Skip to main content

Exercise Testing and Training in Patients with (Chronic) Pain

  • Chapter
Integrative Pain Medicine

Part of the book series: Contemporary Pain Medicine ((CPM))

  • 3325 Accesses

Summary

A vast body of literature supports the idea that exercise training is an important modality in the treatment and rehabilitation of the chronic pain patient. Exercise testing and prescription should therefore be incorporated in the therapeutic armamentarium of health care professionals working with chronic pain patients. In this chapter we present the scientific basis of the positive effects regular exercise can have on pain, mood, sleep, function, and fitness. Moreover, specific guidelines for exercise testing and prescription for the chronic patient are provided.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Tipton C. Introduction: A view of the past. Exercise physiogy: roots and historical perspectives. In: Exercise physiology. Energy, nutrition and human performance. McArdle WD, Katch FI, Katch VL, Eds. Baltimore: Lipincott Williams & Wilkins, 2001: xviiā€“Ixii.

    Google ScholarĀ 

  2. American Society of Exercise Physiologists. Exercise physiology. http://www.asep.org/. 2005.

    Google ScholarĀ 

  3. Booth FW, Gordon SE, Carlson CJ, Hamilton MT. Waging war on modern chronic diseases: primary prevention through exercise biology. J Appl Physiol 2000;88(2):774ā€“787.

    PubMedĀ  CASĀ  Google ScholarĀ 

  4. Colditz GA. Economic costs of obesity and inactivity. Med Sci Sports Exerc 1999;31 (11 Suppl):S663ā€“S667.

    PubMedĀ  CASĀ  Google ScholarĀ 

  5. World Health Organization. 2001. The International Classification of Functioning, Disability and Health (ICF), 2nd edition. Geneva, Switzerland: WHO, Marketing and Dissemination.

    Google ScholarĀ 

  6. Vuori IM. Doseā€“response of physical activity and low back pain, osteoarthritis, and osteoporosis. Med Sci Sports Exerc 2001;33(6Suppl), (Review; 269 refs).

    Google ScholarĀ 

  7. Lawlor DA, Hopker SW. The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. BMJ 2001;322(7289):763ā€“767.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  8. Koltyn KF. Analgesia following exercise: a review. Sports Med 2000;29(2):85ā€“98.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  9. Koltyn KF. Exercise-induced hypoalgesia and intensity of exercise. Sports Med 2002;32(8):477ā€“487.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  10. Hoffman MD, Shepanski MA, Mackenzie SP, Clifford PS. Experimentally induced pain perception is acutely reduced by aerobic exercise in people with chronic low back pain. J Rehabil Res Dev 2005;42(2):183ā€“190.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  11. Whiteside A, Hansen S, Chaudhuri A. Exercise lowers pain threshold in chronic fatigue syndrome. Pain 2004;109(3):497ā€“499.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  12. Dietrich A, McDaniel WF. Endocannabinoids and exercise. Br J Sports Med 2004;38(5):536ā€“541.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  13. Sparling PB, Giuffrida A, Piomelli D, Rosskopf L, Dietrich A. Exercise activates the endocannabinoid system. Neuroreport 2003;14(17):2209ā€“2211.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  14. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, Oā€™ Brien WL, Bassett DR, Jr, Schmitz KH, Emplaincourt PO, Jacobs DR, Jr., Leon AS. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 2000 Sep;32(9 Suppl):S498ā€“S504.

    Google ScholarĀ 

  15. Astrand P, Rodahl K. 1986. Textbook of Work Physiology, Physiological Bases of Exercise, 3rd edition. New York: McGraw-Hill Book Company.

