Open Collections

Todd, Kendra Robyn

University of British Columbia

Neuropathic pain impacts approximately 58% of persons with spinal cord injury (SCI) and is often considered to be more debilitating than paralysis. Current treatments are primarily pharmaceutical, despite the negative side effects that often occur. Individuals who experience greater levels of neuropathic pain often report poorer subjective well-being (SWB). Persons with SCI who experience neuropathic pain have identified the need for pharmaceutical alternatives to neuropathic pain management. Exercise may be a viable neuropathic pain management option, despite the low quality and quantity of evidence. This dissertation aimed to evaluate the relationships between exercise, neuropathic pain and SWB, and assess possible physiological and psychosocial pathways underpinning exercise-related changes in neuropathic pain. First, a scoping review was conducted to provide a comprehensive synthesis of the research evidence regarding the impact of exercise on chronic pain and SWB among persons with SCI. Second, a pre-test post-test quasi-experimental study was conducted to examine the impact of a sub-maximal bout of aerobic exercise on neuropathic pain, inflammation and affect. Third, a quasi-experimental study informed by the results of Study #2 evaluated neuropathic pain experiences among high- versus moderate- frequency and intensity exercisers with SCI. Lastly, a descriptive, mixed-methods study was completed to describe neuropathic pain characteristics and symptoms among physically active persons with SCI, and to understand how these individuals communicate their neuropathic pain. Collectively, results from Studies 1 through 4 suggest that exercise may reduce neuropathic pain and improve SWB among persons with SCI. Moderate-frequency and intensity exercise may lead to greater analgesic effects compared to high-frequency and intensity exercise; however, physically active persons with SCI reported difficulty with communicating their neuropathic pain. Despite these observed exercise-related changes in neuropathic pain, neither physiological, nor psychosocial moderators were identified. While persons with SCI and clinicians can have confidence that exercise may be used as a pharmaceutical alternative to neuropathic pain management, further research is needed to identify optimal pathways and exercise prescription characteristics (e.g., frequency, intensity, time, type) that will maximize analgesic effects and improvements in SWB.

Text

2022-03-08

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/80929

Kinesiology

University of British Columbia

UBCO

http://creativecommons.org/licenses/by-nc-nd/4.0/