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  4. The Role of Exercise in the Alleviation of Neuropathic Pain Following Traumatic Spinal Cord Injuries: A Systematic Review and Meta-analysis

The Role of Exercise in the Alleviation of Neuropathic Pain Following Traumatic Spinal Cord Injuries: A Systematic Review and Meta-analysis

Neurospine, 2023 · DOI: https://doi.org/10.14245/ns.2346588.294 · Published: September 1, 2023

Spinal Cord InjuryPain ManagementRehabilitation

Simple Explanation

Neuropathic pain, a common issue after spinal cord injury (SCI), involves heightened sensitivity to stimuli. Current treatments offer only temporary relief, leading researchers to explore alternative strategies like exercise therapy. This study investigates whether exercise can effectively reduce neuropathic pain following traumatic SCI. By analyzing existing research, the review aims to provide a comprehensive understanding of exercise's role in pain management for SCI patients. The results suggest that exercise is indeed effective in alleviating neuropathic pain in animal models of SCI. Specifically, voluntary, continuous training initiated in the subacute phase of mild SCI shows more prominent effects.

Study Duration
Not specified
Participants
Fifteen preclinical studies (animal models)
Evidence Level
Systematic Review and Meta-analysis

Key Findings

  • 1
    Exercise significantly improves mechanical allodynia, thermal hyperalgesia, and cold allodynia in rodent models of SCI.
  • 2
    The improvement in mechanical allodynia is significantly more pronounced in animals with a compression model of SCI and in mild SCI.
  • 3
    The improvement was more prominent if the training was started 7 to 8 days postinjury and was continued every day, and if exercise was voluntary.

Research Summary

This systematic review and meta-analysis aimed to assess the efficacy of exercise in neuropathic pain following traumatic spinal cord injuries. The meta-analysis of preclinical studies demonstrated that exercise significantly improves mechanical allodynia, thermal hyperalgesia, and cold allodynia in animal models of SCI. The review concludes that continuous voluntary exercise initiated in the subacute phase of moderate to severe SCI is strongly associated with the amelioration of neuropathic pain in rodents.

Practical Implications

Rehabilitation Strategies

Early and continuous exercise programs, especially voluntary ones, should be integrated into SCI rehabilitation to manage neuropathic pain.

Timing of Intervention

Initiating exercise in the subacute phase (7-8 days post-injury) may yield better outcomes in reducing mechanical allodynia.

Exercise Type

Voluntary exercises should be prioritized over forced exercises due to their greater effect on neuropathic pain reduction.

Study Limitations

  • 1
    The search in human studies resulted in no eligible articles.
  • 2
    Risk of bias in all RCTs was considered high.
  • 3
    Low number of included experiments for some subgroups.

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