Relationships between physical activity and pain in people who are overweight, diabetic or in disabling pain
Caravalho, Amanda Lee
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Disabling pain interferes with daily life and can lead to chronic pain. This dissertation involved two studies evaluating the potential role physical activity (PA) could play in managing pain among people with disabling pain or at increased risk for disabling pain due to being overweight, diabetic or postmenopausal. Study 1 used meta-analytic techniques to estimate the population effect size of randomized controlled trials of exercise training effects on bodily pain scores among overweight or diabetic samples. Twenty-one effects were calculated from eleven studies (n = 5826). A small, mean effect size delta (Δ) of 0.07 (95% CI, -0.07, 0.21; p = 0.30) was quantified. No significant moderators were found. Therefore, exercise training has a small effect on pain among overweight and diabetics samples. Study 2 evaluated postmenopausal women with and without disabling pain and examined relationships between PA and both heat pain sensitivity and conditioned pain modulation. It was hypothesized that: (i) inactive women would rate the pain intensity and pain unpleasantness of all heat stimuli higher than active women, (ii) inactive women with disabling pain would rate the pain intensity and pain unpleasantness of heat stimuli higher at the higher heat stimulus intensities compared to active women with disabling pain, and (iii) inactive women would show less pain modulation. A mixed model ANOVA (2 x 4 x 2, PA x temperature x pain status) showed inactive women with disabling pain rated the pain unpleasantness of heat stimuli higher compared to active women with disabling pain (F3,192 = 3.526, partial η2 = .052, p= .016 for accelerometry and F3,192 = 3.60, partial η2 =.053, p = .015 for self-report). Significantly lower pain unpleasantness ratings were found at 49oC only for the active women with disabling pain compared to inactive women in disabling pain (t11=2.523, p=.028 for accelerometry and t11=2.208, p=.049 for the self-report). The other hypotheses were not supported. Therefore PA is associated with reduced sensitivity to the unpleasantness of painful high intensity heat stimuli among women with disabling pain. It is concluded that regular PA may be a useful for reducing pain unpleasantness in postmenopausal women in disabling pain.