n=19，25%)，和PNF(n=20，26%)练习，以及1个对照组（n=19，25％），无干预。压力疼痛阈值和肌筋膜触发点的CPM反应，手臂,和腿部部位在锻炼前后进行评估。有效的EIH反应反映在压力疼痛阈值的改善上。
结果：触发点的压力疼痛阈值和CPM反应增加（P<.001和P<.001），臂（P<.001和P<.001），以及进行PNF和等渗运动的参与者的腿部部位（P<.001和P=.03），而等距运动仅增加腿部部位的压力疼痛阈值（P=0.03）。与对照组相比,等渗(P=.02)和PNF(P<.001)组在触发点显示更大的EIH反应。与对照组相比，与对照组相比，仅PNF运动（P=0.01）显着改善了手臂和腿部部位的压力疼痛阈值和CPM反应。
结论：PNF，等渗,和等距运动可能导致局部和全球EIH效应。PNF和等渗运动后CPM反应的改善表明，不同阻力运动的EIH机制可能归因于额外的偏心和动态肌肉收缩通过运动-感觉相互作用增强了内源性疼痛调节。
背景：中国临床试验注册中心ChiCtr202111090819166165;https://tinyurl.com/2ab93p7n.
目的：本文评估了本体感觉神经肌肉促进（PNF）和抗阻训练对肌筋膜疼痛综合征患者运动诱发的痛觉减退（EIH）和条件性疼痛调节（CPM）的影响。
方法：共76例女性肌筋膜疼痛综合征患者（年龄18-30岁），上斜方肌疼痛，视觉模拟量表评分大于30/100mm，参加了这项研究。参与者被随机分为3个干预组，包括等距(n=18，24%)，等渗(n=19，25%)，和PNF(n=20，26%)练习，以及1个对照组（n=19，25％），无干预。压力疼痛阈值和肌筋膜触发点的CPM反应，手臂,和腿部部位在锻炼前后进行评估。有效的EIH反应反映在压力疼痛阈值的改善上。
结果：触发点的压力疼痛阈值和CPM反应增加（P<.001和P<.001），臂（P<.001和P<.001），以及进行PNF和等渗运动的参与者的腿部部位（P<.001和P=.03），而等距运动仅增加腿部部位的压力疼痛阈值（P=0.03）。与对照组相比,等渗(P=.02)和PNF(P<.001)组在触发点显示更大的EIH反应。与对照组相比，与对照组相比，仅PNF运动（P=0.01）显着改善了手臂和腿部部位的压力疼痛阈值和CPM反应。
结论：PNF，等渗,和等距运动可能导致局部和全球EIH效应。PNF和等渗运动后CPM反应的改善表明，不同阻力运动的EIH机制可能归因于额外的偏心和动态肌肉收缩通过运动-感觉相互作用增强了内源性疼痛调节。
背景：中国临床试验注册中心ChiCtr202111090819166165;https://tinyurl.com/2ab93p7n.
