Dissertation/Thesis Abstract

Inflammatory markers, physical fitness, and pain in children
by Stolzman, Stacy C., Ph.D., Marquette University, 2015, 206; 3714487
Abstract (Summary)

The current pediatric obesity epidemic is associated with increased clinical pain; the relation between pain and obesity is not clear but a potential mechanism is inflammation. Obesity is a chronic pro-inflammatory state associated with risk for metabolic syndrome, diabetes and cardiovascular disease. Furthermore, inflammatory markers contribute to the development and modulation of pain.

Exercise, a hallmark of obesity interventions, is often prescribed for pain management. Pain relief after exercise, exercise induced hypoalgesia (EIH), may be a critical pain management strategy for overweight/obese adolescents, but it is unknown if EIH exists in adolescents. Moreover, mechanisms for EIH are not established; the concept of conditioned pain modulation (CPM), ‘pain inhibits pain,’ is a possible central component of pain relief after exercise through endogenous pain inhibition.

In adolescents across weight status, experimental pain was assessed at baseline, in a CPM protocol, and pre/post maximal aerobic exercise (EIH). Clinical pain, psychosocial parameters, physical fitness, physical activity levels, body composition, and health status were also measured.

In this community sample, normal weight and overweight/obese adolescents did not report clinically significant differences in clinical/experimental pain. Adolescents with higher BMI and central adiposity demonstrated elevated inflammation and metabolic syndrome severity but decreased quality of life. Fit overweight/obese adolescents demonstrated higher quality of life and decreased metabolic syndrome severity but similar inflammation and pain.

Adolescents experienced EIH regardless of weight status, physical activity, and physical fitness; EIH was positively associated with lean mass. CPM was similar between weight status and sex; lean mass uniquely predicted the CPM magnitude. CPM and EIH are mildly associated but further pediatric research is warranted.

These results suggest that adolescents of overweight/obese status experienced increased metabolic syndrome severity but not necessarily clinical pain; physical fitness circumvented metabolic syndrome severity. Aerobic exercise may be utilized for pain relief in adolescents across weight status. Endogenous pain modulation may be a possible mechanism of pain relief after exercise, but pain with exercise is not required for pain relief after exercise. Assessment of EIH and CPM in pediatric populations may help guide and tailor unique interventions to assist with pain management across the weight spectrum.

Indexing (document details)
Advisor: Bement, Marie K.
Commitee: Danduran, Michael, Drendel, Amy, Harkins, April, Skelton, Joseph
School: Marquette University
Department: Physical Therapy
School Location: United States -- Wisconsin
Source: DAI-B 76/12(E), Dissertation Abstracts International
Subjects: Physical therapy
Keywords: Body composition, Conditioned pain modulation, Exercise, Metabolic syndrome, Obesity, Physical activity
Publication Number: 3714487
ISBN: 978-1-321-91817-5
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