    Google ScholarĀ 

  16. Verbunt JA, Seelen HA, Vlaeyen JW, van de Heijden GJ, Heuts PH, Pons K, et al. Disuse and deconditioning in chronic low back pain: concepts and hypotheses on contributing mechanisms. Eur J Pain 2003;7(1):9ā€“21.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  17. Mayer TG, Gatchel RJ, Kishino N, Keeley J, Capra P, Mayer H, et al. Objective assessment of spine function following industrial injury. A prospective study with comparison group and one-year follow-up. Spine 1985;10(6):482ā€“493.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  18. Mayer TG, Gatchel RJ, Kishino N, Keeley J, Mayer H, Capra P, et al. A prospective short-term study of chronic low back pain patients utilizing novel objective functional measurement. Pain 1986;25(1):53ā€“68.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  19. Verbunt JA, Seelen HA, Vlaeyen JW, van der Heijden GJ, Knottnerus JA. Fear of injury and physical deconditioning in patients with chronic low back pain. Arch Phys Med Rehabil 2003;84(8): 1227ā€“1232.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  20. Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000;85(3):317ā€“332.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  21. Stewart AL, Hays RD, Wells KB, Rogers WH, Spritzer KL, Greenfield S. Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the Medical Outcomes Study. J Clin Epidemiol 1994;47(7):719ā€“730.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  22. Statens Beredning for Medicinsk Utvardering. Pain in the Back Pain in the Neck. Summary of Scientific Evidence. Stockholm: Statens Beredning for Medicinsk Utvardering, 2000.

    Google ScholarĀ 

  23. Suni J. 2000. Health related fitness test battery for middle-aged adults with emphasis on musculoskeletal and motor tests. Finland: University of JyvƤskylƤ.

    Google ScholarĀ 

  24. Herr KA, Mobily PR, Smith C. Depression and the experience of chronic back pain: a study of related variables and age differences. Clin J Pain 1993;9(2):104ā€“114.

    PubMedĀ  CASĀ  Google ScholarĀ 

  25. Sullivan MJ, Reesor K, Mikail S, Fisher R. The treatment of depression in chronic low back pain: review and recommendations. Pain 1992;50(1):5ā€“13.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  26. Currie SR, Wang J. Chronic back pain and major depression in the general Canadian population. Pain 2004;107(1ā€“2):54ā€“60.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  27. Dunn AL, Trivedi MH, Oā€™Neal HA. Physical activity doseā€“response effects on outcomes of depression and anxiety. Med Sci Sports Exerc 2001;33(6 Suppl):S587ā€“S597.

    Google ScholarĀ 

  28. North TC, McCullagh P, Tran ZV. Effect of exercise on depression. Exer Sport Sci Rev 1990;18: 379ā€“415.

    ArticleĀ  CASĀ  Google ScholarĀ 

  29. Petruzzello SJ, Landers DM, Hatfield BD. A meta analysis on the anxiety reducing effects of acute and chronic exercise. Sports Med 1991;11:143.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  30. Focht BC. Pre-exercise anxiety and the anxiolytic responses to acute bouts of self-selected and prescribed intensity resistance exercise. J Sports Med Phys Fitness 2002;42(2):217ā€“223.

    PubMedĀ  CASĀ  Google ScholarĀ 

  31. Sculco AD, Paup DC, Fernhall B, Sculco MJ. Effects of aerobic exercise on low back pain patients in treatment. Spine J 2001;1(2):95ā€“101.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  32. Menefee LA, Frank ED, Doghramji K, Picarello K, Park JJ, Jalali S, et al. Self-reported sleep quality and quality of life for individuals with chronic pain conditions. Clin J Pain 2000;16(4):290ā€“297.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  33. 2000 National Sleep Foundation (NSF). Sleep in America poll. http://www.sleepfoundation.org/sleeplibrary/index.php?secid=&id=63 . 2000.

