Abstract
Purpose
Exercise decreases pain sensitivity known as exercise-induced hypoalgesia (EIH). However, the consistency of EIH after an acute exercise protocol based on subjective ratings of perceived exertion has been questioned. Objectives were to compare the effect on pressure pain thresholds (PPTs) after bicycling with work-rate at the lactate threshold compared with quiet rest, and investigate between-session reliability of EIH.
Methods
Thirty-four healthy subjects completed three sessions with 7 days in-between. In session 1, the lactate threshold was determined via blood samples (finger-tip pinprick, > 2 mmol/l increase from warm-up) during a graded bicycling task. In session 2 and 3, all subjects performed (1) 15 min quiet-rest, and (2) 15 min bicycling (work-rate corresponding to the lactate threshold) in the two identical sessions. PPTs at the quadriceps and trapezius muscles were assessed before and after both conditions. Reliability was assessed by intraclass correlations (ICCs).
Results
Bicycling increased quadriceps PPT compared with quiet-rest in both sessions [mean difference: 45 kPa (95% CI 19–72 kPa), P = 0.002]; however, the increase in trapezius PPT was not significant after exercise. The EIH responses demonstrated fair between-session test–retest reliability (quadriceps: ICC = 0.45; trapezius: ICC = 0.57, P < 0.05), and agreement in EIH responders and non-responders between sessions was significant (quadriceps: κ = 0.46 and trapezius: κ = 0.43, P < 0.05).
Conclusions
In conclusion, bicycling at the lactate threshold increased PPT at the exercising muscle with fair reliability of the local EIH response. The results have implications for future EIH studies in subjects with and without pain and for clinicians who design exercise programs for pain relief.
Similar content being viewed by others
Abbreviations
- BMI:
-
Body mass index
- CI:
-
Confidence interval
- CPM:
-
Conditioned pain modulation
- EIH:
-
Exercise-induced hypoalgesia
- ICC:
-
Intraclass correlation coefficient
- kPa:
-
Kilopascal
- [La-]b :
-
Blood-lactate concentration
- NRS:
-
Numerical rating scale
- PPT:
-
Pressure pain threshold
- RM-ANOVA:
-
Repeated-measures analysis of variance
- RPE:
-
Rating of perceived exertion
- RPM:
-
Rounds per minute
- SEM:
-
Standard error of measurement
- VO2max :
-
Maximum rate of oxygen consumption
References
Balaguier R, Madeleine P, Vuillerme N (2016) Is one trial sufficient to obtain excellent pressure pain threshold reliability in the low back of asymptomatic individuals? A test-retes study. PLoS One 11(8):e0160866
Bentley DJ, Newell J, Bishop D (2007) Incremental exercise test design and analysis: implications for performance diagnostics in endurance athletes. Sports Med 37(7):575–586
Bonaventura JM, Sharpe K, Knight E, Fuller KL, Tanner RK, Gore CJ (2015) Reliability and accuracy of six hand-held blood lactate analysers. J Sports Sci Med 14(1):203–214
Buono MJ, Yeager JE (1986) Intraerythrocyte and plasma lactate concentrations during exercise in humans. Eur J Appl Physiol Occup Physiol 55(3):326–329
Coyle EF, Martin WH, Ehsani AA et al (1983) Blood lactate threshold in some well-trained ischemic heart disease patients. J Appl Physiol Respir Environ Exerc Physiol 54(1):18–23
Ellingson LD, Koltyn KF, Kim JS, Cook DB (2014) Does exercise induce hypoalgesia through conditioned pain modulation? Psychophysiology 51(3):267–76
Fingleton C, Smart K, Doody C (2017) Exercise-induced hypoalgesia in people with knee osteoarthritis with normal and abnormal conditioned pain modulation. Clin J Pain 33(5):395–404
Graven-Nielsen T, Vaegter HB, Finocchietti S, Handberg G, Arendt-Nielsen L (2015) Assessment of musculoskeletal pain sensitivity and temporal summation by cuff pressure algometry: A reliability study. Pain 156(11):2193–2202
Heck H, Mader A, Hess G, Mücke S, Müller R, Hollman W (1985) Justification of the 4-mmol/l lactate threshold. Int J Sports Med 6:117–130
Hoeger Bement MK, Rasiarmos RL, DiCapo JM (2009) The role of the menstrual phase in pain perception before and after an isometric fatiguing contraction. Eur J Appl Physiol 106(1):105–112
Hoffman MD, Shepanski MA, Ruble SB, Valic Z, Buckwalter JB, Clifford PS (2004) Intensity and duration threshold for aerobic exercise-induced analgesia to pressure pain. Arch Phys Med Rehabil 85(7):1183–1187
Jacobs RA, Rasmussen P, Siebenmann C et al (2011) Determinants of time trial performance and maximal incremental exercise in highly trained endurance athletes. J Appl Physiol 111(5):1422–1430
