The unique and transient impact of acute exercise on pain perception in older, overweight, or obese adults with knee osteoarthritis

This study examined the unique contribution of acute exercise to perceptions of pain in 32 older, overweight, or obese adults with knee osteoarthritis (OA), statistically controlling for the effect of diurnal variation, supplemental medication intake, and stress. Using an ecological momentary assessment method, 964 pain appraisals were recorded and coded into experience samplings that occurred either on a nonexercise day or before or following scheduled activity on an exercise day. Univariate and multivariate multilevel modeling analyses controlling for supplemental medication intake and stress revealed a quadratic trend in diurnal pain variations with the peak occurring mid-afternoon. Although pain was significantly elevated following exercise in comparison with the predicted diurnal pattern, pain reports later in the day following exercise were significantly lower than immediately following exercise. We conclude that the pain associated with acute exercise by older, overweight, or obese adults who have knee OA is transient. Findings are discussed in terms of the implications of exercise therapy for patients with knee OA.

[1]  J. Kellgren,et al.  Osteo-arthrosis and Disk Degeneration in an Urban Population * , 1958, Annals of the rheumatic diseases.

[2]  Simon Folkard,et al.  Diurnal variation and individual differences in the perception of intractable pain. , 1976 .

[3]  Richard J. Haier,et al.  Naloxone alters pain perception after jogging , 1981, Psychiatry Research.

[4]  M. Knapp,et al.  Domiciliary self-measurement in the rheumatoid arthritis and the demonstration of circadian rhythmicity. , 1982, Annals of the rheumatic diseases.

[5]  T. Huopaniemi,et al.  The influence of exercise on dental pain thresholds and the release of stress hormones , 1984, Physiology & Behavior.

[6]  W. Clark,et al.  Pain sensitivity, mood and plasma endocrine levels in man following long-distance running: Effects of naloxone , 1984, Pain.

[7]  A. Reinberg,et al.  Timing optimizes sustained‐release indomethacin treatment of osteoarthritis , 1985, Clinical pharmacology and therapeutics.

[8]  E. Braunwald,et al.  Circadian variation in the frequency of onset of acute myocardial infarction. , 1985, The New England journal of medicine.

[9]  S. Andersson,et al.  Effects of naloxone on dental pain threshold following muscle exercise and low frequency transcutaneous nerve stimulation: a comparative study in man. , 1986, Acta physiologica Scandinavica.

[10]  J. Nunley,et al.  Osteoarthritic knee pain: a behavioral analysis , 1987, Pain.

[11]  N. Bellamy,et al.  Rhythmic variations in pain perception in osteoarthritis of the knee. , 1990, The Journal of rheumatology.

[12]  J. Neuhaus,et al.  Knee osteoarthritis and physical functioning: evidence from the NHANES I Epidemiologic Followup Study. , 1991, The Journal of rheumatology.

[13]  M. Greenlee,et al.  Experimental pain thresholds and plasma beta-endorphin levels during exercise. , 1991, Medicine and science in sports and exercise.

[14]  M. Segal,et al.  Correlates of knee pain among US adults with and without radiographic knee osteoarthritis. , 1992, The Journal of rheumatology.

[15]  W. Jack Rejeski,et al.  The Exercise-Induced Feeling Inventory: Development and Initial Validation , 1993 .

[16]  J. Jaccard,et al.  Statistical analysis of temporal data with many observations: Issues for behavioral medicine data. , 1993 .

[17]  D. Pendergast,et al.  Effects of a muscle exercise program on exercise capacity in subjects with osteoarthritis. , 1994, Archives of physical medicine and rehabilitation.

[18]  M. M. Ward,et al.  Temporal stability of ambulatory cardiovascular reactivity. , 1994 .

[19]  S. Shumaker,et al.  Knee osteoarthritis and health-related quality of life. , 1994, Medicine and science in sports and exercise.

[20]  G. Affleck,et al.  Person and contextual features of daily stress reactivity: individual differences in relations of undesirable daily events with mood disturbance and chronic pain intensity. , 1994, Journal of personality and social psychology.

[21]  G Labrecque,et al.  Biological rhythms in pain and in the effects of opioid analgesics. , 1995, Pharmacology & therapeutics.

[22]  W. Ettinger,et al.  The evaluation of pain in patients with knee osteoarthritis: the knee pain scale. , 1995, The Journal of rheumatology.

[23]  Rejeski Wj,et al.  Physical Activity and Health‐related Quality of Life , 1996, Exercise and sport sciences reviews.

[24]  K. Koltyn,et al.  Perception of pain following aerobic exercise. , 1996, Medicine and science in sports and exercise.

[25]  R. Eldar,et al.  A community-oriented programme for rehabilitation of persons with arthritis. , 1996, Disability and rehabilitation.

[26]  R. Lousberg,et al.  Within-person relationships among pain intensity, mood and physical activity in chronic pain: a naturalistic approach , 1997, Pain.

[27]  W. Ettinger,et al.  Compliance to exercise therapy in older participants with knee osteoarthritis: implications for treating disability. , 1997, Medicine and science in sports and exercise.

[28]  S Folkard,et al.  Complex interaction of the sleep-wake cycle and circadian phase modulates mood in healthy subjects. , 1997, Archives of general psychiatry.

[29]  W. Applegate,et al.  A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). , 1997, JAMA.

[30]  A. Stone,et al.  The experience of rheumatoid arthritis pain and fatigue: examining momentary reports and correlates over one week. , 1997, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[31]  A. Stone,et al.  Strategies for analyzing ecological momentary assessment data. , 1998, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[32]  K. Koltyn,et al.  Perception of pain after resistance exercise. , 1998, British journal of sports medicine.

[33]  G. Borg.  Borg's Perceived Exertion and Pain Scales , 1998 .

[34]  W. Ettinger,et al.  Treating disability in knee osteoarthritis with exercise therapy: a central role for self-efficacy and pain. , 1998, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[35]  S. Kashikar-Zuck,et al.  Everyday life with osteoarthritis or rheumatoid arthritis: independent effects of disease and gender on daily pain, mood, and coping , 1999, PAIN®.

[36]  G. Affleck,et al.  The relationship of arthritis self-efficacy to daily pain, daily mood, and daily pain coping in rheumatoid arthritis patients , 1999, Pain.

[37]  D. Cook,et al.  Exercise and pain: the neurobiology, measurement, and laboratory study of pain in relation to exercise in humans. , 1999, Exercise and sport sciences reviews.

[38]  D. Cook,et al.  Pain and exercise. , 2000 .

[39]  A. Diez-Roux.  Multilevel analysis in public health research. , 2000, Annual review of public health.

[40]  G. Affleck,et al.  The relationship of daily mood and stressful events to symptoms in juvenile rheumatic disease. , 2000, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[41]  R. Kushner,et al.  Obesity and quality of life. , 2000, Nutrition.

[42]  B. Reboussin,et al.  Contributions of acute bouts of vigorous physical activity to explaining diurnal variations in feeling states in active, middle-aged women. , 2000, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[43]  A. McLeod,et al.  Multivariate multilevel models , 2001 .