Physical Activity Levels Predict Exercise-induced Hypoalgesia in Older Adults

Prior research indicates that older adults exhibit a deficient capacity to activate multiple pain inhibitory mechanisms, including pain inhibition after acute exercise termed exercise-induced hypoalgesia (EIH). The influence of physical activity levels and psychological processes on EIH in older adults remains unclear. PURPOSE This study examined potential psychological and physical activity predictors of the magnitude of EIH following submaximal isometric exercise in healthy older adult men and women. METHODS Fifty-two healthy older adults completed a test of EIH, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia, and wore an accelerometer on the hip for one week to assess physical activity levels. For the test of EIH, participants complete a 3-minute isometric handgrip at 25% of maximum voluntary contraction. Pressure pain thresholds (PPTs) and a 30-sec continuous heat pain test were completed before and immediately after the exercise. RESULTS Mixed model ANOVAs revealed that older adults demonstrated significantly decreased PPTs following isometric exercise (p=.030), and no changes on the heat pain trials from pre to post test (p>.05). A multiple regression revealed that accumulated moderate to vigorous physical activity (MVPA) per week significantly predicted the change in PPT following exercise (β=0.35, p=.012). Participants who averaged greater MVPA experienced a greater increase in PPTs after exercise. No relationships were found with EIH and the psychological variables. CONCLUSIONS Older adults did not exhibit EIH following submaximal isometric exercise. However, those who did more MVPA per week experienced a greater magnitude of pain inhibition following acute exercise

The Effect of Active Gaming on Pressure Pain Sensitivity

poster abstractAn acute bout of moderate to vigorous exercise temporarily reduces pain sensitivity in healthy adults, a phenomenon termed exercise-induced hypoalgesia (EIH). Recently, active gaming, which allows an individual to be physically active during video game play, has been rising in popularity as a means of light to moderate exercise. While evidence has shown that active gaming elicits positive cardiovascular and balance outcomes, no research has investigated active gaming as a modifier of pain. The purpose of this study was to determine whether an acute bout of active gaming increases pressure pain thresholds (PPT) in healthy adults. Fourteen young adults were enrolled in this study. Participants completed a training session and four experimental sessions. During each session, participants played one of the following active games for 15 minutes: Kinect Boxing, Kinect Tennis, Wii Boxing, and Wii Tennis. Pressure pain thresholds were measured on the trapezius muscle and the forearm before and immediately after a 15-minute active gaming session. Heart rate was also measured during game play. PPT data was analyzed with repeated measures ANOVA. Bivariate correlations examined the relationship between average percentage of heart rate reserve (HRR%) during game play and magnitude of pain reduction (post– pre). The results showed that PPTs 1) on the forearm and trapezius muscle significantly increased from pre to posttest during the Kinect Boxing session, 2) increased on the trapezius muscle during the Wii Boxing session, and 3) decreased on the forearm during the control session (p’s<.05). Greater HRR% during game play was associated with greater pain reduction (trapezius r=.33; forearm r=0.28; p’s<.05). In conclusion, active games played at a moderate intensity appear to be capable of temporarily reducing pressure pain sensitivity. This study was sponsored by the NIFS Student Research Fund

The Effect of Active Gaming on Cardiovascular Outcomes

poster abstractThe U.S. society has become more accustomed to a sedentary lifestyle in the past few decades, partially due to increased time spent in front of a screen. Recently, active gaming, which allows an individual to be physically active during video game play, has been rising in popularity as a means of exercise. However, more research is needed to evaluate whether active gaming can produce cardiovascular responses that fall within the recommended ranges for daily physical activity given by the American College of Sports Medicine (40-60% of heart rate reserve (HRR)). The purpose of this study was to determine the effects of active gaming on cardiovascular outcomes and enjoyment. Nine young adults have been enrolled in this study and data collection is ongoing. Participants completed a training session and four experimental sessions. During each session, participants played one of the following active games at a self-selected intensity for 15 minutes. Heart rate (HR) and rate of perceived exertion (RPE) were measured during game play. Enjoyment was assessed on a 10-cm VAS after each game. Repeated measures ANOVAs were used to determine differences in HRR%, RPE, and enjoyment between games. The results showed that HRR% was greater for Kinect boxing (M=42.7±12.5) compared to all other games (p=.012; Kinect Tennis=35.4±10.7, Wii Boxing=31.8±14.5, Wii Tennis=35.4±10.8). RPE was significantly greater for Kinect Boxing (M=11.3±2.0) compared to Wii Tennis (M=9.67±1.5), p=.038. Enjoyment levels did not differ between games, p=.58 (Kinect Boxing=6.6±2.1, Kinect Tennis=7.1±1.2, Wii Boxing=5.9±0.8, Wii Tennis=6.9±0.9). In conclusion, the active games played at a self-selected intensity were perceived as moderately to highly enjoyable and were able to increase cardiovascular responses. However, the intensity of activity depended on the game. Participants achieved a moderate intensity level (i.e., 40-60% of HRR) while playing Kinect Boxing, but only achieved a light intensity level while playing the other games. Mentor: Kelly M. Naugle, Department of Kinesiology, School of Physical Education, Tourism, and Management, IUPU

