An examination of the relationships between neuropathic pain, exercise and affect in adults with spinal cord injury

Purpose: Neuropathic pain affects up to 75% of individuals with a spinal cord injury (SCI), with many reporting pain as more disabling than the injury itself. Currently, treatments are primarily pharmaceutical, however exercise may alleviate neuropathic pain. Daily fluctuations in neuropathic pain are not well understood, specifically in relation to exercise participation. Additionally, the connection between exercise and affective mood states of adults with SCI is unclear. The purpose of this study was to utilize ecological momentary assessment to measure intra-individual diurnal variations in neuropathic pain sensations and affect. This study aimed to provide a deeper understanding of how neuropathic pain and affect change from pre- to post-exercise, and over time. Methods: Six physically active adults with SCI participated in a 6-day study protocol. They responded to six daily prompts between 9:00 AM and 9:00 PM, and before and after exercising, using the Smartphone application mEMA. The prompts required participants to answer the Feeling Scale, Felt Arousal Scale, and a modified version of the Neuropathic Pain Scale. Neuropathic pain scores were averaged into a composite score and data were analyzed by plotting neuropathic pain and affective scores over the 6 days. Paired samples t-tests were conducted to observe changes in neuropathic pain and affect from pre- to post-exercise. Bivariate Pearson’s correlational analyses were performed to observe if correlations existed between time of day, neuropathic pain and affect within-subjects. Results: Overall, participants experienced a significant decrease in neuropathic pain (t(5) = 3.93; p=0.011) following completion of at least one bout of exercise. However, two participants experienced an increase in neuropathic pain following one bout of exercise. With regards to affect, a large, but non-significant increase (Hgav=0.76) in Feeling Scale scores occurred following one bout of exercise. Changes in arousal were non-significant following exercise. Time of day, neuropathic pain and affect were significantly correlated for one participant. Conclusion: These results suggest that exercise can reduce neuropathic pain, and may also increase feelings of pleasure. Further research is needed to look at both individual characteristics, and characteristics of exercise that may moderate exercise-induced changes in neuropathic pain and affect for adults with SCI.Graduate Studies, College of (Okanagan)Graduat