{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:46:29Z","timestamp":1792586789011,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Exercise\u2010induced hypoalgesia (EIH) is a well\u2010established phenomenon; however, its magnitude varies among individuals and clinical conditions. In patients with rotator cuff tear (RCT), movement\u2010evoked pain during arm elevation is a key symptom directly linked to functional limitations, making EIH particularly clinically relevant. This study aimed to investigate whether pre\u2010exercise endogenous pain inhibitory capacity, assessed using conditioned pain modulation (CPM), is associated with EIH magnitude in patients with painful RCT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty patients with symptomatic RCT performed 25\u2009min of moderate\u2010intensity stationary cycling. Movement\u2010evoked pain during active shoulder flexion and pressure pain thresholds at the affected deltoid, contralateral deltoid and contralateral tibialis anterior were assessed before and immediately after exercise. CPM was evaluated using cuff algometry before the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A significant reduction in movement\u2010evoked pain was observed following exercise (median reduction: 21.0 [9.0\u201335.0] mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001,\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.83), accompanied by increased PPTs at all sites (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). A moderate correlation was observed between CPM efficiency and post\u2010exercise pain reduction (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). ROC analysis identified a CPM cutoff value of 4.05\u2009kPa for detecting EIH responders (AUC\u2009=\u20090.917).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinically meaningful reductions in movement\u2010evoked pain were observed following moderate\u2010intensity aerobic exercise in patients with painful rotator cuff tears. Greater pre\u2010exercise CPM efficiency was associated with greater post\u2010exercise pain reduction, suggesting that endogenous pain inhibitory function may contribute to inter\u2010individual variability in the immediate pain response following exercise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>This study demonstrates that pre\u2010exercise conditioned pain modulation (CPM) is associated with the magnitude of exercise\u2010induced hypoalgesia in patients with rotator cuff tear. Unlike previous studies focusing primarily on experimental pain sensitivity, we demonstrated clinically meaningful reductions in movement\u2010evoked pain together with widespread increases in pressure pain thresholds. These findings identify pre\u2010exercise CPM as a potential marker of individual variability in the immediate analgesic response to exercise and provide a basis for future mechanism\u2010based stratification of exercise interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70426","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:00:38Z","timestamp":1792072838000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre\u2010Exercise Conditioned Pain Modulation Is Associated With Exercise\u2010Induced Hypoalgesia in Patients With Painful Rotator Cuff Tears"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8640-2788","authenticated-orcid":false,"given":"Shota","family":"Oda","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, Kochi Medical School Hospital Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8592-6069","authenticated-orcid":false,"given":"Masashi","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kochi Medical School Hospital Kochi University  Nankoku Kochi Japan"},{"name":"Department of Orthopaedic Surgery, Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Horino","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kochi Medical School Hospital Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kochi Medical School Hospital Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dai","family":"Ooishi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kochi Medical School Hospital Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuki","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Ikeuchi","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Kochi Medical School Hospital Kochi University  Nankoku Kochi Japan"},{"name":"Department of Orthopaedic Surgery, Kochi Medical School Kochi University  Nankoku Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1515\/sjpain-2020-0033"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2020.08.004"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-1800"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2013.12.023"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001431"},{"key":"e_1_2_10_7_1","first-page":"215","article-title":"Changes in Pain Perception in Women During and Following an Exhaustive Incremental Cycling Exercise","volume":"4","author":"Drury D. 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