    Google ScholarĀ 

  34. Sherrill DL, Kotchou K, Quan SF. Association of physical activity and human sleep disorders. Arch Intern Med 1998;158(17):1894ā€“1898.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  35. Driver HS, Taylor SR. Exercise and sleep. Sleep Med Rev 2000;4(4):387ā€“402.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  36. Kubitz KA, Landers DM, Petruzzello SJ, Han M. The effects of acute and chronic exercise on sleep. A meta-analytic review. Sports Med 1996;21(4):277ā€“291.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  37. Russo-Neustadt AA, Chen MJ. Brain-derived neurotrophic factor and antidepressant activity. Curr Pharm Des 2005;11(12):1495ā€“1510.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  38. Mattson MP, Duan W, Wan R, Guo Z. Prophylactic activation of neuroprotective stress response pathways by dietary and behavioral manipulations. NeuroRx 2004;1(1):111ā€“116.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  39. Lim BV, Jang MH, Shin MC, Kim HB, Kim YJ, Kim YP, et al. Caffeine inhibits exercise-induced increase in tryptophan hydroxylase expression in dorsal and median raphe of Sprague-Dawley rats. Neurosci Lett 2001;308(1):25ā€“28.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  40. Swain RA, Harris AB, Wiener EC, Dutka MV, Morris HD, Theien BE, et al. Prolonged exercise induces angiogenesis and increases cerebral blood volume in primary motor cortex of the rat. Neuroscience 2003;117(4):1037ā€“1046.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  41. Black JE, Isaacs KR, Anderson BJ, Alcantara AA, Greenough WT. Learning causes synaptogenesis, whereas motor activity causes angiogenesis, in cerebellar cortex of adult rats. Proc Natl Acad Sci USA 1990;87(14):5568ā€“5572.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  42. Shephard RJ. Sepsis and mechanisms of inflammatory response: is exercise a good model? Br J Sports Med 2001;35(4):223ā€“230.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  43. Jonsdottir IH. Special feature for the Olympics: effects of exercise on the immune system: neuropeptides and their interaction with exercise and immune function. Immunol Cell Biol 2000;78(5):562ā€“570.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  44. Shephard RJ, Allen C, Benade AJ, Davies CT, Di Prampero PE, Hedman R, et al. The maximum oxygen intake. An international reference standard of cardiorespiratory fitness. Bull World Health Organ 1968;38(5):757ā€“764.

    PubMedĀ  CASĀ  Google ScholarĀ 

  45. Fick A. Ueber die Messung des Blutquantums in den Herzventrikeln. 2 ed. Wurzburg: Sitx. der Physik-Med. Ges. 1870.

    Google ScholarĀ 

  46. Wittink H, Michel TH, Kulich R, Wagner A, Sukiennik A, Maciewicz R, et al. Aerobic fitness testing in patients with chronic low back pain: which test is best? Spine 2000;25(13):1704ā€“1710.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  47. Noonan V, Dean E. Submaximal exercise testing: clinical application and interpretation. Phys Ther 2000;80(8):782ā€“807.

    PubMedĀ  CASĀ  Google ScholarĀ 

  48. Cooper KH. A means of assessing maximal oxygen intake. Correlation between field and treadmill testing. JAMA 1968;203(3):201ā€“204.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  49. Leger LA, Lambert J. A maximal multistage 20-m shuttle run test to predict VO2 max. Eur J Appl Physiol Occup Physiol 1982;49(1):1ā€“12.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  50. Francis KT. Fitness assessment using step tests. Compr Ther 1987;13(4):36ā€“41.

    PubMedĀ  CASĀ  Google ScholarĀ 

  51. Siconolfi SF, Garber CE, Lasater TM, Carleton RA. A simple, valid step test for estimating maximal oxygen uptake in epidemiologic studies. Am J Epidemiol 1985;121(3):382ā€“390.

    PubMedĀ  CASĀ  Google ScholarĀ 

  52. Oja P, Laukkanen R, Pasanen M, Tyry T, Vuori I. A 2-km walking test for assessing the cardiorespiratory fitness of healthy adults. Int J Sports Med 1991;12(4):356ā€“362.

