Embed Size (px)
DESCRIPTION
Comunicación del 3er Congreso Internacional de Fisioterapia y Dolor (ICPFA y SEFID, 2014)
Citation preview
Control y modulación del dolor mediante el ejercicio físico: Determinantes para la
calidad de vida.
Dr. Castillo-Lozano
D. Domínguez-Vera
@RomCastLoz
@RomCastLoz
THE INTERACTION BETWEEN EXERCISE AND PAIN PERCEPTION.
The acute effect of a single exercise session.
The basal pain perception of athletes who routinely engaged in exercise.
Sternberg et al., 2001; Hoffman et al., 2004; Kosek & Lundberg, 2003; Boecker et al., 2008; Butler & Finn, 2009; Scheef et al., 2012.
This phenomenon, lasting 30 minutes, is termed ‘‘Exercise-Induced Hypoalgesia’’ (EIH)
Recruitment of enhanced endogenous antinociceptive mechanisms.
@RomCastLoz
…Acute effect of exercise,…
…there is less evidence of the effect of chronic exercise on basal pain perception of athletes.
@RomCastLoz
A considerable amount of stress and pain over several hours daily.
EFFECT OF CHRONIC EXERCISE.
The effect of chronic physical exercise and related stress on the pain system.
Static Measurements.
Evaluate Pain Response.
Dynamic Measurements.
Conditioned Pain Modulation (CPM).
@RomCastLoz
Fear of Pain (McNeil et al., 1998).
Pain Catastrophizing (Sullivan et al., 2000; Sullivan et al., 2002).
ROBUST PREDICTORS
Perceived Stress (Chapman et al., 2008).
Pain Thresholds.Pain Tolerance.Perceived Pain Intensity.Conditioned Pain Modulation Procedure (CPM).Temporal Summation of Pain.
MEASUREMENT
@RomCastLoz
Higher pain tolerance.
Lower suprathreshold pain ratings.
Stronger CPM.
Level of fear of pain and of pain catastrophizing was lower.
Sport PAIN vs Sedentary PAIN
Ord & Gijsbers, 2003; Tesarze et al., 2012; Geva & Defrin, 2013.
Psychological and cognitive aspects of pain perception that may underlie their ability to persevere despite extreme effort and pain.
@RomCastLoz
Specifically, CPM signifies the diffuse noxious inhibitory control system whereby neurons within the caudal subnucleus reticularis dorsalis are activated by noxious stimuli and, in turn, activate descending inhibitory projections to spinal nociceptive neurons
LeBars, 2002; Van Wijk & Veldhuijzen, 2010; Nir et al., 2012; Lautenbacher et al., 2007; Defrin et al., 2010.
A MORE POWERFUL CPM = MORE EFFICIENT PHYSIOLOGICAL PAIN MODULATION
CPM can be influenced by psychological manipulation, such as expectations and attention.
@RomCastLoz
…greater pain tolerance and pain modulation are INHERENT or ACQUIRED??
The nociceptive inputs constantly trigger the brain stem structures responsible for pain inhibition, which, in turn, produce a more powerful pain modulation and tolerance.
@RomCastLoz
The gradual increase in pain tolerance following 12 weeks of training.
Positive emotions and reduced distress are associated with reduced pain levels.
Athletes may also be affected by negative affect. However, this influence seems insufficient to reduce their overall pain modulation.
Physical exercise involves considerable pain, physical and psychological stress.
Athletes showed higher pain tolerance, lower pain score, and the slightest fear of pain scores than sedentary subjects.
Negatively correlated with fear of pain and perceived mental stress during training and competition.
