The Role of Exercise and Types of Exercise in the Rehabilitation of Chronic Pain: Specific or Nonspecific Benefits (original) (raw)
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Physical Rehabilitation for Patients with Chronic Pain
Raj's Practical Management of Pain, 2008
Exercise therapy is one key management strategy used in patients with pain to address impairments (problems with body function or structure, such as pain or weakness), activity limitations (diffi culties in activities such as walking, sitting, and standing), and participation restrictions (problems in everyday life situations such as working, playing sports, or socializing) . Exercise is a subcategory of physical activity that may be defi ned as "physical activity that is planned, structured, repetitive, and purposive in the sense that improvement or maintenance of one or more components of physical fi tness is the objective" . Multiple meta-analyses on the effects of exercise therapy on various painful conditions report that exercise reduces pain and increases aerobic capacity and physical function. e mechanisms behind these eff ects are not completely clear and are most likely due to multiple factors . Systematic reviews and meta-analyses have provided strong evidence for the effi cacy of therapeutic exercise for patients with conditions such as multiple sclerosis, osteoarthritis of the knee, chronic low back pain, coronary heart disease, chronic heart failure, chronic obstructive pulmonary disease, cystic fi brosis, and chronic and
The Clinical Journal of Pain, 2014
Exercise is an AQ4 effective treatment strategy in various chronic musculoskeletal pain disorders, including chronic neck pain, osteoarthritis, headache, fibromyalgia, and chronic low back pain. Although exercise can benefit those with chronic pain, some patients (eg, those with fibromyalgia or chronic whiplash-associated disorders) encounter exercise as a pain-inducing stimulus and report symptom flares due to exercise. This paper focuses on benefits and detrimental effects of exercise in patients with chronic pain. It summarizes positive and negative effects of exercise therapy in migraine and tension-type headache and provides an overview of the scientific evidence of dysfunctional endogenous analgesia during exercise in patients with certain types of chronic pain. Further, the paper explains the relationship between exercise and recovery highlighting the need to address recovery strategies as well as exercise regimes during rehabilitation. The characteristics, demands, and strategies of adequate recovery to compensate stress from exercise and return to homeostatic balance will be described. Exercise is shown to be effective in the treatment of chronic tension-type headache and migraine. Aerobic exercise is the best option in migraine prophylaxis, whereas specific neck and shoulder exercises is a better choice in treating chronic tension-type headache. Besides the consensus that exercise therapy is beneficial in the treatment of chronic pain, the lack of endogenous analgesia in some chronic pain disorders should not be ignored. Furthermore, optimizing the balance between exercise and recovery is of crucial merit to avoid stress-related detrimental effects and achieve optimal functioning in patients with chronic pain.
2021
Chronic pain is perhaps the most pervasive medical issue in the United States. The longterm impacts of chronic pain often cause individuals to reduce or eliminate physical activity. Chronic pain is generally defined as any pain that lasts longer than expected healing time, but typically the label "chronic" is applied when pain continues longer than three to six months (Treede et al., 2015). It is estimated that 20% of adults in the U.S. experience chronic pain, with an additional 8% of adults experiencing frequent, and at times debilitating, chronic pain (Geneen et al., 2017). In fact, chronic pain is the most common reason adults seek medical treatment in the United States (Geneen et al., 2017). Chronic pain can impact physical, mental, and emotional well-being, which can limit daily activity and quality of life. This impact on wellbeing ranges in severity from moderate to severe (Dueñas et al., 2016; Geneen et al., 2017). The purpose of this fact sheet is to address the common barriers to being physically active with chronic pain and provide suggestions for safe ways to be physically active even when chronic pain is present.
Levels of physical activity in people with chronic pain
South African Journal of Physiotherapy, 2017
Background: People who suffer from chronic pain are thought to have lower levels of physical activity compared to healthy individuals. However, there is a lack of evidence concerning levels of physical activity in South Africans with chronic pain. Objectives: To compare levels of physical activity in a South African sample of people with chronic pain compared to matched controls. Methods: A cross-sectional study was conducted with 24 participants (12 with chronic pain and 12 in the control group matched for age, gender and residential area). Convenience sampling was used. The participants with chronic pain (12) were identified from the Groote Schuur Hospital, Chronic Pain Management Clinic (CPMC) waiting list and had not yet received any chronic pain management intervention. Healthy matched controls were selected from volunteers in the community. With the desired alpha level set at 0.05 and the power at 0.9, 45 participants were required to detect a minimum of a 50 per cent difference between groups in levels of physical activity as measured in steps per day using pedometers. The international physical activity questionnaire (IPAQ) and the brief pain inventory (BPI) were used as measures of physical activity and pain. Objective indicators of physical activity that were used included the 6-minute walk test (6MWT), repeated sit-to-stand test (RSST), 7 days of pedometry and body mass index (BMI). Results: The chronic pain group performed significantly worse on the 6MWT (335 m [30-430] vs 680 m [430-795]; U = 0.5; p < 0.01) and on the RSST (17.9 s [11.83-105] vs 7.85 s [5.5-11.5]; U = 0; p < 0.01). The chronic pain group also had significantly lower scores on pedometry (mean daily: 2985.1 [32.8-13785.4] vs 6409.4 [4207.1-15313.6]; U = 35; p < 0.03). The BMI for the chronic pain group was significantly higher than matched controls (29.36 kg/m 2 [18.94-34.63] vs 22.16 kg/m 2 [17.1-30.86]; U = 34; p < 0.03). Conclusion: Participants with chronic pain had a reduced capacity for physical activity. The pedometry results illustrate a range of maladaptive strategies adopted by those with chronic pain. The majority of people with chronic pain appear to avoid physical activity leading to greater disability as a result of immobility and muscle atrophy. However, a small subgroup appears to ignore their pain and push themselves physically despite their pain. This perseverance behaviour leads to further pain as a consequence of muscle and joint overuse. Both maladaptive behavioural responses result in further sensitisation of the central nervous system. The method used to target physical activity in these patients should be considered in treatment planning, specifically for physiotherapy.