    PubMedĀ  CASĀ  Google ScholarĀ 

  53. Astrand I. Aerobic work capacity in men and women with special reference to age. Acta Physiol Scand 1960;49:1ā€“92.

    ArticleĀ  CASĀ  Google ScholarĀ 

  54. Astrand PO, Ryhming I. A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during submaximal work. J Appl Physiol 1954;7:218.

    PubMedĀ  CASĀ  Google ScholarĀ 

  55. Guyatt GH, Sullivan MJ, Thompson PJ, Fallen EL, Pugsley SO, Taylor, et al. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J 1985;132(8):919ā€“923.

    Google ScholarĀ 

  56. Demers C, McKelvie RS. Reliability, validity, and responsiveness of the six-minute walk test in patients with heart failure. Am Heart J 2001;142(4):698ā€“703.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  57. Bradley J, Howard J, Wallace E, Elborn S. Reliability, repeatability, and sensitivity of the modified shuttle test in adult cystic fibrosis. Chest 2000;117(6):1666ā€“1671.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  58. Emtner M, Finne M, Stalenheim G. A 3-year follow-up of asthmatic patients participating in a 10-week rehabilitation program with emphasis on physical training. Archiv Phys MedRehabil 1998;79(5):539ā€“544.

    ArticleĀ  CASĀ  Google ScholarĀ 

  59. McInnis K, Balady G, Weiner D, Ryan T. Comparison of ischaemic and physiologic responses during exercise tests in men using the standard and modified Bruce protocols. Am J Cardiol 1992;69:84ā€“89.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  60. Balke B. A simple field test for the assessment of physical fitness. REP 63ā€“6. Rep Civ Aeromed Res Inst USA 1963;53:1ā€“8.

    CASĀ  Google ScholarĀ 

  61. Cooper KH. A means of assessing maximal oxygen intake. Correlation between field and treadmill testing. JAMA 1968;203(3):201ā€“204.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  62. Butland RJ, Pang J, Gross ER, Woodcock AA, Geddes DM. Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J Clin Res Ed 1982;284(6329):1607ā€“1608.

    PubMedĀ  CASĀ  Google ScholarĀ 

  63. Sadaria KS, Bohannon RW. The 6-minute walk test: a brief review of literature. Clin Exerc Physiol 2001;3:127ā€“132.

    Google ScholarĀ 

  64. Nixon PA, Joswiak ML, Fricker FJ. A six-minute walk test for assessing exercise tolerance in severely ill children. J Pediatr 1996;129(3):362ā€“366.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  65. Foley A, Halbert J, Hewitt T, Crotty M. Does hydrotherapy improve strength and physical function in patients with osteoarthritisā€”a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme. Ann Rheum Dis 2003;62(12):1162ā€“1167.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  66. Guimaraes GV, Bellotti G, Bacal F, Mocelin A, Bocchi EA. Can the cardiopulmonary 6-minute walk test reproduce the usual activities of patients with heart failure? Arq Bras Cardiol 2002;78(6): 553ā€“560.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  67. Solway S, Brooks D, Lacasse Y, Thomas S. A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest 2001;119(1):256ā€“270.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  68. Minor MA, Kay DR. Arthritis. In: ACSMā€™s exercise management for persons with chronic diseases and disabilities. Durstine JL, Ed. Champaign, Ill: Human Kinetics, 1997:149ā€“154.

    Google ScholarĀ 

  69. Mannerkorpi K, Svantesson U, Carlsson J, Ekdahl C. Tests of functional limitations in fibromyalgia syndrome: a reliability study. Arthritis Care Res 1999;12(3):193ā€“199.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  70. Pankoff B, Overend T, Lucy D, White K. Validity and responsiveness of the 6 minute walk test for people with fibromyalgia. J Rheumatol 2000;27(11):2666ā€“2670.

