Exercise-induced hypoalgesia in young adult females with long-standing patellofemoral pain – A randomized crossover study

Christian L. Straszek*, Michael S. Rathleff, Thomas Graven-Nielsen, Kristian K. Petersen, Ewa M. Roos, Sinead Holden

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: Patellofemoral pain (PFP) is a common knee pain condition where hip and knee exercises help improve treatment outcomes. This study compared the acute effect of hip versus knee exercises on anti-nociceptive and pro-nociceptive mechanisms in young females with long-standing PFP. Methods: In this randomized cross-over study, 29 females with PFP performed hip and knee exercises in randomized order during a single day. Pressure pain thresholds (PPTs) were assessed by handheld pressure algometry at the patella, the tibialis anterior muscle, and the contralateral elbow. Cuff pressure algometry at the lower legs was used to assess pain detection threshold (cPDT) and tolerance (cPTT) as well as conditioned pain modulation (CPM: change in cPDT during contralateral cuff pain conditioning) and temporal summation of pain (TSP: ten painful cuff stimulations assessed on a visual analogue scale [VAS]). Results: PPTs at the tibialis anterior muscle but not at the patella increased compared with baseline following both exercises (p <.002). Compared with baseline, the cPDTs and cPTTs increased after both types of exercises (p <.001). The cPTTs increased more after knee compared to hip exercises (p <.007). VAS scores for TSP were increased following hip exercises (p <.001) although the rate of VAS increase over repeated stimulations was not significantly affected by exercises. The CPM-effect was reduced after both types of exercises (p <.001). Conclusion: A general hypoalgesic response to slowly increasing pressure stimuli was observed following both hip and knee exercises as well as decreased conditioned pain modulation, potentially indicating an attenuated ability from exercise to inhibit pain.

Original languageEnglish
JournalEuropean Journal of Pain
Volume23
Issue number10
Pages (from-to)1780-1789
ISSN1090-3801
DOIs
Publication statusPublished - Nov 2019

Fingerprint

Cross-Over Studies
Young Adult
Exercise
Knee
Hip
Pain Threshold
Visual Analog Scale
Patella
Muscles
Elbow
Leg

Cite this

Straszek, Christian L. ; Rathleff, Michael S. ; Graven-Nielsen, Thomas ; Petersen, Kristian K. ; Roos, Ewa M. ; Holden, Sinead. / Exercise-induced hypoalgesia in young adult females with long-standing patellofemoral pain – A randomized crossover study. In: European Journal of Pain. 2019 ; Vol. 23, No. 10. pp. 1780-1789.
@article{115c3cbd01844eacafe7de26d9ef802a,
title = "Exercise-induced hypoalgesia in young adult females with long-standing patellofemoral pain – A randomized crossover study",
abstract = "Background: Patellofemoral pain (PFP) is a common knee pain condition where hip and knee exercises help improve treatment outcomes. This study compared the acute effect of hip versus knee exercises on anti-nociceptive and pro-nociceptive mechanisms in young females with long-standing PFP. Methods: In this randomized cross-over study, 29 females with PFP performed hip and knee exercises in randomized order during a single day. Pressure pain thresholds (PPTs) were assessed by handheld pressure algometry at the patella, the tibialis anterior muscle, and the contralateral elbow. Cuff pressure algometry at the lower legs was used to assess pain detection threshold (cPDT) and tolerance (cPTT) as well as conditioned pain modulation (CPM: change in cPDT during contralateral cuff pain conditioning) and temporal summation of pain (TSP: ten painful cuff stimulations assessed on a visual analogue scale [VAS]). Results: PPTs at the tibialis anterior muscle but not at the patella increased compared with baseline following both exercises (p <.002). Compared with baseline, the cPDTs and cPTTs increased after both types of exercises (p <.001). The cPTTs increased more after knee compared to hip exercises (p <.007). VAS scores for TSP were increased following hip exercises (p <.001) although the rate of VAS increase over repeated stimulations was not significantly affected by exercises. The CPM-effect was reduced after both types of exercises (p <.001). Conclusion: A general hypoalgesic response to slowly increasing pressure stimuli was observed following both hip and knee exercises as well as decreased conditioned pain modulation, potentially indicating an attenuated ability from exercise to inhibit pain.",
author = "Straszek, {Christian L.} and Rathleff, {Michael S.} and Thomas Graven-Nielsen and Petersen, {Kristian K.} and Roos, {Ewa M.} and Sinead Holden",
year = "2019",
month = "11",
doi = "10.1002/ejp.1452",
language = "English",
volume = "23",
pages = "1780--1789",
journal = "European Journal of Pain",
issn = "1090-3801",
publisher = "JohnWiley & Sons Ltd.",
number = "10",

}

Exercise-induced hypoalgesia in young adult females with long-standing patellofemoral pain – A randomized crossover study. / Straszek, Christian L.; Rathleff, Michael S.; Graven-Nielsen, Thomas; Petersen, Kristian K.; Roos, Ewa M.; Holden, Sinead.

