Orthostatic-induced Hypotension Attenuates Cold Pressor Pain Perception

In recent years, numerous studies have established a connection between blood pressure and nocioception. While this connection is well documented in the literature, its underlying physiological mechanisms have yet to be elucidated. Much attention has focused on the relationship between cardiovascular regulatory centers and nocioception, yet the intricacies of this relationship have not been fully explored. Therefore, the purpose of this investigation was to examine the role of the baroreflex system as a modulator of pain perception. Twenty normotensive males participated in two laboratory sessions. Time to cold pain threshold and pain tolerance was measured at rest during the first visit. On visit two, blood pressure was orthostatically manipulated via tilt table at postures 90o, 120o, and 180o. Orthostatic manipulation significantly lowered systolic blood pressure (SBP), pain threshold, and pain tolerance from seated baseline at 120o and 180o. The regression models for baroreceptor reflex sensitivity (BRS) assessed during seated baseline and at 120o and 180o revealed a significant negative beta weight for the effect of SBP. A significant negative beta weight for the effects of BRS, SBP, and their interaction was observed at 90o. In conclusion, orthostatic baroreceptor activation appears to exert an inhibitory effect on the brain that decreases pain sensitivity

Exercise Intensity as a Determinant of Exercise Induced Hypoalgesia

The purpose of this study was to examine pain perception during and following two separate 30-min bouts of exercise above and below the Lactate Threshold (LT). Pain Threshold (PT) and Pain Intensity (PI) were monitored during (15 and 30 min) and after exercise (15 and 30 min into recovery) using a Cold Pressor Test (CPT) and Visual Analog Scale (VAS) for pain of the non-dominant hand. Significant differences in PT scores were found both during and after exercise conditions. Post hoc analysis revealed significant differences in PT scores at 30 min of exercise (P=0.024, P=0.02) and 15 min of recovery (P=0.03, P=0.01) for exercise conditions above and below LT, respectively. No differences (P=0.05) in PT scores were found at any time point between exercise conditions. No differences were found in PI scores at any time point within each trial (P=0.05) as well as between exercise conditions (p=0.05). Based upon these data, the effects of moderate exercise on PT appear to be similar at exercise intensities just above and below LT. This may indicate that the requisite intensity needed to ellicit Exercise-Induced Hypoalgesia may be lower than previously reported. Because a hypoalgesic effect was not observed in either condition until 30 min of exercise had been completed, total exercise time may be an important factor in the augmentation of pain perception under these conditions

Unmasking Pain: A Look at the Latest Research

Recent research into the physical and psychological mechanisms of pain in revealing new ways to help ease the hurt without the use of medication

Current Exercise Behaviors of Breast Cancer Patients Diagnosed with Chemotherapy-Induced Peripheral Neuropathy

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, dose-limiting effect of cancer therapy. The neuropathic pain associated with CIPN often has negative implications on an individual’s quality of life (QOL) and has long been recognized as one of the more difficult types of pain to treat. Treatment of neuropathic pain due to CIPN often requires a multidisciplinary approach, with much attention focused on the use of pharmacological therapies. However, in most instances, these agents have been shown to have additional negative side effects for cancer patients. Thus, other interventions that address the symptoms of CIPN should be considered. One such possible intervention is exercise rehabilitation, which has previously been reported effective in attenuating numerous cancer treatment-related toxicities and enhancing the QOL of patients. However, to our knowledge, there have been no published clinical trials examining the role of exercise in preserving neurological function following chemotherapy. As such, the purpose of this investigation was to examine the current exercise habits of breast cancer patients who are diagnosed with CIPN and the impact on pain and QOL. Methods: 300 women listed in the Breast Cancer Registry of Greater Cincinnati database were recruited by mail and asked to complete three questionnaires (McGill QOL, Leeds Assessment of Neuropathic Symptoms and Signs, and Current Exercise Behaviors). Data was analyzed at the 0.05 level of significance using a student’s t-test and a Pearson’s product moment correlation. Results: 134 completed surveys were returned and analyzed (44.6% response rate). Overall, QOL and exercise behaviors were moderately correlated (r = 0.56). Patients reported exercising an average of 2.3 d/wk and an overall QOL of 4.7. Of the patients completing the recommended amount of physical activity (EX, n = 21), QOL was 6.3, which was significantly higher than patients who did not meet these recommendations (SED, n = 113, p\u3c0.001). Likewise, only 15% of EX patients reported experiencing pain compared to 72% of SED patients (p\u3c0.001). Conclusions: Based on these data, it seems likely that an exercise intervention would be successful in attenuating symptoms of CIPN and improving the overall QOL of breast cancer patients