    PubMedĀ  CASĀ  Google ScholarĀ 

  71. Wittink HM. Physical fitness, function and physical therapy in patients with pain: clinical measures of aerobic fitness and performance in patients with chronic low back pain. In: Pain 1999ā€”an updated review. Refresher Course Syllabus. Max M, Ed. Seattle: IASP press, 1999:137ā€“145.

    Google ScholarĀ 

  72. King S, Wessel J, Bhambhani Y, Maikala R, Sholter D, Maksymowych W. Validity and reliability of the 6 minute walk in persons with fibromyalgia. J Rheumatol 1999;26(10):2233ā€“2237.

    PubMedĀ  CASĀ  Google ScholarĀ 

  73. Pankoff BA, Overend TJ, Lucy SD, White KP. Reliability of the six-minute walk test in people with fibromyalgia. Arthritis Care Res 2000;13(5):291ā€“295.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  74. Gibbons WJ, Fruchter N, Sloan S, Levy RD. Reference values for a multiple repetition 6-minute walk test in healthy adults older than 20 years. J Cardiopulm Rehabil 2001;21(2):87ā€“93.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  75. Crapo RO, Casaburi R, Coates AL, Enright PL, et al. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166(1):111ā€“117.

    Google ScholarĀ 

  76. Troosters T, Gosselink R, Decramer M. Six minute walking distance in healthy elderly subjects. Eur Respir J 1999;14(2):270ā€“274.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  77. Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med 1998;158(5 Pt 1):1384ā€“1387.

    PubMedĀ  CASĀ  Google ScholarĀ 

  78. Borg G. Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work, EnvironHealth 1990;16(Suppl 1):55ā€“58.

    Google ScholarĀ 

  79. Felson DT, Lawrence RC, Hochberg MC, Mcalindon T, Dieppe PA, Minor MA, et al. Osteoarthritis: new insights. Part 2: treatment approaches. Ann Intern Med 2000;133(9):726ā€“737.

    PubMedĀ  CASĀ  Google ScholarĀ 

  80. Brosseau L, MacLeay L, Robinson V, Wells G, Tugwell P. Intensity of exercise for the treatment of osteoarthritis. Cochrane Database Syst Rev 2003;(2):CD004259.

    Google ScholarĀ 

  81. Fransen M, McConnell S, Bell M. Exercise for osteoarthritis of the hip or knee. Cochrane Database Syst Rev 2003;(3):CD004286.

    Google ScholarĀ 

  82. Roddy E, Zhang W, Doherty M. Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review. Ann Rheum Dis 2005;64(4):544ā€“548.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  83. Hakkinen A, Sokka T, Kotaniemi A, Hannonen P. A randomized two-year study of the effects of dynamic strength training on muscle strength, disease activity, functional capacity, and bone mineral density in early rheumatoid arthritis. Arthritis Rheum 2001;44(3):515ā€“522.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  84. Hakkinen A, Sokka T, Kautiainen H, Kotaniemi A, Hannonen P. Sustained maintenance of exercise induced muscle strength gains and normal bone mineral density in patients withearly rheumatoid arthritis: a 5 year follow up. Ann Rheum Dis 2004;63(8):910ā€“916.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  85. Busch A, Schachter CL, Peloso PM, Bombardier C. Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev 2002;(3):CD003786.

    Google ScholarĀ 

  86. Green S, Buchbinder R, Hetrick S. Physiotherapy interventions for shoulder pain. Cochrane Database Syst Rev 2003;(2):CD004258.

    PubMedĀ  Google ScholarĀ 

  87. van Tulder MW, Malmivaara A, Esmail R, Koes BW. Exercise therapy for low back pain. Cochrane Database Syst Rev 2000;(Issue 2):CD000335. 2000.

    Google ScholarĀ 

  88. Hayden JA, van Tulder MW, Malmivaara AV, Koes BW. Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med 2005;142(9):765ā€“775.

    PubMedĀ  Google ScholarĀ 

  89. Hayden JA, van Tulder MW, Tomlinson G. Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med 2005;142(9):776ā€“785.

