Comunicación del 3er Congreso Internacional de Fisioterapia y Dolor (ICPFA y SEFID, 2014)

1. Control y modulación del dolor mediante
el ejercicio físico: Determinantes para la
calidad de vida.
Dr. Castillo-Lozano
D. Domínguez-Vera
@RomCastLoz
romualdocl@euosuna.org

2. PAIN INJURY           
   NO RELATIONSHIP  

@RomCastLoz
romualdocl@euosuna.org

3. PAIN = STRESS COMPLEX
@RomCastLoz
romualdocl@euosuna.org

4. THE INTERACTION BETWEEN EXERCISE AND PAIN PERCEPTION.
The acute effect of a single
exercise session.
This phenomenon, lasting 30 minutes, is termed ‘‘Exercise-Induced
Hypoalgesia’’ (EIH)
Recruitment of enhanced endogenous antinociceptive mechanisms.
@RomCastLoz
romualdocl@euosuna.org
The basal pain perception of
athletes who routinely engaged in
exercise.
Sternberg et al., 2001; Hoffman et al., 2004; Kosek & Lundberg, 2003; Boecker et al., 2008; Butler & Finn, 2009; Scheef et
al., 2012.

5. …Acute effect of exercise,…
…there is less evidence of the effect of chronic exercise on basal pain perception of
athletes.
@RomCastLoz
romualdocl@euosuna.org

6. EFFECT OF CHRONIC EXERCISE.
A considerable amount of stress and pain over several hours daily.
The effect of chronic physical exercise and related stress on the pain system.
Static Measurements.
Evaluate Pain Response.
@RomCastLoz
romualdocl@euosuna.org
Dynamic Measurements.
Conditioned Pain Modulation
(CPM).

7. ROBUST PREDICTORS
Fear of Pain (McNeil et al., 1998).
Pain Catastrophizing (Sullivan et al., 2000; Sullivan et al., 2002).
Perceived Stress (Chapman et al., 2008).
MEASUREMENT
Pain Thresholds.
Pain Tolerance.
Perceived Pain Intensity.
Conditioned Pain Modulation Procedure (CPM).
Temporal Summation of Pain.
@RomCastLoz
romualdocl@euosuna.org

8. Sport PAIN vs Sedentary PAIN
Higher pain tolerance.
Lower suprathreshold pain ratings.
Stronger CPM.
Level of fear of pain and of pain catastrophizing was lower.
Psychological and cognitive aspects of pain perception that may underlie their
ability to persevere despite extreme effort and pain.
Ord & Gijsbers, 2003; Tesarze et al., 2012; Geva & Defrin, 2013.
@RomCastLoz
romualdocl@euosuna.org

9. Specifically, CPM signifies the diffuse noxious inhibitory control system whereby
neurons within the caudal subnucleus reticularis dorsalis are activated by noxious
stimuli and, in turn, activate descending inhibitory projections to spinal nociceptive
neurons
A MORE POWERFUL CPM = MORE EFFICIENT PHYSIOLOGICAL PAIN MODULATION
CPM can be influenced by psychological manipulation, such as
expectations and attention.
LeBars, 2002; Van Wijk & Veldhuijzen, 2010; Nir et al., 2012; Lautenbacher et al., 2007; Defrin et al., 2010.
@RomCastLoz
romualdocl@euosuna.org

10. …greater pain tolerance and pain modulation are INHERENT or ACQUIRED??
The nociceptive inputs constantly trigger the brain stem
structures responsible for pain inhibition, which, in turn,
produce a more powerful pain modulation and tolerance.
@RomCastLoz
romualdocl@euosuna.org

11. The gradual increase in pain tolerance following 12 weeks of training.
Positive emotions and reduced distress are associated with reduced
pain levels.
Athletes may also be affected by negative affect. However, this influence
seems insufficient to reduce their overall pain modulation.
Physical exercise involves considerable pain, physical and psychological
stress.
Athletes showed higher pain tolerance, lower pain score, and the slightest
fear of pain scores than sedentary subjects.
Negatively correlated with fear of pain and perceived mental stress
during training and competition.
@RomCastLoz
romualdocl@euosuna.org

12. PERSEVERANCE
AND CONSTANCY
IN PHYSICAL
EXERCISE =
@RomCastLoz
romualdocl@euosuna.org