The following is a summary of “Exercise-induced changes in central sensitization outcomes in individuals with chronic musculoskeletal pain: A systematic review with meta-analysis,” published in the April 2024 issue of Pain by Chen et al.
Despite temporal summation of pain (TSP) and conditioned pain modulation (CPM) being standard measures of central sensitization (CS), their response to exercise interventions remains unclear.
Researchers conducted a retrospective study examining whether exercise alone improves CS markers in people with chronic musculoskeletal pain.
They conducted a systematic review and meta-analysis, searching MEDLINE, EMBASE, CINAHL, PEDro, and Cochrane databases. Data were extracted and categorized by exercise modality (aerobic, resistance, isometric, or motor control). The risk of bias was evaluated using RoB2, RoB2 for crossover trials, and ROBINS-I tools. GRADE assessed the quality of evidence. Random-effects meta-analyses were performed, including subgroup analysis for each exercise modality.
The results showed 13 studies, including 8 non-randomized studies, 3 RCTs, and 3 randomized crossover trials. Data were grouped into four subgroups based on exercise modality. Neither TSP nor conditioned pain modulation exhibited statistically significant effects. However, motor control exercise significantly enhanced conditioned pain modulation. No significant disparities were observed between exercise subgroups for TSP and conditioned pain modulation.
Investigators concluded that while exercise lacked a significant effect on pain sensitivity, motor control exercise showed promise for chronic neck pain. This highlights the need for targeted research on exercise modalities and mechanisms.