Effects of an exercise programme on musculoskeletal and neuropathic pain after spinal cord injury—results from a seated double-poling ergometer study

Abstract

Objectives: To assess pain relieving effects of an intensive exercise programme on a seated double-poling ergometer in individuals with spinal cord injury (SCI). Setting: Stockholm, Sweden. Methods: A total of 13 wheelchair-dependent individuals with a thoracic or lumbar SCI were recruited to a 10-week training period (three times weekly) assessing the effects of regular training on upper-body strength, aerobic and mechanical power, and crossover effects on functional performance, as well as cardiovascular risk factors. Eight of the participants reported pain and were included in this exploratory pain protocol and assessed using the International SCI Basic Pain Data set, the Wheelchair Users' Shoulder Pain Index and International SCI Quality of Life Basic Data set. Results: For those with neuropathic pain, median pain intensity ratings decreased from 5 on a 0-10 numerical rating scale at baseline to 3 at the end of study, and four of seven participants reported an improvement on the Patient Global Impression of Change scale. For those with musculoskeletal pain (n¼5), median pain intensity ratings improved from 4 at baseline to 0 at the end of study. All but one rated no musculoskeletal pain at all at the end of study and number of days with pain per week decreased from 5.5 to 0.7. None of the participants developed pain, because of overuse during the training period and few reported unwanted side effects. Conclusion: Considering its promising effects and safety, an intensive exercise programme can be tried for treating musculoskeletal pain and also neuropathic pain following SCI.

Effects of wheelchair propulsion on neuropathic pain and resting electroencephalography after spinal cord injury

“…With regard to the effects of exercise on pain after SCI, Norrbrink et al (12) used a seated double-poling ergometer for 10 weeks and reported that NP intensity after SCI was decreased by aerobic exercise. In addition, Kressler et al (10) showed that pain after SCI was decreased by overground bionic ambulation training for 6 weeks, and Cruciger et al (11) observed that gait training with a robot suit decreased pain after SCI in 12 weeks.…”

“…It has been reported recently that gait or aerobic exercises improve NP, such as that after SCI (10)(11)(12). Moreover, this has led to a renewal of interest in exercises that can decrease pain after SCI.…”

Physical activity promotion for people with spinal cord injury: physiotherapists’ beliefs and actions

“…[14,15] Being physically active has been shown to reduce levels of perceived musculoskeletal and neuropathic pain, decrease the risk factors of cardiovascular disease and type 2 diabetes, and lead to greater functional capacity such as ease of transfer thereby improving SWB. [16][17][18] Moreover, PA can impact SWB through reducing depression, enhancing physical self-concept and increasing life satisfaction, [19,20] and improve PWB through facilitating experiences (such as personal control, responsibility and risk taking) that promote post-traumatic growth. [21] Yet despite the array of health and well-being benefits to be gained from regular PA, most people with SCI live insufficiently active lifestyles with an estimated 50% completely sedentary.…”

Exercise and Neurologic Disease

“…Various neuro-rehabilitative approaches are utilized to promote plasticity and assist recovery. 77 Future work should address the influence of time since injury on the impact of exercise in spinal cord injury, as compensatory measures will likely develop over a period of months to years. This is followed by active exercises to promote plasticity both caudal and rostral to the lesion level.…”