In: European Journal of Pain, Vol. 23, No. 10, 11.2019, p. 1780-1789.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Exercise-induced hypoalgesia in young adult females with long-standing patellofemoral pain – A randomized crossover study

AU - Straszek, Christian L.

AU - Rathleff, Michael S.

AU - Graven-Nielsen, Thomas

AU - Petersen, Kristian K.

AU - Roos, Ewa M.

AU - Holden, Sinead

PY - 2019/11

Y1 - 2019/11

N2 - Background: Patellofemoral pain (PFP) is a common knee pain condition where hip and knee exercises help improve treatment outcomes. This study compared the acute effect of hip versus knee exercises on anti-nociceptive and pro-nociceptive mechanisms in young females with long-standing PFP. Methods: In this randomized cross-over study, 29 females with PFP performed hip and knee exercises in randomized order during a single day. Pressure pain thresholds (PPTs) were assessed by handheld pressure algometry at the patella, the tibialis anterior muscle, and the contralateral elbow. Cuff pressure algometry at the lower legs was used to assess pain detection threshold (cPDT) and tolerance (cPTT) as well as conditioned pain modulation (CPM: change in cPDT during contralateral cuff pain conditioning) and temporal summation of pain (TSP: ten painful cuff stimulations assessed on a visual analogue scale [VAS]). Results: PPTs at the tibialis anterior muscle but not at the patella increased compared with baseline following both exercises (p <.002). Compared with baseline, the cPDTs and cPTTs increased after both types of exercises (p <.001). The cPTTs increased more after knee compared to hip exercises (p <.007). VAS scores for TSP were increased following hip exercises (p <.001) although the rate of VAS increase over repeated stimulations was not significantly affected by exercises. The CPM-effect was reduced after both types of exercises (p <.001). Conclusion: A general hypoalgesic response to slowly increasing pressure stimuli was observed following both hip and knee exercises as well as decreased conditioned pain modulation, potentially indicating an attenuated ability from exercise to inhibit pain.

AB - Background: Patellofemoral pain (PFP) is a common knee pain condition where hip and knee exercises help improve treatment outcomes. This study compared the acute effect of hip versus knee exercises on anti-nociceptive and pro-nociceptive mechanisms in young females with long-standing PFP. Methods: In this randomized cross-over study, 29 females with PFP performed hip and knee exercises in randomized order during a single day. Pressure pain thresholds (PPTs) were assessed by handheld pressure algometry at the patella, the tibialis anterior muscle, and the contralateral elbow. Cuff pressure algometry at the lower legs was used to assess pain detection threshold (cPDT) and tolerance (cPTT) as well as conditioned pain modulation (CPM: change in cPDT during contralateral cuff pain conditioning) and temporal summation of pain (TSP: ten painful cuff stimulations assessed on a visual analogue scale [VAS]). Results: PPTs at the tibialis anterior muscle but not at the patella increased compared with baseline following both exercises (p <.002). Compared with baseline, the cPDTs and cPTTs increased after both types of exercises (p <.001). The cPTTs increased more after knee compared to hip exercises (p <.007). VAS scores for TSP were increased following hip exercises (p <.001) although the rate of VAS increase over repeated stimulations was not significantly affected by exercises. The CPM-effect was reduced after both types of exercises (p <.001). Conclusion: A general hypoalgesic response to slowly increasing pressure stimuli was observed following both hip and knee exercises as well as decreased conditioned pain modulation, potentially indicating an attenuated ability from exercise to inhibit pain.

U2 - 10.1002/ejp.1452

DO - 10.1002/ejp.1452

M3 - Journal article

C2 - 31392790

AN - SCOPUS:85070720910

VL - 23

SP - 1780

EP - 1789

JO - European Journal of Pain

JF - European Journal of Pain

SN - 1090-3801

IS - 10

ER -