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      Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain.

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          Abstract

          Increasing evidence purports exercise as a first-line therapeutic for the treatment of nearly all forms of chronic pain. However, knowledge of efficacious dosing respective to treatment modality and pain condition is virtually absent in the literature. The purpose of this analysis was to calculate the extent to which exercise treatment shows dose-dependent effects similar to what is seen with pharmacological treatments.

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          The West Haven-Yale Multidimensional Pain Inventory (WHYMPI).

          Robert D Kerns, Dennis C Turk, Thomas Rudy (1985)
          The complexity of chronic pain has represented a major dilemma for clinical researchers interested in the reliable and valid assessment of the problem and the evaluation of treatment approaches. The West Haven-Yale Multidimensional Pain Inventory (WHYMPI) was developed in order to fill a widely recognized void in the assessment of clinical pain. Assets of the inventory are its brevity and clarity, its foundation in contemporary psychological theory, its multidimensional focus, and its strong psychometric properties. Three parts of the inventory, comprised of 12 scales, examine the impact of pain on the patients' lives, the responses of others to the patients' communications of pain, and the extent to which patients participate in common daily activities. The instrument is recommended for use in conjunction with behavioral and psychophysiological assessment strategies in the evaluation of chronic pain patients in clinical settings. The utility of the WHYMPI in empirical investigations of chronic pain is also discussed.
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            The validation of visual analogue scales as ratio scale measures for chronic and experimental pain.

            D. Price, A Rafii, Colman McGrath … (1983)
            Visual analogue scales (VAS) of sensory intensity and affective magnitude were validated as ratio scale measures for both chronic and experimental pain. Chronic pain patients and healthy volunteers made VAS sensory and affective responses to 6 noxious thermal stimuli (43, 45, 47, 48, 49 and 51 degrees C) applied for 5 sec to the forearm by a contact thermode. Sensory VAS and affective VAS responses to these temperatures yielded power functions with exponents 2.1 and 3.8, respectively; these functions were similar for pain patients and for volunteers. The power functions were predictive of estimated ratios of sensation or affect produced by pairs of standard temperatures (e.g. 47 and 49 degrees C), thereby providing direct evidence for ratio scaling properties of VAS. Vas sensory intensity responses to experimental pain, VAS sensory intensity responses to different levels of chronic pain, and direct temperature (experimental pain) matches to 3 levels of chronic pain were all internally consistent, thereby demonstrating the valid use of VAS for the measurement of and comparison between chronic pain and experimental heat pain.
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              Exercise treatment for depression: efficacy and dose response.

              Andrea L Dunn, Madhukar Trivedi, James B Kampert … (2005)
              This study, conducted between 1998 and 2001 and analyzed in 2002 and 2003, was designed to test (1) whether exercise is an efficacious treatment for mild to moderate major depressive disorder (MDD), and (2) the dose-response relation of exercise and reduction in depressive symptoms. The study was a randomized 2x2 factorial design, plus placebo control. All exercise was performed in a supervised laboratory setting with adults (n =80) aged 20 to 45 years diagnosed with mild to moderate MDD. Participants were randomized to one of four aerobic exercise treatment groups that varied total energy expenditure (7.0 kcal/kg/week or 17.5 kcal/kg/week) and frequency (3 days/week or 5 days/week) or to exercise placebo control (3 days/week flexibility exercise). The 17.5-kcal/kg/week dose is consistent with public health recommendations for physical activity and was termed "public health dose" (PHD). The 7.0-kcal/kg/week dose was termed "low dose" (LD). The primary outcome was the score on the 17-item Hamilton Rating Scale for Depression (HRSD(17)). The main effect of energy expenditure in reducing HRSD(17) scores at 12 weeks was significant. Adjusted mean HRSD(17) scores at 12 weeks were reduced 47% from baseline for PHD, compared with 30% for LD and 29% for control. There was no main effect of exercise frequency at 12 weeks. Aerobic exercise at a dose consistent with public health recommendations is an effective treatment for MDD of mild to moderate severity. A lower dose is comparable to placebo effect.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): PLoS One
                Title: PloS one
                Publisher: Public Library of Science (PLoS)
                ISSN (Electronic): 1932-6203
                ISSN (Print): 1932-6203
                Publication date (Electronic): 2019
                Volume: 14
                Issue: 1
                Affiliations
                [1 ] Department of Biological Sciences, Duquesne University, Pittsburgh, Pennsylvania, United States of America.
                [2 ] Chronic Pain Research Consortium, Duquesne University, Pittsburgh, Pennsylvania, United States of America.
                [3 ] Palumbo Donahue School of Business, Duquesne University, Pittsburgh, Pennsylvania, United States of America.
                [4 ] Department of Physical Therapy, Duquesne University, Pittsburgh, Pennsylvania, United States of America.
                [5 ] Department of Occupational Therapy, Duquesne University, Pittsburgh, Pennsylvania, United States of America.
                Article
                Publisher Item ID: PONE-D-18-24024
                DOI: 10.1371/journal.pone.0210418
                PMC ID: 6326521
                PubMed ID: 30625201
                SO-VID: 990ba83c-bb46-496c-b438-4e66e5c37212
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