    PubMedĀ  Google ScholarĀ 

  90. Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 1970;2(2):92ā€“98.

    PubMedĀ  CASĀ  Google ScholarĀ 

  91. Robertson RJ, Noble BJ. Perception of physical exertion: methods, mediators, and applications. Exerc Sport Sci Rev 1997;25:407ā€“452.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  92. Gamberale F. Perceived exertion, heart rate, oxygen uptake and blood lactate in different work operations. Ergonomics 1972;15(5):545ā€“554.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  93. Morgan WP. Psychological factors influencing perceived exertion. Med Sci Sports 1973;5(2): 97ā€“103.

    PubMedĀ  CASĀ  Google ScholarĀ 

  94. Hollander DB, Durand RJ, Trynicki JL, Larock D, Castracane VD, Hebert EP, et al. RPE, pain, and physiological adjustment to concentric and eccentric contractions. Med Sci Sports Exerc 2003;35(6):1017ā€“1025.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  95. Smutok MA, Skrinar GS, Pandolf KB. Exercise intensity: subjective regulation by perceived exertion. Arch Phys Med Rehabil 1980;61(12):569ā€“574.

    PubMedĀ  CASĀ  Google ScholarĀ 

  96. Robertson RJ, Stanko RT, Goss FL, Spina RJ, Reilly JJ, Greenawalt KD. Blood glucose extraction as a mediator of perceived exertion during prolonged exercise. Eur J Appl Physiol Occup Physiol 1990;61(1ā€“2):100ā€“105.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  97. Toner MM, Drolet LL, Pandolf KB. Perceptual and physiological responses during exercise in cool and cold water. Percept Mot Skills 1986;62(1):211ā€“220.

    PubMedĀ  CASĀ  Google ScholarĀ 

  98. Borg G, Ljunggren G, Ceci R. The increase of perceived exertion, aches and pain in the legs, heart rate and blood lactate during exercise on a bicycle ergometer. Eur J Appl Physiol Occup Physiol 1985;54(4):343ā€“349.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  99. Lin C, Michel TH, Steiner LA. 1999. The perception of exertion in chronic low back pain patients.

    Google ScholarĀ 

  100. Barker KL, Dawes H, Hansford P, Shamley D. Perceived and measured levels of exertion of patients with chronic back pain exercising in a hydrotherapy pool. Arch Phys Med Rehabil 2003;84(9): 1319ā€“1323.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  101. Anshel MH, Russell KG. Effect of aerobic and strength training on pain tolerance, pain appraisal and mood of unfit males as a function of pain location. J Sports Sci 1994;12:535ā€“547.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  102. Michel TH, Wittink HM. 2002. Pathophysiology of activity intolerance. In: Chronic pain management for physical therapists. Wittink HM, Michel TH, Eds. Boston: Butterworth-Heinemann, pp 101ā€“127.

    Google ScholarĀ 

  103. Pollock ML, Gaesser GA, Butcher, J.D., Despres J-P, Dishman RK et al. American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 1998;30(6):975ā€“991.

    ArticleĀ  Google ScholarĀ 

  104. Karvonen MJ, Kentala E, Mustafa O. The effects of training on heart rate. Annal Med Exp Biol Fenniae 1957;35:307ā€“315.

    CASĀ  Google ScholarĀ 

  105. Stromme SB, Ingjer F, Meen HD. Assessment of maximal aerobic power in specifically trained athletes. J Appl Physiol 1977;42(6):833ā€“837.

    PubMedĀ  CASĀ  Google ScholarĀ 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

Ā© 2008 Humana Press

About this chapter

Cite this chapter

Wittink, H., Takken, T. (2008). Exercise Testing and Training in Patients with (Chronic) Pain. In: Audette, J.F., Bailey, A. (eds) Integrative Pain Medicine. Contemporary Pain Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-344-8_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-344-8_8

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-786-0

  • Online ISBN: 978-1-59745-344-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics