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Marc-Olivier St-Aubin, Philippe Chalaye, François-Pierre Counil and Sylvie Lafrenaye

to contribute to the reduction of pain sensations following physical activity. Cardiovascular responses (changes in blood pressure and heart rate) to acute physical activity could also be related to exercise-induced analgesia (EIA) ( 22 ). However, it is currently not known how the habitual physical

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Kelli F. Koltyn

Chronic pain is a significant problem for many older adults. Strategies for pain management appear to be limited, with the prescription of analgesic medication used most often to treat pain. Older adults, however, are often sensitive to adverse side effects from analgesic medications, so nonpharmacological strategies for treating pain are receiving increased attention. This review article summarizes results from studies that have examined whether improvements in pain occur after an exercise intervention. Limited research has been conducted, and it can be characterized as both experimental and quasi-experimental. In addition, pain has usually been a secondary variable assessed in conjunction with a number of other variables. Results from most studies indicate that improvement in pain can occur after exercise training, but several investigators did not find changes in pain after an exercise-training program. Even less research has been conducted with older adults residing in assisted-care facilities, and this research is limited by small sample sizes.

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Paula Chaves, Daniela Simões, Maria Paço, Sandra Silva, Francisco Pinho, José Alberto Duarte and Fernando Ribeiro

inducing better outcomes. To test this hypothesis, this study aims to assess whether the immediate effects of DFM on clinical outcomes, namely pain (pain intensity upon palpation and time to onset of analgesia), and muscle strength are dependent on the pressure applied during the DFM application in

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Karl Fullam, Brian Caulfield, Garrett F. Coughlan, Wayne McNulty, David Campbell and Eamonn Delahunt

One of the purported benefits of cryotherapy is the ability of this therapeutic modality to induce analgesia. 1 , 2 Cryotherapy is, therefore, regularly used as an immediate treatment for pain relief following acute injuries, potentially allowing athletes who incur minor sprains or contusions to

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Athanasios Trampas, Anastasia Mpeneka, Vivian Malliou, George Godolias and Periklis Vlachakis


Previous studies showed improved dynamic-balance (DB) performance after core-stability (CS) exercises in populations with chronic low back pain. Although clinical massage plus exercise is likely to better enhance analgesia than exercise alone, its efficacy on balance remains unclear.


To evaluate the immediate effects of CS exercises plus myofascial trigger-point (MTrP) therapy in comparison with CS exercises alone on DB performance, pressure-pain threshold (PPT), and cross-sectional area of active MTrPs in patients with clinical instability of the lumbar spine and chronic myofascial pain syndrome.


Randomized, assessor-blind, test–retest.


University research laboratory.


10 physically active adults (5 men, 5 women).

Main Outcome Measures:

Single-leg DB performance and side-to-side ratios in 2 planes of motion (frontal, sagittal), as well as PPT and cross-sectional area of active MTrPs, were measured using stabilometry, pressure algometry, and real-time ultrasound scanning, respectively.


The 1st group performed CS exercises alone, whereas the same exercise program was applied in the 2nd group plus cross-fiber friction on active MTrPs (3.5 min/MTrP).


Within-group statistically and clinically significant differences were observed only for group II in PPT. However, group I also exhibited a large effect size with clinically significant changes from baseline on this outcome. Furthermore, patients in group II clinically improved their balance ratios and differed from group I at posttest in sagittal-plane DB performance of the painful side.


CS exercises immediately increase the PPT of active MTrPs in physically active adults with clinical instability of the lumbar spine and chronic myofascial pain syndrome. When MTrP therapy is added, side-to-side asymmetries in DB are minimized.

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Jennifer Ostrowski, Angelina Purchio, Maria Beck and JoLynn Leisinger

the greatest decrease from baseline. Previous research has suggested that skin temperature less than 13.6°C is needed to induce localized analgesia, less than 12.5°C to reduce nerve conduction velocity, and between 10°C and 11°C to lower metabolic enzyme activity by 50%. 17 Other research has found

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Blaine C. Long

hyperstimulation analgesia and blood flow changes. Hyperstimulation analgesia is the purported blockage of superficial pain by intense stimulation or counterirritation. 4 It is suggested that this form of pain relief occurs through dry needling and needle electrical intramuscular stimulation, 28 and appears to

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Jennifer Ostrowski, Angelina Purchio, Maria Beck, JoLynn Leisinger, Mackenzie Tucker and Sarah Hurst

temperature, nerve conduction velocity decreases by approximately 0.4 m/s. 25 Given the 3.5-times greater decrease in skin temperature with PP-ice versus PP-gel, it can be assumed that PP-ice is better able to decrease nerve conduction velocity and induce localized analgesia. However, skin temperature is

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Josep C. Benítez-Martínez, Pablo Martínez-Ramírez, Fermín Valera-Garrido, Jose Casaña-Granell and Francesc Medina-Mirapeix

10.1111/j.1600-0838.2005.00466.x 15998342 18. Rio E , Kidgell D , Purdam C , et al . Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy . Br J Sports Med . 2015 ; 49 ( 19 ): 1277 – 1283 . PubMed ID: 25979840 doi:10.1136/bjsports-2014-094386 25979840 10

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Neil Maguire, Paul Chesterton and Cormac Ryan

of screening serious or potentially sinister pathologies. 13 Signs and symptoms for such pathologies include history of cancer, systemic symptoms such as fever or unexplained weight loss, and saddle analgesia. The use of red flag screening is advocated by the National Institute for Health and Care