Stephanie Doyle

February 15, 2008

February 15, 2008 (Kissimmee, FL) — Physical conditioning in chronic pain patients can have immediate and long-term benefits, according to a new study presented at the American Academy of Pain Medicine 24th Annual Meeting.

A frequent comorbid condition of chronic pain is profound physical deconditioning, which results from inactivity. "People with chronic pain don't want to exercise — the main reason is that they are in so much pain," the study's lead investigator, Amy M. Burleson, PsyD, from the Cleveland Clinic Foundation, in Ohio, told Medscape Neurology & Neurosurgery here. "We were hoping this [study] would show people how important exercise is."

Effects of Brief Exercise

Objective assessment of physical conditioning in patients with chronic pain has been impeded by several factors that this study attempted to overcome, the authors write. "Of primary importance is verifying the efficacy of a physical reconditioning program." Decreases in pain, depression, and anxiety following treatment in a pain rehabilitation program have been well documented, they add, but to date, no study has determined the immediate effects of brief exercise on these factors.

The review aimed to determine the effect of a 3-week aerobic training program on physical conditioning and to assess the acute effects of a brief, 10-minute exercise protocol on pain, mood, and perceived exertion. The final sample of 28 patients — lowered from 54 due to factors such as lack of motivation to exercise and fear of exercise — had an immediate perception change about exercise upon starting the program.

Measures of heart rate, mood, pain, and perceived exertion were obtained. On average, patients received 5 hours of conditioning per week, in addition to routine daily activities. Results demonstrated significant short- and long-term benefits of exercise. Patients showed a statistically significant reduction in exercise-induced cardiac acceleration from admission to 3 weeks. The brief exercise protocol also produced significant immediate antidepressant and anxiolytic effects. The research suggests that relatively modest exercise leads to improved mood and physical capacity, which has further implications for mortality risk. The review also suggests that brief exercise is a safe, cost-free, nonpharmacologic strategy for immediately reducing depression and anxiety.

"I think a lot of people think you can treat chronic pain with 1 specialty," Burleson said. "I think what this study shows is that the interdisciplinary team is so important. We feel like the entire team makes a difference in the chronic pain of the patient."

Additional Benefits?

Todd Sitzman, MD, president of the American Academy of Pain Medicine, told Medscape Neurology & Neurosurgery that he hopes that a duplicate study extending exercise beyond 3 weeks will show additional benefits.

"My hope is that with a prolonged exercise program, analgesic pain relief also will be obtained," said Dr. Sitzman, who was not involved in the study.

American Academy of Pain Medicine 24th Annual Meeting: Abstract 105.

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