Association between psychosocial factors, pain and exercise-induced hypoalgesia in individuals with chronic low back pain

• Autor(a) principal: Neves, Márcia Juliana Silva
• Data de Publicação: 2022
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10773/34843
• topic: Chronic low back pain; Exercise-induced hypoalgesia; Psychosocial factors; Exercise intensity

Background: Aerobic exercise is an effective treatment for chronic low back pain (CLBP). In healthy individuals, the common response to an acute bout of exercise is a hypoalgesic effect. However, psychosocial factors, such as catastrophizing, kinesiophobia, anxiety and depression seem to be associated with increased pain and potentially compromise exercise-induced hypoalgesia (EIH) in individuals with pain. Objectives: To investigate whether catastrophizing, kinesiophobia, anxiety and depression are associated with pain intensity and pain sensitivity; and to investigate whether these psychosocial factors are associated with acute EIH in individuals with CLBP and whether this association varies with exercise intensity. Methods: This is an experimental, randomized and controlled trial with 83 participants with CLBP, randomly distributed into one of three groups (control, moderate and high intensity exercise groups). At baseline, participants were assessed for age, sex, kinesiophobia, catastrophizing, anxiety and depression, pain intensity and pressure pain threshold (PPT). Pain intensity and PPT were also evaluated at post-intervention. The experimental groups performed 15 minutes of aerobic exercise at moderate and high intensity each; control group did not perform any exercise. Univariate and multivariate linear regression were used to assess the association between psychosocial factors and pain intensity and sensitivity and EIH. Results: Catastrophizing, kinesiophobia and gender explained 21.6% of the VAS variance, and gender explained 8.2% of the PPT at a distant point and 24.2% of the PPT at the lower back. At post-intervention, anxiety explained 4.8% of the PPT changes variance at the distant point and depression, gender and anxiety explained 12.5% of the PPT changes variance at the lower back. No variables remained in the model to explain the changes in pain intensity. It was not possible to investigate whether the association between psychosocial factors and HIE varies with its intensity. Conclusion: Different factors might be associated with pain intensity and pain sensitivity and changes in these variables in response to exercise. Further research is needed with higher durations of exercise.