Key result
A single bout of aerobic or resistance exercise elicited abnormal autonomic responses, such as sympathetic activation and parasympathetic withdrawal, in patients with chronic musculoskeletal pain, though long-term exercise effects were inconsistent.
Why the study?
It was unknown whether patients with chronic musculoskeletal pain show autonomic dysregulation after exercise, and the interventional effects of exercise on this dysregulation had not been elucidated.
Does aerobic and resistance exercise alter autonomic nervous system responses in patients with chronic musculoskeletal pain?
Systematic Review (n=617)
Does aerobic and resistance exercise alter autonomic nervous system responses in patients with chronic musculoskeletal pain?
Patients with chronic musculoskeletal pain exhibit dysfunctional autonomic responses following a single bout of exercise, highlighting the need to carefully manage therapeutic exercise doses.
Clinicians should monitor autonomic responses during initial exercise in chronic musculoskeletal pain; confirms acute dysregulation but leaves long-term adaptation unresolved.
BACKGROUND: It is unknown whether patients with chronic musculoskeletal pain (CMP) show autonomic dysregulation after exercise, and the interventional effects of exercise on the autonomic dysregulation have not been elucidated. The objectives of this study were to reveal acute autonomic responses after aerobic and resistance exercises and the interventional effects of both exercises on autonomic dysregulation in patients with CMP. METHODS: A systematic search using nine electronic databases was performed based on three key search terms: "chronic musculoskeletal pain," "autonomic nervous system," and "exercise." Data were extracted from measurements of the autonomic nervous system and pain. RESULTS: We found a total of 1170 articles; 17 were finally included, incorporating 12 observational and five interventional studies. Although a comparator has not been specified, healthy controls were compared to patients with CMP in observational studies. Three of five interventional studies were pre-post study with healthy controls as a comparator or no controls. The other two interventional studies were randomized controlled trial with a different treatment e.g., stretching. There were four good, 10 fair, and three poor-quality articles. The total number of participants was 617, of which 551 were female. There was high heterogeneity among the five disease conditions and nine outcome measures. Following one-time exposure to aerobic and resistance exercises, abnormal autonomic responses (sympathetic activation and parasympathetic withdrawal), which were absent in healthy controls, were observed in patients with CMP. The effects of aerobic and resistance exercise as long-term interventions were unclear since we identified both positive effects and no change in the autonomic activities in patients with CMP. CONCLUSIONS: This study indicates dysfunctional autonomic responses following one-time exposure to exercise and inconsistent interventional effects in the autonomic activities in patients with CMP. Appropriate therapeutic dose is necessary for studying the management of autonomic regulation and pain after exercise.
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Uzawa et al. (2023) conducted a systematic review in Chronic musculoskeletal pain (n=617). Aerobic and resistance exercise vs. Healthy controls, no intervention, or alternative treatment (e.g., stretching) was evaluated on Autonomic nervous system responses (e.g., heart rate variability, heart rate recovery, muscle sympathetic nervous activity). A single bout of aerobic or resistance exercise elicited abnormal autonomic responses, such as sympathetic activation and parasympathetic withdrawal, in patients with chronic musculoskeletal pain, though long-term exercise effects were inconsistent.
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