Active Gaming as a Form of Exercise to Induce Hypoalgesia

Objective: An acute bout of moderate-to-vigorous exercise temporarily reduces pain sensitivity in healthy adults. Recently, active gaming has been rising in popularity as a means of light-to-moderate exercise and may be particularly suitable for deconditioned individuals. Whether the physical activity elicited in active games can produce a hypoalgesic effect remains unknown. The purpose of this study was to determine whether active videogames can reduce pressure and heat pain sensitivity in healthy adults. We also evaluated the relationship between the physical activity elicited by the games and the magnitude of the hypoalgesic response. Materials and Methods: Twenty-one healthy adults played four different active games on separate days, including Microsoft® Kinect Xbox® One's Fighter Within and Sports Rival's Tennis, and Nintendo® Wii™ Sports' Boxing and Tennis. Heat pain thresholds on the forearm and pressure pain thresholds (PPTs) on the trapezius and forearm were assessed immediately before and after a 15-minute active gaming or control session. Minutes spent in sedentary time and moderate-to-vigorous physical activity (MVPA) during active gaming were measured with an accelerometer. Results: The analyses revealed that PPTs at the forearm and trapezius significantly increased from pretest to posttest following Kinect Fighter Within. PPTs at the trapezius also significantly increased from pretest to posttest following Wii Boxing. The magnitude of the hypoalgesic response was significantly correlated with MVPA and sedentary time during gameplay. Conclusion: These results suggest that an active gaming session played at a moderate intensity is capable of temporarily reducing pain sensitivity

The Decline of Endogenous Pain Modulation With Aging: A Meta-Analysis of Temporal Summation and Conditioned Pain Modulation

The purpose of this article was to examine age-related changes in conditioned pain modulation (CPM) and temporal summation (TS) of pain using meta-analytic techniques. Five electronic databases were searched for studies, which compared measures of CPM and TS among healthy, chronic pain-free younger, middle-aged, and older adults. Eleven studies were included in the final review for TS and 11 studies were included in the review of CPM. The results suggested a moderate magnitude of difference in TS among younger and middle-aged/older adults, with the older cohorts exhibiting enhanced TS of pain. Considerable variability existed in the magnitude of the effect sizes, which was likely due to the different experimental methodologies used across studies (ie, interstimulus interval, stimulus type, and body location). In regards to CPM, the data revealed a large magnitude of difference between younger and older adults, with younger adults exhibiting more efficient pain inhibition. Differences in CPM between middle-aged and older adults were minimal. The magnitude of pain inhibition during CPM in older adults may depend on the use of concurrent versus nonconcurrent protocols. In summary, the data provided strong quantitative evidence of a general age-related decline in endogenous pain modulatory function as measured by TS and CPM

Effect of different Kinesio tape tensions on experimentally-induced thermal and muscle pain in healthy adults

Athletes and rehabilitation specialists have used Kinesio tape (KT) to help alleviate pain symptoms. Currently, no clear mechanism exists as to why pain is relieved with the use of KT and whether the pain relieving effect is simply a placebo effect. Additionally, the most effective taping parameters (tension of tape) for pain reduction remain unknown. We used quantitative sensory testing to address these key gaps in the KT and pain literature. Using a repeated-measures laboratory design, we examined whether KT applied at different tensions reduces experimentally-induced pain compared to a no tape condition and KT with minimal tension. Heat pain thresholds (HPT's), pressure pain thresholds (PPT's), and pressure pain suprathreshold (PPS: 125% of PPT) tests were administered to the forearm prior to and during KT and no tape conditions. Tape was applied to the ventral forearm at 25% of max tension, 75% of max tension, and no tension (placebo). Repeated measures ANOVA's evaluated the pain outcomes between conditions and across time. KT had no significant effect on PPT's and HPT's (p's >0.05). The ANOVA on PPS revealed that KT applied at 25% of tension significantly reduced pain ratings from the pretest (M = 34.4, SE = 5.5) to post-test 1 (M = 30.3, SE = 4.7) and post-test 2 (M = 30.4, SE = 4.7). No other conditions significantly reduced suprathreshold pressure pain. However, pain ratings at posttest-1 during the no-tape condition (M = 36.4, SE = 5.3) were significantly greater than pain ratings during post-test 1 and post-test 2 of all three tape conditions. In conclusion, the current study revealed that KT applied at low tension is the optimal tension to reduce pressure-evoked muscle pain. Additionally, the results suggested that KT applied at low, high, or no tension may acutely prevent increased muscle sensitivity with repeated pressure stimulation

