Pain is one of the most troubling impairments of Parkinson’s disease, with up to 85% of people affected (Broen et al., 2012). While exercise has many benefits in assisting people with Parkinson’s disease to optimise their health, balance, strength and mobility, there is limited research exploring the benefits of exercise for pain management.
People with some chronic pain conditions, such as fibromyalgia, sometimes demonstrate immediate increases in experimental and clinical pain sensitivity following a single bout of exercise (Staud et al., 2005). In contrast, pain-free individuals usually demonstrate immediate reductions in experimental pain sensitivity following a single bout of exercise (Naugle et al., 2012). Our recent study explored the immediate pain response to single bouts of aerobic and isometric (static) exercise in people with Parkinson’s disease and age-matched controls.
Experimental pain sensitivity was measured using pressure pain thresholds on the upper limb (biceps) and lower limb (quadriceps) immediately before and after exercise. Exercise consisted of short duration (3 min), moderate intensity isometric arm exercise and treadmill walking for 10-25 min (depending on the participant’s physical abilities) at low and moderate intensities. An increase in pressure pain threshold after exercise indicates a reduction in pain sensitivity.
WHAT DID WE FIND?
Pain sensitivity was reduced following isometric and aerobic exercise. More specifically, pressure pain thresholds increased by 29% over the exercised muscles following isometric exercise and by 7% and 9% following low and moderate intensity treadmill walking, respectively. Pressure pain thresholds over unexercised muscles also increased by 10 – 16%, indicating a ‘systemic’ effect of exercise on reducing expermental pain sensitivity. The extent of pain sensitivity reduction was similar in people with Parkinson’s disease compared to age-matched controls.
SIGNIFICANCE AND IMPLICATIONS
This is the first study to show that exercise can lead to an immediate reduction in pain sensitivity in people with Parkinson’s disease. As ongoing exercise programs are an important component of the management of Parkinson’s disease, the results of this study provide assurance that people with Parkinson’s disease and pain can exercise without exacerbating their pain. Further, the reduction in pain sensitivity with both isometric and aerobic exercise (low and moderate intensity) indicate that people with Parkinson’s disease and pain can choose the mode and intensity of exercise that best suits their needs.
Nguy, V., Barry, B., Moloney, N., Hassett, L., Caning, C., Lewis, S. and Allen, N. (2019). Exercise-induced hypoalgesia is present in people with Parkinson’s disease: Two observational cross-sectional studies. Eur J Pain, EPub ahead of print, doi: 10.1002/ejp.1400.
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Broen, MP., Braaksma, MM., Paitjin, J. and Weber, WE. (2012). Prevalence of pain in Parkinson’s disease: a systematic review using the modified QUADAS tool. Mov Disord, 27(4): 480-484.
Naugle, KM., Fillingim, RB. and Riley, JL 3rd. (2012). A meta-analytic review of the hypoalgesic effects of exercise. J Pain, 13(12): 1139-1150.
Staud, R., Robinson, ME. and Price, DD. (2005). Isometric exercise has opposite effects on central pain mechanisms in fibromyalgia patients compared to normal controls. Pain, 118(1-2): 176-184.
Vanessa Nguy is an Accredited Exercise Physiologist and PhD student at the University of Sydney. Vanessa’s research focuses on the role of exercise and physical activity in the management of pain in Parkinson’s disease. She can be followed on Twitter @NguyVanessa
Dr Natalie Allen is a physiotherapist and a Senior Lecturer in the Discipline of Physiotherapy at the University of Sydney. Natalie’s research focuses on exercise interventions to help people with PD to optimise their movement and manage any pain. You can learn more about Natalie and her research here: http://sydney.edu.au/health-sciences/about/people/profiles/natalie.allen.php