Evaluation of the relationship between neuropathic pain intensity and quality of sleep in adults with a spinal cord injury who exercise


Neuropathic pain affects approximately 60% of persons with spinal cord injury (SCI) and often impacts sleep quality. Exercise has been shown to independently influence sleep and pain among persons with SCI. However, it is unknown whether the frequency/intensity of exercise is differentially related to pain and sleep interference, and whether it moderates the relationship between these variables among persons with SCI. The purpose of this study was to compare neuropathic pain intensity and sleep interference among high versus moderate frequency and intensity exercisers. High frequency/intensity exercise (HFHI) was operationalized as exercise performed by Paralympic athletes, whereas moderate frequency/intensity (MFMI) exercise was performed by recreational athletes. Fifty-two participants were recruited (HFHI, n=25; MFMI, n=27; Mage= 38±11.8 years) and interviewed over the phone using the International Spinal Cord Injury Basic Pain Data Set (v2.0). Independent samples t-tests were conducted to compare pain intensity and sleep interference between groups. Pain intensity was significantly higher for HFHI exercisers (p=0.032). No significant difference was observed for sleep interference (ps>0.5). Pearson's correlations were computed to assess the relationship between these variables. Both groups demonstrated a positive correlation between these variables, but the strength of the relationships differed (HFHI, r=0.15, p=0.52; MFMI, r=0.37, p=0.07). Results suggest that the frequency/intensity of exercise may not be related to neuropathic pain and sleep interference, but it may influence the relationship strength between these outcomes. Research should focus on developing controlled exercise protocols to ascertain whether varying levels of exercise can impact neuropathic pain and sleep quality among adults with SCI.