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Table 2 Summary of clinical evidence examining the impact of exercise on neuropathic pain

From: Exercise and Neuropathic Pain: A General Overview of Preclinical and Clinical Research

Study Diagnosis Condition Groups Exercise Duration Exercise Session (frequency and duration) Exercise Intensity Outcome
Ziegler et al (2009)a [67] Diabetes and myocardial infarction NA NA NA NA Individuals who reported at least 1 h a week of leisure time sports activities year-round were at a lower risk for having neuropathic pain than those who reported less sport activity.
Kluding et al. (2012) [69] Diabetes and metabolic syndrome Combined (AET and RT) 10 weeks 3–4 days/week
30–50 min
AET
2–4 days/week
RT
1–2 days/week
10–20 reps
Moderate
(50–70% VO2max)
↔ Current pain
↔ Usual pain
↓ Worst pain over the past month
↑ Intraepidermal nerve fiber branching
Hamed and Raoof (2014) [70] Diabetes and obesity Aerobic 15 weeks Moderate
3 days/week
50 min
HIIT
3 days/week
20 min
Moderate
(50–60% MHR)
Vigorous
(85–95% MHR)
↓ Pain for HIIT compared to moderate intensity
Yoo et al. (2015) [71] Diabetes Aerobic 16 weeks 3 days/week
30–50 min/day
Moderate
(50–70% VO2 reserve)
↔ Pain intensity
↓ Pain interference
Chiang et al (2016)a [68] Diabetes NA NA NA NA Participants who reported 30 min or more per day of exercise had lower odds of having neuropathic pain compared to those who reported less than 30 min per day of exercise and those who reported no exercise.
Nadi et al. (2017) [72] Diabetes Vitamin D only
Vitamin D + combined (AET and RT)
12 weeks 3 days/week
60 min/day
Moderate
(AET
50-70% MHR
RT
50% 10-RM)
↓ Pain
Stubbs Jr. et al. (2019) [73] Diabetes Health education
Aerobic
Resistance
Combined (AET and RT)
12 weeks Health Education:
12 sessions
Exercise:
3 days/week
30–45 min/day
Moderate
(60–90% VO2peak)
↔ Vibration detection threshold (all programs)
↔ Cooling detection threshold (all programs)
↔ Heat pain threshold (all programs)
Cox et al. (2020) [74] Diabetes Usual care
Combined
(AET and RT)
Combined HIIT
(AET and RT)
8 weeks Combined:
4 days/week
52.5 min/day
Combined HIIT:
3 days/week
26 min/day
Moderate
(55–69% HRpeak; fairly light to somewhat hard)
Vigorous
(85–95% HRpeak; very hard)
↓ Musculoskeletal pain (combined HIIT only)
↔ Neuropathy symptoms (all conditions)
↔ Cooling detection threshold (all conditions)
↔ Warm detection threshold (all conditions)
↔ Vibration detection threshold (all conditions)
↔ Mechanical detection threshold (all conditions)
↔ Vibration detection threshold (all conditions)
↔ Pressure pain threshold (all conditions)
Wonders et al. (2013) [75] CIPN Home-based
combined (AET and RT)
10 weeks AET:
2–5 days/week
10–30 min/day
RT:
3 days/ week
Moderate
(55–65% MHR)
↓ Pain
Dhawan et al. (2019) [76] CIPN Usual care
Home-based (RT and balance)
10 weeks RT & Balance
7 days/week
30 min/day
Not indicated ↓ Pain (RT and balance)
Mols et al. (2015)a [66] Colorectal cancer survivors NA NA NA NA There were fewer people who reported aching/burning pain, trouble handling small objects, pain, trouble standing/walking, weakness, cramps, and loss of strength in their hands in individuals who had chemotherapy and met the national PA guidelines compared to individuals who had chemotherapy and did not meet the national PA guidelines.
Maharaj et al. (2018) [77] HIV distal symmetrical polyneuropathy Control:
HIV education
Aerobic
Resistance
12 weeks 3 days/week
30 min/day
Low–moderate
(AET
40–65% MHR
RT
40–65% 1-RM)
↓ Pain intensity (AET; RT)
  1. aindicates an observational study
  2. Studies are grouped by diagnosis then organized chronologically. AET Aerobic training, CIPN Chemotherapy-induced peripheral neuropathy, HIV Human immunodeficiency virus, HRpeak Peak heart rate, MHR Maximal heart rate, NA Not applicable, rep Repetition, RT Resistance training, RM Repetition maximum test, ↓ = decrease in outcome, ↑ = increase in outcome, ↔ = no change in outcome