Abstract
BackgroundLow back pain (LBP) is common in the general population and among postpartum women. Abdominal muscle exercise is often used to treat LBP, but it is unknown if fatiguing abdominal muscle exercise can produce exercise-induced hypoalgesia (EIH).ObjectivesTo assess pressure pain thresholds (PPTs) at rest and following fatiguing trunk flexor exercise (EIH) in (1) nulligravid and postpartum women to evaluate the impact of pregnancy and childbirth and (2) nulligravid women and men to examine sex differences.MethodsSeventy healthy adults (31 postpartum women, 23 nulligravid women, 16 men) participated. Postpartum and nulligravid women were tested twice (16–18 weeks apart) to identify changes in EIH with postpartum recovery. PPTs were measured at the nailbed and superior rectus abdominis before and after exercise to investigate systemic and local EIH, respectively. Rectus abdominis muscle thickness was assessed with ultrasound.ResultsPostpartum women reported lower PPTs than nulligravid women at the abdomen (p < 0.05) whereas postpartum women had lower PPTs at the nailbed during the first session only. Men reported higher nailbed PPTs (p = 0.047) and similar PPTs at the abdomen than women (p = 0.294). All groups demonstrated EIH at the abdomen (p < 0.05). Systemic EIH was absent in postpartum and nulligravid women (p > 0.05), while men demonstrated hyperalgesia. Local EIH was positively associated with muscle thickness for men and women, which was not significant at the second timepoint.LimitationsAcute exercise response may not reflect changes that occur with exercise training.ConclusionFatiguing trunk flexor exercise produced local EIH for all groups including postpartum and nulligravid women. Clinically, trunk exercises may be useful for acute pain relief for clinical populations that are characterized by pain and/or weakness in the abdominal region muscles in populations with abdominal pain syndromes.
Highlights
30% of adults in the United States experience chronic pain, with the low back being the most commonly reported location (Johannes et al, 2010)
Low back pain (LBP) has been identified as the leading cause of years lived with disability globally (Vos et al, 2012), and women are more likely than men to experience chronic LBP that impacts activities of daily living (Chenot et al, 2008)
Because postpartum women are at high risk of LBP and have low strength and endurance of the abdominal muscles compared with nulligravid women (Deering et al, 2018a,b), and as abdominal muscle exercise is typically used in the treatment of LBP for both men and women (Richardson et al, 1999; Hodges, 2003; Bastiaenen et al, 2004; Koumantakis et al, 2005; Pennick, 2007; Vleeming et al, 2008; Liddle and Pennick, 2015), we evaluated Pressure pain thresholds (PPTs) before and after fatiguing exercise of the trunk flexor muscles in (1) postpartum and nulligravid women to examine the impact of pregnancy and childbirth on pain thresholds and exercise-induced hypoalgesia (EIH), and (2) healthy men and nulligravid women to examine potential sex differences in pain thresholds and EIH (Koltyn et al, 2001) following abdominal muscle exercise
Summary
30% of adults in the United States experience chronic pain, with the low back being the most commonly reported location (Johannes et al, 2010). Low back pain (LBP) has been identified as the leading cause of years lived with disability globally (Vos et al, 2012), and women are more likely than men to experience chronic LBP that impacts activities of daily living (Chenot et al, 2008). In postpartum women, increased inter-recti distance, suggesting compromised fascial integrity, has been associated with low back and pelvic pain (Parker and Millar, 2008). These findings suggest that dysfunction of the abdominal muscles may play a role in the etiology of LBP, with rehabilitation implications including the response to exercise. Abdominal muscle exercise is often used to treat LBP, but it is unknown if fatiguing abdominal muscle exercise can produce exercise-induced hypoalgesia (EIH)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
