{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T02:43:50Z","timestamp":1789872230043,"version":"4.0.1"},"reference-count":76,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vagal activity has analgesic effects that are attributed to exercise\u2010induced hypoalgesia (EIH). High vagal tone and low pain sensitivity are reported in individuals who routinely exercise yet, their association is unclear. Furthermore, it is unknown if the heightened vagal tone following high physical activity predicts and intensifies EIH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty\u2010one healthy participants (27 low\u2013moderately physically active; 27 females) underwent a resting\u2010state electrocardiogram followed by heart rate variability analysis. Pain measurements, including pressure (PPT) and heat (HPT) pain thresholds, ratings of tonic heat pain (THP) and conditioned pain modulation (CPM) paradigm, were conducted pre\u2010 and post\u2010exercise on a cycle ergometer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The highly active group demonstrated higher vagal tone compared to the low\u2013moderately active (root mean square of successive differences between R\u2013R intervals: 63.96.92 vs. 34.78\u2009ms,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018; percentage of successive R\u2013R intervals that exceed 50\u2009ms: 24.41 vs. 11.52%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012). Based on repeated\u2010measure ANOVA, the highly active group showed higher PPT at pre\u2010exercise, compared to the low\u2013moderately active group (382\u2009kPa vs. 327\u2009kPa;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007). Post\u2010exercise, both groups demonstrated EIH, increased HPT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013) and decreased THP ratings (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Linear regression revealed that only in the low\u2013moderately active group, higher vagal tone was associated with more efficient pre\u2010exercise CPM and a greater reduction in THP ratings post\u2010exercise (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Highly active individuals demonstrate greater vagal tone and lower pain sensitivity but no greater EIH. Vagal tone moderates pain inhibition efficiency and EIH only in low\u2013moderately active individuals. These findings suggest that physical activity level moderates the vagal\u2013pain association via the endogenous analgesia system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Highly physically active individuals exhibit greater vagal tone and reduced sensitivity to experimental pain, yet they do not benefit more from exercise\u2010induced hypoalgesia (EIH) compared to low\u2013moderately active individuals. Moreover, low\u2013moderately active individuals with greater vagal tone exhibited more efficient endogenous pain inhibition and greater EIH, suggestive of the moderation effect of physical activity level on vagal\u2013pain associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.2275","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T06:45:09Z","timestamp":1712904309000},"page":"1524-1535","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Vagal tone, pain sensitivity and exercise\u2010induced hypoalgesia: The effect of physical activity level"],"prefix":"10.1002","volume":"28","author":[{"given":"Ela","family":"Michaeli\u00a0Izak","sequence":"first","affiliation":[{"name":"Physical Therapy Department, Faculty of Social Welfare and Health Sciences University of Haifa  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4540-4039","authenticated-orcid":false,"given":"Einat","family":"Kodesh","sequence":"additional","affiliation":[{"name":"Physical Therapy Department, Faculty of Social Welfare and Health Sciences University of Haifa  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5675-8919","authenticated-orcid":false,"given":"Irit","family":"Weissman\u2010Fogel","sequence":"additional","affiliation":[{"name":"Physical Therapy Department, Faculty of Social Welfare and Health Sciences University of Haifa  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2009.07.004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsycho.2007.10.004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2009.02.002"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1335"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200333120-00003"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000001186"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000072802.84202.86"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200333010-00003"},{"key":"e_1_2_8_11_1","first-page":"37","article-title":"Endurance exercise training\u2010induced resting bradycardia: A brief review","volume":"8","author":"Chen C. 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