Perception of Pain and Exertion During Exercise on a Cycle Ergometer in Chronic Pain Patients

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Abstract
Chronic pain patients (CPP) are generally thought to present with reduced fitness in relation with pain enhancement during exercise. A distortion of exertion perception may coexist, which could lead CPP to reduce physical activities. Case-control study, with a nonrandomized consecutive sample that was age matched. A Chronic Pain Unit in a Multidisciplinary Pain Center of a university hospital in a city of > 1,000,000 inhabitants. 42 CPP referred for evaluation and 34 controls (staff members and relatives). Fitness index and exertion perception index was obtained by a cycle ergometer test. Trend analysis was performed on pain scores reported on a visual analogue scale during exertion. Male CPP mean fitness index was found to be significantly reduced. No difference in exertion perception was found between groups. Trend analysis of reported pain revealed that 49% of CPP showed a positive trend, 5% a negative trend, and 46% showed no significant trend as exercise intensity increased. There was no significant relation between type of trend and fitness nor exertion perception index. Only male CPP have a reduced work capacity. Exertion perception seems normal among CPP. The possible distortion of exertion perception as a causal factor in the reduced fitness of CPP has to be rejected. Lack of significant correlation between type of trend of pain while exercising on a cycle ergometer and fitness index shows that one should be careful in proposing that reduced fitness is only related to pain enhancement during exercise in CPP.

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