IU Indianapolis ScholarWorks :: Browsing by Author "Naugle, Kelly M."

Browsing by Author "Naugle, Kelly M."

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Active Gaming as a Form of Exercise to Induce Hypoalgesia
(Liebert, 2017-08) Carey, Christopher; Naugle, Keith E.; Aqeel, Dania; Ohlman, Thomas; Naugle, Kelly M.; Kinesiology, School of Physical Education and Tourism Management
Objective: An acute bout of moderate-to-vigorous exercise temporarily reduces pain sensitivity in healthy adults. Recently, active gaming has been rising in popularity as a means of light-to-moderate exercise and may be particularly suitable for deconditioned individuals. Whether the physical activity elicited in active games can produce a hypoalgesic effect remains unknown. The purpose of this study was to determine whether active videogames can reduce pressure and heat pain sensitivity in healthy adults. We also evaluated the relationship between the physical activity elicited by the games and the magnitude of the hypoalgesic response. Materials and Methods: Twenty-one healthy adults played four different active games on separate days, including Microsoft® Kinect Xbox® One's Fighter Within and Sports Rival's Tennis, and Nintendo® Wii™ Sports' Boxing and Tennis. Heat pain thresholds on the forearm and pressure pain thresholds (PPTs) on the trapezius and forearm were assessed immediately before and after a 15-minute active gaming or control session. Minutes spent in sedentary time and moderate-to-vigorous physical activity (MVPA) during active gaming were measured with an accelerometer. Results: The analyses revealed that PPTs at the forearm and trapezius significantly increased from pretest to posttest following Kinect Fighter Within. PPTs at the trapezius also significantly increased from pretest to posttest following Wii Boxing. The magnitude of the hypoalgesic response was significantly correlated with MVPA and sedentary time during gameplay. Conclusion: These results suggest that an active gaming session played at a moderate intensity is capable of temporarily reducing pain sensitivity.
Active Virtual Reality Games Reduce Pain Sensitivity in Young, Healthy Adults
(Frontiers, 2021-11) Evans, Eric; Naugle, Keith E.; Ovispo, Alex; Kaleth, Anthony S.; Arnold, Brent; Naugle, Kelly M.; Kinesiology, School of Health and Human Sciences
Separately, both physical activity and virtual reality can attenuate pain sensitivity in healthy adults. What is unknown is whether virtual reality combined with physical activity (active virtual reality) could have a greater hypoalgesic effect compared to non-active virtual reality distraction (passive virtual reality engagement). Objective: The purpose of this study was to determine whether playing physically active virtual reality games exert a greater hypoalgesic effect than a non-active virtual reality game. Methods: Participants (n = 36) played three different active virtual reality games (Beat Saber, Holopoint, and Hot Squat) and one non-active virtual reality game (Relax Walk) for 15 min on four different visits. During gameplay, participants wore accelerometers on the thigh, wrist, and waist to measure movement intensity and quantity. Pressure pain thresholds were measured on the forearm and thigh immediately prior to gameplay (pretest) and immediately following each gaming bout (posttest). Results: Analysis of the accelerometer data indicated that Hot Squat elicited greater whole-body and lower body moderate to vigorous physical activity compared to the other games. The ANOVA revealed an overall hypoalgesic effect of the virtual reality games on the forearm, regardless of game type. Results also showed a significant hypoalgesic effect on the thigh following gameplay for Hot Squat, Holopoint, and Relax Walk VR. The magnitude of pain reduction was significantly greater during Hot Squat compared to the other games. Conclusion: Virtual reality gameplay exerted a hypoalgesic effect on experimental pressure pain. Additionally, the data provided evidence of a potential enhanced hypoalgesic effect of physically active virtual reality compared to non-active VR on pressure pain sensitivity.
