Influence of an individualized physical exercise program on the endogenous pain modulation profile and on the psychosocial and behavioral aspects in patients with chronic myofascial masticatory pain: a controlled randomized clinical trial

• Grant number: 20/02479-5
• Support Opportunities: Regular Research Grants
• Start date: April 01, 2021
• End date: March 31, 2024
• Field of knowledge: Health Sciences - Dentistry - Dental Clinics
• Principal Investigator: Paulo César Rodrigues Conti
• Grantee: Paulo César Rodrigues Conti
• Host Institution: Faculdade de Odontologia de Bauru (FOB). Universidade de São Paulo (USP). Bauru , SP, Brazil

Abstract

The relationship between physical exercise and chronic pain has been considered for long time. It is hypothesized that a regular practice of physical exercise would have a beneficial effect in the control of chronic pain as adjunct. However, there is still not enough data to explain this relationship, specifically in patients with chronic masticatory myofascial pain (CMMP). One of the ways to measure such an impact is through changes in the endogenous pain modulation profile (PMP), determined by methods that use tests for inhibition and excitation of painful stimuli. Still, it tries to understand which is the best measurement technique for these methods and whether alternative modalities are capable of altering this modulatory profile. The general aim of this randomized clinical trial is to evaluate the variation in PMP among healthy individuals with CMMP after a controlled and individualized program of aerobic physical exercise in the short and medium term. In addition, using different techniques for determining the values of conditioned pain modulation (CPM), and finally compare alternative techniques, such as controlled exposure to videos with pleasant sounds, for analgesic potential. The sample will have 80 volunteers (40 with DMMC and 40 asymptomatic) who will be randomly and confidentially allocated into 4 groups: 2 experimental groups (20 individuals with DMMC and 20 asymptomatic) who will perform a physical exercise program controlled by heart rate and VO2max for a 5-month period and 2 control groups (20 individuals with DMMC and 20 asymptomatic) who will not perform the exercise program. During the initial evaluations, different PMP determination techniques will be compared, changing the conditioning stimuli of the tests. Participants will answer questionnaires on psychosocial and behavioral aspects. At all times of the research (baseline and 1, 2, 3, 4 and 5 months) for all participants, the BMI, VO2max, Pressure Pain Threshold (PPT) of masseter or temporal muscle and pain level will be measured (the PMP and questionnaires will be applied again after 3 months and at the end of the research). ANOVA tests 3 criteria and repeated measures will be carried out, and Pearson's correlation test (significance level 5%). (AU)