Physiotherapy Research International, 2015
Background and Purpose. The purpose of this narrative review is to present an overview and theoretical rationale of medical exercise therapy (MET) as a physiotherapeutic rehabilitation treatment for musculoskeletal pain conditions. Results from randomized controlled trials (RCTs) conducted on MET are also presented. Methods. Computerized searches for any RCTs were conducted on the MET concept in the databases PubMed, Medline, Embase and ISI Web of science up to 2013. Results. Overall findings from five included MET RCTs are longterm (≥1 year) reductions in pain and improved physical and functional capabilities. These results are interpreted in the context of the biopsychosocial model, advancing the view of a dynamic interaction among physiologic, psychological and social factors that influence pain modulation. Discussion. MET is a biopsychosocial treatment that reduces pain and improves activities of daily living in patients with a musculoskeletal pain condition. Pain modulation is a key feature of MET, and an important area for further research is to elucidate the specific mechanisms behind the treatment effects.
The effect of a home exercise program prescribed by physiotherapists for pain relief
2021
Muhammed Arca1, Elif Dilara Durmaz1, Omer Satıcı2, Ayse Ferdane Oguzoncul3 1Physical therapy and rehabilitation, Saglik Bilimleri University, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakır 2Department of Biostatistics, Dicle University, Medical Faculty, Diyarbakır 3Department of Public Health, Firat University, Medical Faculty, Elazig, Turkey Home training program and its effects on pain The effect of a home exercise program prescribed by physiotherapists for pain relief
The Journal of Community Health Management, 2023
Chronic pain, a multifaceted and incapacitating condition, affects countless individuals globally. While conventional methods for managing this kind of pain frequently rely on medications and surgical interventions, an expanding body of research is endorsing the effectiveness of exercise and weight loss in modulating chronic pain. This document offers an in-depth examination of the most recent studies, elucidating the physiological processes, advantages, and guidelines surrounding the implementation of exercise and weight reduction as means for managing chronic pain. The objective is to underscore the promising nature of these non-drug approaches, advocating for their incorporation into holistic pain management schemes. Keywords: Weight reduction, Exercise, Strategy, Chronic pain, Human health
High-intensity interval training for chronic pain conditions: a narrative review
Journal of Exercise Rehabilitation, 2022
Chronic pain is defined as pain that persists past the normal healing time. Physical activity and exercise programs are increasingly being promoted and used for a variety of chronic pain conditions. Evidence suggests that physical exercise is an intervention with few adverse events that may improve pain severity and physical function, thus improving the quality of life. High-intensity interval training (HIIT) has been shown to improve physical outcome measures and to decrease disorder-related disability in people with chronic disorders. Since an overview of the benefits of HIIT on chronic pain conditions has not been published yet, this review aims to report the effects of HIIT alone or in combination with other forms of training on different kind of chronic pain conditions. A search in the main scientific electronic databases was performed. The results of the studies included in this review showed that HIIT is beneficial for several chronic pain conditions, improving pain and physi...
Exercise and Weight Loss as a Strategy for Chronic Pain Control: A Comprehensive Review
Journal of Advances in Medicine and Medical Research
Chronic pain is a complex and debilitating condition affecting millions worldwide. Traditional pain management strategies often focus on medication and invasive procedures, but growing evidence supports the role of exercise and weight loss in chronic pain control. This manuscript provides a detailed review of current literature, discussing the physiological mechanisms, benefits, and recommendations of exercise and weight loss as a strategy for chronic pain management. The aim is to highlight the potential of these non-pharmacological approaches and their integration into comprehensive pain management plans.
Exercise Improves the Impact of Chronic Pain in Older Adults: Results of an RCT
The Open Pain Journal, 2022
Background: Chronic Pain (CP) is a crucial determinant for disability in older adults. CP amplifies the impact of other common age-related diseases and increases cardiovascular risk. Physical exercise can improve CP. Randomized Controlled Trials (RCTs) with high-intensity exercise in older adults excluded people with Moderate Chronic Illness (MCI) and CP. Objective: This study aimed at evaluating in an RCT whether moderate exercise training can improve chronic pain in a sample of older adults, including people with MCI, and if any modification persists over time. Methods: A sample of 120 older adults was randomly selected for a moderate-intensity exercise program or cultural activities (control group). Chronic pain was assessed at t0, at t12 (end of the trial), and t48 weeks, by means of the Italian version of the SIP-Roland Scale. Results: Seventy-nine participants completed the follow-up (age 72.3±4.7, women 55.3%). At the end of RCT, an improvement in the SIP scale score was foun...