Objective: To investigate if exercise-induced analgesia (EIA) is present in people with Parkinson’s disease (PD) compared to an age-matched control group.

Background: Pain is a troubling symptom experienced by up to 85% of people with PD. Expert opinion often recommends exercise as one component of a pain management program. In the general population exercise is known to have analgesic effects, known as exercise induced analgesia (EIA). However, some people with pain-related conditions (e.g. fibromyalgia) experience an exacerbation of pain symptoms following exercise. It is unclear if people with PD experience EIA or exacerbation of pain symptoms following exercise.

Methods: Cognitively intact people with idiopathic PD with and without pain were assessed while ON medication, along with a pain-free, age-matched, control group. Pain was assessed using the King’s PD Pain Scale. Pressure pain thresholds were measured over both biceps brachii and quadriceps muscles before and after isometric exercise. The exercise was 3 maximum voluntary contractions (MVC) of the right elbow flexors followed by a 3-minute sustained contraction at 40% of the highest MVC.

Results: Preliminary results from 26 participants with PD (age 67.0, SD 8.3; 16 male) and 11 controls (age 64.7, SD 11.2; 5 male) are presented. Participants with PD had a mean MDS-UPDRS motor score of 33.8 (SD 12.3) and a mean King’s PD Pain Scale score of 12.7 (SD 10.0). Paired samples t-tests demonstrated significantly increased pressure pain thresholds in both groups in all locations following the exercise bout.

Pressure pain thresholds (N/cm²) before and after isometric right elbow flexor exercise

Location	PD pre-exercise mean (SD)	PD post-exercise mean (SD)	95% CI (p value) for change in threshold	Control pre-exercise mean (SD)	Control post-exercise mean (SD)	95% CI (p value) for change in threshold
Right bicep	19.0 (11.5)	24.4 (15.7)	2.3 – 8.6 (p=0.002)	18.9 (7.6)	26.0 (12.3)	0.5 – 13.8 (p=0.04)
Left bicep	18.6 (10.2)	23.6 (14.6)	2.6 – 7.4 (p<0.001)	18.8 (7.1)	23.3 (9.6)	0.3 – 8.7 (p=0.04)
Quadriceps (mean of right and left)	46.6 (21.3)	54.2 (24.9)	4.5 – 10.6 (p<0.001)	47.0 (18.9)	53.2 (20.3)	2.6 – 9.8 (p=0.003)

PD = Parkinson’s disease; SD = standard deviation; CI = confidence interval Independent samples t-tests showed that there were no significant differences between the PD and control group with respect to changes in pressure pain threshold. Pressure pain thresholds over the right biceps muscle increased by 28% in the PD group and 38% in the control group after the exercise bout.

Conclusions: People with PD experience similar EIA responses to people without PD. Further research is warranted to investigate EIA with alternative modes of exercise as well as potential longer term analgesic effects.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/exercise-induced-analgesia-is-present-in-people-with-parkinsons-disease/