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Grainer, Alessandro (2013) Variazioni nella percezione e tolleranza al dolore attraverso l'esercizio fisico. [Tesi di dottorato]

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Abstract (inglese)

Muscoloskeletal pain is the gold standard in “commercial” pharmacological treatment.
Physical activity is supposed to decrease pain perception, with other specific benefits. In scientific literature, the term “analgesia post exercise” is very common since the early 80’s.
However, there are no absolute certainties about the true effects of exercise in pain treatment after recovery.
Our work wants to examine this topic, and will try to understand how healty volunteers respond to a noxious stimulus after exercise and after recovery from exercise of various intensity and duration.
We evaluated the responses to two types of exercise: a) strong and short exercise, and b) medium and very long exercise.
The first part of the study analyses a group of 30 athletes: 15 cyclists and 15 volunteers coming from other sports: we evaluated pain perception and tolerance thresholds with two different kind of noxious stimuli.
In the second part we evaluated pain perception and tolerance in a group of 27 ultratrailers, before, after and after 15 min recovery from a running race of 80km and 5.500m of positive slope.
Results of the first two experimets, show a return to basal values after recovery for cyclists group and for the control group we notice the tendence to an hyperalgesia post-recovery. Both groups, immediately after having finished the test, show an analgesic response to pain test.
Third test gave us a yperalgesic response in both after and after recovery test.
The use of exercise in treatment of chronic pain, combined to pharmacologic treatment has to be more investigated, taking into account intensity and time of exercise, with the goal of lenghten the time of analgesia

Abstract (italiano)

I dolori articolari o muscolari sono la maggior parte dei dolori trattati dai farmaci “commerciali”.
All’attività fisica viene attribuita, oltre ad altri innumerevoli benefici, anche quello di diminuire la percezione del dolore. La definizione di “analgesia post-exercise” è nota da anni nella letteratura scientifica. Questa caratteristica viene però meno divulgata, forse perché non esistono ancora riscontri certi su quelli che possono essere gli effetti una volta recuperata la fase acuta.
Questa tesi intende approfondire l’argomento, cercando di capire come reagisce il soggetto immediatamente dopo l’esercizio e dopo il recupero, rispetto alla percezione e alla tolleranza a uno stimolo doloroso. Sono stati valutati, sostanzialmente, le risposte a seguito di due tipi di esercizio fisico: a) esercizio fisico strenuo e breve; b) esercizio fisico elevato e prolungato nel tempo
La prima parte dello studio tratta un gruppo di 30 soggetti, 15 ciclisti e 15 soggetti in buona forma fisica ma non ciclisti e valuta la loro percezione al dolore immediatamente dopo e dopo il recupero da un esercizio ad esaurimento al cicloergometro, con due differenti tipi di stimolo dolorifico e tecniche di rilevazione della sua percezione e tolleranza.
Nella seconda parte della tesi si intende valutare la percezione e tolleranza ad uno stimolo dolorifico di un gruppo di atleti ultramaratoneti prima e dopo (immediatamente e dopo breve recupero) una gara lunga 80km con 5.500 metri di dislivello positivo.
I risultati dei primi due esperimenti mostrano una tendenza al ritorno ai valori basali dopo il recupero da un esercizio a esaurimento per i soggetti più allenati, mentre per i meno allenati la tendenza è quella di un’iperalgesia post-recupero. Appena terminato il test per entrambi i gruppi abbiamo notato un innalzamento della soglia di percezione al dolore.
I risultati del terzo esperimento evidenziano, con una significatività molto alta, una marcata iperalgesia post esercizio, che permane anche dopo il recupero.
Per arrivare a prescrizioni di esercizio fisico con l’obiettivo di trattare il dolore cronico con un abbinamento fra trattamento farmacologico e non farmacologico, sarà necessario approfondire gli studi su intensità e durata dell’esercizio con l’obiettivo di allungare il tempo di analgesia

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Tipo di EPrint:Tesi di dottorato
Relatore:Reggiani , Carlo
Dottorato (corsi e scuole):Ciclo 25 > Scuole 25 > SCIENZE MEDICHE, CLINICHE E SPERIMENTALI > NEUROSCIENZE
Data di deposito della tesi:27 Gennaio 2013
Anno di Pubblicazione:27 Gennaio 2013
Parole chiave (italiano / inglese):percezione del dolore, tolleranza al dolore, esercizio fisico, esercizio aerobico/pain perception, pain tolerance, exercise, aerobic exercise
Settori scientifico-disciplinari MIUR:Area 05 - Scienze biologiche > BIO/09 Fisiologia
Struttura di riferimento:Dipartimenti > Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari
Dipartimenti > Dipartimento di Scienze Biomediche
Codice ID:5536
Depositato il:16 Ott 2013 09:15
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