The Interaction Between Psychosocial Factors and Exercise-Induced Hypoalgesia in Pain-Free Nurses

Kristian Johnsen; Patrick J Owen; Scott D Tagliaferri; Jessica Van Oosterwijck; Bernadette M Fitzgibbon; Jon J Ford; Daniel L Belavy; Clint T Miller

doi:10.2147/JPR.S386440

The Interaction Between Psychosocial Factors and Exercise-Induced Hypoalgesia in Pain-Free Nurses

J Pain Res. 2023 Feb 17:16:529-541. doi: 10.2147/JPR.S386440. eCollection 2023.

Authors

Kristian Johnsen¹, Patrick J Owen¹, Scott D Tagliaferri¹, Jessica Van Oosterwijck^{2

3

4}, Bernadette M Fitzgibbon⁵, Jon J Ford^{6

7}, Daniel L Belavy^{1

8}, Clint T Miller¹

Affiliations

¹ Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
² Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
³ Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
⁴ Research Foundation - Flanders (FWO), Brussels, Belgium.
⁵ School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
⁶ Advance HealthCare, Boronia, VIC, Australia.
⁷ Low Back Research Team, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, Australia.
⁸ Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit, Bochum, Germany.

Abstract

Purpose: This cross-sectional study aimed to investigate whether psychosocial factors were predictive for exercise-induced hypoalgesia (EIH) in pain-free adults.

Methods: A sample of 38 pain-free nurses with a mean (SD) age of 26 (6) years were included in this study. Participants completed psychosocial questionnaires prior to physical tests. Pressure pain threshold (PPT) was assessed bilaterally at the calves (local), lower back (semi-local) and forearm (remote) before and immediately after a maximal graded cycling exercise test. Separate linear mixed effects models were used to determine change in PPT before and after cycling exercise (EIH). Multiple linear regression for all psychosocial variables and best subset regression was used to identify predictors of EIH at all locations.

Results: The relative mean increase in PPT at the forearm, lumbar, calf, and globally (all sites pooled) was 6.0% (p<0.001), 10.1% (p<0.001), 13.9% (p<0.001), and 10.2% (p=0.013), respectively. Separate best subset multiple linear regression models at the forearm (predictors; Multidimensional Scale of Perceived Social Support (MSPSS) total), lumbar (predictors; MSPSS total, Pain Catastrophizing Scale (PCS) total, Depression Anxiety Stress Scale (DASS) depression), calf (predictors; MSPSS friends, PCS total), and global (predictors; MSPSS friends, PCS total) accounted for 7.5% (p=0.053), 13% (p=0.052), 24% (p=0.003), and 17% (p=0.015) of the variance, respectively.

Conclusion: These findings confirm that cycling exercise produced EIH in young nurses and provided preliminary evidence to support the interaction between perceived social support, pain catastrophizing and EIH. Further investigation is required to better understand psychological and social factors that mediate EIH on a larger sample of adults at high risk of developing chronic musculoskeletal pain.

Keywords: acute exercise; aerobic exercise; kinesiophobia; pain pressure threshold; perceived social support.