Endogenous pain modulation (EPM) changes after a course of exercise therapy in low back pain (LBP): A pilot feasibility study.

IF 1.5 Q4 CLINICAL NEUROLOGY

British Journal of Pain Pub Date : 2025-08-03 DOI:10.1177/20494637251365688

Lee-Ran Goodman, Lisa Carlesso, Ada Tang, Luciana Macedo

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引用次数: 0

Abstract

Objectives: A significant driver of low back pain (LBP) is adaptations to endogenous pain modulation (EPM). Exercise modulates pain through various mechanisms, however, there is a lack of information on its relation to EPM. The objective of this study was to evaluate the feasibility of a protocol investigating if changes in EPM occurs after exercise therapy.

Methods: Participants were recruited from an ongoing randomized controlled trial comparing graded activity to motor control exercises. Participants attended 2 in person sessions pre and post intervention to assess pain pressure threshold (PPT), temporal summation (TS), conditioned pain modulation (CPM) and exercise induced hypoalgesia (EIH). Feasibility outcomes included attrition, recruitment rate, exercise adherence, protocol burden and consistency. In total, 36 (53%) eligible participants enrolled and completed baseline assessments.

Results: A-priori thresholds for feasibility were met for attrition 32/36 (89%), recruitment rate (53% of eligible participant enrolled and 36 recruited in 6 months), exercise adherence (93.8%) and satisfaction with assessment protocols (bothersome 88.9%, future participation 97.2%), apart from discomfort with assessment (58.3%). Participants reported that the CPM caused the most discomfort. There was a trend for an increase in low back PPT, no change in TS, and a decrease in CPM and thumbnail PPT at follow up. The results demonstrated that the protocol is feasible for all pre-specified outcomes.

Discussion: This article presents a protocol for EPM using PPT, TS, CPM and EIH that is feasible in a clinical trial for LBP. A future study is needed to further investigate EPM changes after exercise therapy in this population.

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内源性疼痛调节（EPM）变化在运动治疗后腰痛（LBP）：一项试点可行性研究。

目的：腰痛（LBP）的一个重要驱动因素是对内源性疼痛调节（EPM）的适应。运动通过各种机制调节疼痛，然而，缺乏关于其与EPM关系的信息。本研究的目的是评估运动治疗后EPM是否发生改变的方案的可行性。方法：参与者是从一项正在进行的随机对照试验中招募的，该试验比较了分级活动和运动控制练习。参与者在干预前和干预后分别参加了2次亲自会议，以评估疼痛压力阈值（PPT）、时间累积（TS）、条理性疼痛调节（CPM）和运动诱发的痛觉减退（EIH）。可行性指标包括减员、招募率、运动依从性、方案负担和一致性。共有36名（53%）符合条件的参与者入组并完成基线评估。结果：除评估不适（58.3%）外，减员32/36（89%）、招募率（53%符合条件的参与者入组，6个月内招募36人）、运动依从性（93.8%）和评估方案满意度（麻烦88.9%，未来参与97.2%）均符合可行性先验阈值。参与者报告说CPM引起了最大的不适。随访时腰背部PPT有增加趋势，TS无变化，CPM和缩略图PPT有下降趋势。结果表明，该方案对所有预定结果都是可行的。讨论：本文提出了一种使用PPT、TS、CPM和EIH的EPM方案，该方案在LBP的临床试验中是可行的。未来的研究需要进一步研究运动治疗后EPM的变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Pain CLINICAL NEUROLOGY-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： British Journal of Pain is a peer-reviewed quarterly British journal with an international multidisciplinary Editorial Board. The journal publishes original research and reviews on all major aspects of pain and pain management. Reviews reflect the body of evidence of the topic and are suitable for a multidisciplinary readership. Where empirical evidence is lacking, the reviews reflect the generally held opinions of experts in the field. The Journal has broadened its scope and has become a forum for publishing primary research together with brief reports related to pain and pain interventions. Submissions from all over the world have been published and are welcome. Official journal of the British Pain Society.