Active Virtual Reality Games Reduce Pain Sensitivity in Young, Healthy Adults

Separately, both physical activity and virtual reality can attenuate pain sensitivity in healthy adults. What is unknown is whether virtual reality combined with physical activity (active virtual reality) could have a greater hypoalgesic effect compared to non-active virtual reality distraction (passive virtual reality engagement). Objective: The purpose of this study was to determine whether playing physically active virtual reality games exert a greater hypoalgesic effect than a non-active virtual reality game. Methods: Participants (n = 36) played three different active virtual reality games (Beat Saber, Holopoint, and Hot Squat) and one non-active virtual reality game (Relax Walk) for 15 min on four different visits. During gameplay, participants wore accelerometers on the thigh, wrist, and waist to measure movement intensity and quantity. Pressure pain thresholds were measured on the forearm and thigh immediately prior to gameplay (pretest) and immediately following each gaming bout (posttest). Results: Analysis of the accelerometer data indicated that Hot Squat elicited greater whole-body and lower body moderate to vigorous physical activity compared to the other games. The ANOVA revealed an overall hypoalgesic effect of the virtual reality games on the forearm, regardless of game type. Results also showed a significant hypoalgesic effect on the thigh following gameplay for Hot Squat, Holopoint, and Relax Walk VR. The magnitude of pain reduction was significantly greater during Hot Squat compared to the other games. Conclusion: Virtual reality gameplay exerted a hypoalgesic effect on experimental pressure pain. Additionally, the data provided evidence of a potential enhanced hypoalgesic effect of physically active virtual reality compared to non-active VR on pressure pain sensitivity

Reduced Modulation of Pain in Older Adults After Isometric and Aerobic Exercise

Laboratory-based studies show that acute aerobic and isometric exercise reduces sensitivity to painful stimuli in young healthy individuals, indicative of a hypoalgesic response. However, little is known regarding the effect of aging on exercise-induced hypoalgesia (EIH). The purpose of this study was to examine age differences in EIH after submaximal isometric exercise and moderate and vigorous aerobic exercise. Healthy older and younger adults completed 1 training session and 4 testing sessions consisting of a submaximal isometric handgrip exercise, vigorous or moderate intensity stationary cycling, or quiet rest (control). The following measures were taken before and after exercise/quiet rest: 1) pressure pain thresholds, 2) suprathreshold pressure pain ratings, 3) pain ratings during 30 seconds of prolonged noxious heat stimulation, and 4) temporal summation of heat pain. The results revealed age differences in EIH after isometric and aerobic exercise, with younger adults experiencing greater EIH compared with older adults. The age differences in EIH varied across pain induction techniques and exercise type. These results provide evidence for abnormal pain modulation after acute exercise in older adults

Exploring actual and perceived levels of physical activity intensity during virtual reality active games

Background: Research suggests that engaging in active virtual reality (VR) video games can elicit light to moderate levels of physical activity (PA), making it a novel and fun mode of exercise. Further research is needed to understand the influence of VR on perceptions of exertion and enjoyment during PA. Objective: The objectives of this study are (1) to compare actual and perceived exertion within and between active VR games with varying levels of difficulty and (2) to determine how playing active VR games influences PA enjoyment during gameplay. Methods: A total of 18 participants completed four separate study sessions, during which they engaged in either a 15-min bout of traditional exercise (stationary cycling) or played one VR game. Heart rate (HR) and ratings of perceived exertion (RPE) using the Borg CR10 scale were assessed during VR gameplay and cycling. Enjoyment was measured after gameplay. VR games included playing Holopoint at level 2 and level 3 and Hot Squat. Repeated measures ANOVAs were used to examine (1) changes in HR and RPE across time within games and (2) differences in actual and perceived levels of intensity and enjoyment between games. Bivariate correlations examined the relationship between the degree of change in actual intensity and the degree of change in perceived intensity during each VR game and cycling. Results: The analyses revealed that RPE and HR significantly increased from baseline during each condition and generally increased across the 15-min of gameplay. Hot Squat and cycling elicited a significantly higher percentage of heart rate reserve (%HRR) than Holopoint at levels 2 and 3. Holopoint level 3 elicited a higher %HRR than Holopoint level 2. The participants reported greater average and max RPE during Hot Squat and cycling compared with Holopoint at levels 2 and 3. The correlations revealed a significant positive correlation between the degree of change in HR and RPE for cycling, but no significant correlations were observed for any of the VR conditions. The physical activity during Holopoint at both levels was rated as more enjoyable than Hot Squat and cycling. Conclusion: Our data support the notion that VR has the potential to alter individuals' perceptions of exertion during PA and, in particular, may reduce their awareness of increases in actual exertion