The Role of Exercise in Chemotherapy-Induced Peripheral Neuropathy

Chemotherapy-induced peripheral neuropathy (CIPN) is the most common neurological side effect of chemotherapy and is characterized by damage to the nervous system that is a direct result of the medications associated with chemotherapy. Often, this damage to the central nervous system pain pathways results in neuropathic pain described as burning, paroxysmal, stabbing, or elective shock-like and accompanied by pins-and-needles sensations and itching. The presence and severity of neuropathic pain is often shown to be associated with impairments in walking, general activities, sleep, work, mood, enjoyment of life, and relationships with others. Treatment of neuropathic pain due to CIPN often requires a multidisciplinary approach due to the broad variety of symptoms and their negative impact on quality of life. To provide treatment strategies that are effective for patients, they should include a combination of pharmacological agents and exercise rehabilitation. Exercise rehabilitation programs should be designed in order to help patients familiarize themselves to changes in physical functioning. The goals of the program should target three main areas: maximize functional capacities, prolong or maintain independent function, and improve quality of life

Ten weeks of home-based exercise attenuates symptoms of chemotherapy-induced peripheral neuropathy in breast cancer patients

The purpose of this investigation was to determine if a structured, home-based exercise program was beneficial to reduce symptoms of chemotherapy-induced peripheral neuropathy and improve quality of life (QOL). A total of 50 women who are breast cancer survivors and are listed in the Breast Cancer Registry of Greater Cincinnati database were recruited by mail. Participants were initially asked to complete the McGill QOL questionnaire and the Leeds Assessment of Neuropathic Symptoms and Signs, before beginning a 10-week home-based exercise program. At the completion of the exercise program, subjects were asked again to complete the same two questionnaires. Pre- and post-intervention data were analyzed using a repeated measures ANOVA, at a significance level of α<0.05. Six individuals completed the investigation. Prior to the 10-week exercise program, participants described their pain as unpleasant skin sensations (Pre-HBEx, N=6), abnormally sensitive to touch (Pre-HBEx, N=6), and coming on suddenly in bursts for no apparent reason (Pre-HBEx, N=5). Following 10-weeks of exercise, participants reported experiencing less of these symptoms (Post- HBEx, N=3, 1, and 4 respectively; P=0.05). It was also determined that troublesome symp- toms were significantly reduced after 10- weeks of home-based exercise (P=0.05)

Acute Exercise Protects Against Doxorubucin Cardiotoxicity

Numerous methods have been used to minimize the cardiotoxic effects of the chemotherapeutic agent doxorubicin (DOX), and most have had limited success. Chronic endurance exercise has been shown to protect against DOX cardiotoxicity, but little is known regarding the effects of acute exercise on DOX-induced cardiac dysfunction. Purpose. The purpose of this study was to determine the effects of a single bout of acute endurance exercise on the cardiac dysfunction associated with DOX treatment. Methods. Male Sprague-Dawley rats either performed an acute exercise bout on a motorized treadmill for 60 minutes at a maximal speed of 25 m/min with a 5% grade (EX) or remained sedentary (SED) 24 hours before receiving either a 15-mg/kg DOX bolus dose or saline (SAL). Cardiac function was then analyzed 5 days post injection using a Langendorff isolated perfused heart model. In addition, myocardial lipid peroxidation was analyzed as an indicator of oxidative stress. Results. Doxorubicin treatment alone (SED+DOX) promoted a significant decline in end-systolic pressure (–35%), left ventricular developed pressure (–59%), and the maximal rate of left ventricular pressure development (–43%) as well as a 45% increase in lipid peroxidation products when compared with SED+SAL (P \u3c .05). Acute exercise 24 hours before DOX treatment, however, had a cardioprotective effect, as end-systolic pressure, left ventricular developed pressure, and the maximal rate of left ventricular pressure development were significantly higher in EX+DOX compared with SED+DOX (P \u3c .05) and EX+DOX had similar levels of lipid peroxidation products as SED+SAL Conclusions. An acute exercise bout performed 24 hours before DOX treatment protected against cardiac dysfunction, and this exercise-induced cardioprotection may partly be explained by a reduction in the generation of reactive oxygen species

Treatment strategies for chemotherapy-induced peripheral neuropathy: potential role of exercise

Chemotherapy-induced peripheral neuropathy (CIPN) is a common, dose-limiting effect of cancer therapy that often has negative implications on a patient’s quality of life. The pain associated with CIPN has long been recognized as one of the most difficult types of pain to treat. Historically, much effort has been made to explore pharmacological therapies aimed at reducing symptoms of CIPN. While many of these agents provide a modest relief in the symptoms of peripheral neuropathy, many have been shown to have additional negative side effects for cancer patients. Therefore, the authors suggest exercise rehabilitation as one lifestyle modification that may positively impact the lives of patients with CIPN. To our knowledge, there are currently no published clinical trials examining the role of exercise in preserving neurological function following chemotherapy. However, investigations using low-to-moderate intensity exercise as an intervention in patients with diabetic peripheral neuropathy and hereditary motor and sensory neuropathies have produced promising results. Given that cancer patients appear to tolerate exercise, it seems plausible that exercise rehabilitation could be used as an effective strategy to minimize CIPN-induced detriments to quality of life