Kindermann W, Simon G, Keul J (1979) The significance of the aerobic-anaerobic transition for the determination of work load intensities during endurance training. Eur J Appl Physiol Occup Physiol 42(1):25–34
Koltyn KF, Trine MR, Stegner AJ, Tobar DA (2001) Effect of isometric exercise on pain perception and blood pressure in men and women. Med Sci Sports Exerc 33(2):282–290
Kosek E, Lundberg L (2003) Segmental and plurisegmental modulation of pressure pain thresholds during static muscle contractions in healthy individuals. Eur J Pain 7(3):251–258
Kosek E, Ekholm J, Hansson P (1996) Modulation of pressure pain thresholds during and following isometric contraction in patients with fibromyalgia and in healthy controls. Pain 64(3):415–423
Lannersten L, Kosek E (2010) Dysfunction of endogenous pain inhibition during exercise with painful muscles in patients with shoulder myalgia and fibromyalgia. Pain 151(1):77–86
Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150(3699):971–979
Micalos PS, Marino FE, Kay D (2004) Reduced muscle pain intensity rating during repeated cycling trials. J Sports Sci Med 3(2):70–75
Naugle KM, Naugle KE, Fillingim RB, Samuels B, Riley (2014) JL 3rd. Intensity thresholds for aerobic exercise-induced hypoalgesia. Med Sci Sports Exerc 46(4):817–825
Nielsen MM, Mortensen A, Sorensen JK, Simonsen O, Graven-Nielsen T (2009) Reduction of experimental muscle pain by passive physiological movements. Man Ther 14(1):101–109
Riley JL 3rd, Robinson ME, Wise EA, Price DD (1999) A meta-analytic review of pain perception across the menstrual cycle. Pain 81(3):225–235
Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428
Sjodin B, Jacobs I (1981) Onset of blood lactate accumulation and marathon running performance. Int J Sports Med 2(1):23–26
Stegmann H, Kindermann W, Schnabel A (1981) Lactate kinetics and individual anaerobic threshold. Int J Sports Med 2(3):160–165
Sternberg WF, Bokat C, Kass L, Alboyadjian A, Gracely RH (2001) Sex-dependent components of the analgesia produced by athletic competition. J Pain 2(1):65–74
Vaegter HB, Handberg G, Graven-Nielsen T (2014) Similarities between exercise-induced hypoalgesia and conditioned pain modulation in humans. Pain 155(1):158–167
Vaegter HB, Handberg G, Jorgensen MN, Kinly A, Graven-Nielsen T (2015) Aerobic exercise and cold pressor test induce hypoalgesia in active and inactive men and women. Pain Med 16(5):923–933
Vaegter HB, Handberg G, Graven-Nielsen T (2016) Hypoalgesia after exercise and the cold pressor test is reduced in chronic musculoskeletal pain patients with high pain sensitivity. Clin J Pain 32(1):58–69
Vaegter HB, Handberg G, Emmeluth C, Graven-Nielsen T (2017) Preoperative hypoalgesia after cold pressor test and aerobic exercise is associated with pain relief six months after total knee replacement. Clin J Pain 33(6):475–484
Vaegter HB, Dorge DB, Schmidt KS, Jensen AH, Graven-Nielsen T (2018a) Test–retest reliabilty of exercise-induced hypoalgesia after aerobic exercise. Pain Med (Epub ahead of print)
Vaegter HB, Lyng KD, Yttereng FW, Christensen MH, Sørensen MB, Graven-Nielsen T (2018b). Exercise-induced hypoalgesia after isometric wall squat exercise: a test-retest reliability study. Pain Med (Epub ahead of print)
Wasserman K, Whipp BJ, Koyl SN, Beaver WL (1973) Anaerobic threshold and respiratory gas exchange during exercise. J Appl Physiol 35(2):236–243
Weir JP (2005) Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res 19(1):231–240
Funding
No funding was received for this study. TGN is a part of Center for Neuroplasticity and Pain (CNAP) supported by the Danish National Research Foundation (DNRF121).
Author information
Authors and Affiliations
Contributions
HBV, LKB, M-MR, SHR, and TG-N: All authors contributed to the design of the study, the analysis and interpretation of the data, as well as making intellectual contributions to its content. HBV, LKB, M-MR, and SHR collected all data in the laboratory. All authors approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
There are no actual or potential conflicts of interest for any of the authors.
Additional information
Communicated by Bénédicte Schepens.
Rights and permissions
About this article
Cite this article
Vaegter, H.B., Bjerregaard, L.K., Redin, MM. et al. Hypoalgesia after bicycling at lactate threshold is reliable between sessions. Eur J Appl Physiol 119, 91–102 (2019). https://doi.org/10.1007/s00421-018-4002-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-018-4002-0