Neuroendocrine effects of a single bout of functional and core stabilization training in women with chronic nonspecific low back pain: A crossover stud

Abstract

Exercise-induced hypoalgesia (EIH) is characterized as the pain reduction after an exercise session and it seems to be related to the release of plasma ¿-endorphin. In this sense, the core stabilization training (CT) has been suggested for patients with chronic nonspecific low back pain (CNSLBP), but it is unclear whether it induces EIH. Patients with CNSLBP have neuromotor dysfunctionsthat can affect the perfor mance of functional tasks, thus, performing functional training (FT) could improve motor control and promote EIH, since functional training uses multi-joint exercises that aim to improve the functionality of actions performed in daily life. EIH is usually assessed using quantitative sensory tests (QST) such as conditioned pain modula tion, pressure pain threshold, and temporal summation. Thus, the sum of param etersfrom quantitative sensory tests and plasma ¿-endorphin would make it possible to understand what the neuroendocrine effects of FT and CT session are. Our study compared the acute effect of CT and FT on the EIH and plasma ¿-endorphin release, and correlated plasma ¿-endorphin with quantitative sensory testing in patients with CNSLBP. Eighteen women performed two training sessions (CT and FT) with an interval of 48h between sessions. EIH was assessed by QST and plasma ¿-endorphin levels. Results showed that only FT significantly increased plasma ¿-endorphin (FT p<0.01; CT p = 0.45), which correlated with pain pressure threshold (PPT) and con ditioned pain modulation (CPM). However, QST values were not different in women with CNSLBP after CT or FT protocols. Plasma ¿-endorphin correlated with PPT and CPM, however, the same did not occur with a temporal summation. KEYWORDS activities of daily living, analgesia, exercise, opioid peptides, pain, spine