Biology Reference
In-Depth Information
spinal cord (
Bobinski et al., 2011
), and modulation of the spatial and tem-
poral pattern of neurotrophins expression both in the CNS and in the PNS
(
Cobianchi et al., 2013
). Accordingly, in female rats, 1 h daily of treadmill
running at mild to moderate intensity, performed from day 3 to day 7 after
sciatic nerve transection and direct repair, reduces nociception in the
hindpaw and improves response latencies in the affected hindlimb to either
thermal or mechanical stimulation (
Cobianchi et al., 2013
). Lower expres-
sion of pronociceptive BDNF and GDNF in the dorsal horn accompanies
treadmill running-associated hypoalgesia (
Cobianchi et al., 2013
).
Joint manual mobilization also reduces the intensity of ankle joint pain
and the extent of activity along nociceptive pathways in the spinal cord that
are induced experimentally by capsaicin injection into the ankle joint
(
Malisza et al., 2003
). In addition, ankle mobilization applied every other
day for the first 5 weeks following sciatic nerve crush in the rat reduces
hyperalgesia and spinal glial activation and accelerates normalization of sci-
atic function index scores (
Martins et al., 2011
). The hypoalgesic property of
physical exercise and joint movement is not specific to neuropathic pain and
appears to involve the opioid and serotonergic systems (
Mazzardo-Martins
et al., 2010
).
4. TRANSLATIONAL RESEARCH AND CLINICAL STUDIES
In relative contrast with research on animal models, clinical research
fails in demonstrating the therapeutic potential of physical exercise and pas-
sive mobilization in the treatment of traumatic PNS injury in human sub-
jects. From Cochrane Database of systematic reviews, there is little evidence
that exercise therapy contributes to ameliorate functional ability in people
with neuropathy (
White, Pritchard, & Turner-Stokes, 2004
), carpal tunnel
syndrome (
Page, O'Connor, Pitt, &Massy-Westropp, 2012
), ulnar neurop-
athy (
Caliandro, La Torre, Padua, Giannini, & Padua, 2012
), or Bell's palsy
(
Teixeira, Valbuza, & Prado, 2011
). In addition, endurance exercise, mean-
ing low- to moderate-intensity prolonged exercise, seems to bring no addi-
tional benefit in measures of functional ability in participants with peripheral
neuropathy (
White et al., 2004
). However, there is some evidence that resis-
tance exercise programs, thus more focused in stimulating force generation
by specific muscle groups, moderately improve muscle strength in people
with PNS dysfunction (
White et al., 2004
).