Age-related differences in conditioned pain modulation of sensitizing and desensitizing trends during response dependent stimulation
(Elsevier, 2015-08) Naugle, Kelly M.; Cruz-Almeida, Yenisel; Vierck, Charles J.; Mauderli, Andre P.; Riley III, Joseph L.; Department of Kinesiology, School of Physical Education and Tourism Management
The current study evaluated age differences in conditioned pain modulation using a test stimulus that provided the opportunity to evaluate changes in heat pain sensitivity, sensitization, and desensitization within the same paradigm. During this psychophysical test, pain intensity clamping uses REsponse Dependent STIMulation (REDSTIM) methodology to automatically adjust stimulus intensity to maintain a desired pain rating set-point. Specifically, stimulus intensity increases until a pre-defined pain rating (the setpoint) is exceeded, and then decreases until pain ratings fall below the setpoint, with continued increases and decreases dictated by ratings. The subjects are blinded in terms of the setpoint and stimulus intensities. Younger and older subjects completed two test sessions of two REDSTIM trials, with presentation of conditioning cold stimulation between the trials of one session but not the other. The results indicated that conditioning cold stimulation similarly decreased the overall sensitivity of younger and older subjects, as measured by the average temperature that maintained a setpoint rating of 20 (on a scale of 0-100). The conditioning stimulus also significantly enhanced sensitization following ascending stimulus progressions and desensitization following descending stimulus progressions in older subjects relative to younger subjects. Thus, older subjects experienced greater swings in sensitivity in response to varying levels of painful stimulation. These results are discussed in terms of control over pain intensity by descending central modulatory systems. These findings potentially shed new light on the central control over descending inhibition and facilitation of pain.
The Decline of Endogenous Pain Modulation With Aging: A Meta-Analysis of Temporal Summation and Conditioned Pain Modulation
(Elsevier, 2019) Hackett, Jason; Naugle, Keith E.; Naugle, Kelly M.; Kinesiology, School of Physical Education and Tourism Management
The purpose of this article was to examine age-related changes in conditioned pain modulation (CPM) and temporal summation (TS) of pain using meta-analytic techniques. Five electronic databases were searched for studies, which compared measures of CPM and TS among healthy, chronic pain-free younger, middle-aged, and older adults. Eleven studies were included in the final review for TS and 11 studies were included in the review of CPM. The results suggested a moderate magnitude of difference in TS among younger and middle-aged/older adults, with the older cohorts exhibiting enhanced TS of pain. Considerable variability existed in the magnitude of the effect sizes, which was likely due to the different experimental methodologies used across studies (ie, interstimulus interval, stimulus type, and body location). In regards to CPM, the data revealed a large magnitude of difference between younger and older adults, with younger adults exhibiting more efficient pain inhibition. Differences in CPM between middle-aged and older adults were minimal. The magnitude of pain inhibition during CPM in older adults may depend on the use of concurrent versus nonconcurrent protocols. In summary, the data provided strong quantitative evidence of a general age-related decline in endogenous pain modulatory function as measured by TS and CPM.
The Effect of Active Gaming on Cardiovascular Outcomes
(Office of the Vice Chancellor for Research, 2015-04-17) Aqeel, Dania; Ohlman, Tom; Mikesky, Alan E.; Naugle, Keith E.; Naugle, Kelly M.
The U.S. society has become more accustomed to a sedentary lifestyle in the past few decades, partially due to increased time spent in front of a screen. Recently, active gaming, which allows an individual to be physically active during video game play, has been rising in popularity as a means of exercise. However, more research is needed to evaluate whether active gaming can produce cardiovascular responses that fall within the recommended ranges for daily physical activity given by the American College of Sports Medicine (40-60% of heart rate reserve (HRR)). The purpose of this study was to determine the effects of active gaming on cardiovascular outcomes and enjoyment. Nine young adults have been enrolled in this study and data collection is ongoing. Participants completed a training session and four experimental sessions. During each session, participants played one of the following active games at a self-selected intensity for 15 minutes. Heart rate (HR) and rate of perceived exertion (RPE) were measured during game play. Enjoyment was assessed on a 10-cm VAS after each game. Repeated measures ANOVAs were used to determine differences in HRR%, RPE, and enjoyment between games. The results showed that HRR% was greater for Kinect boxing (M=42.7±12.5) compared to all other games (p=.012; Kinect Tennis=35.4±10.7, Wii Boxing=31.8±14.5, Wii Tennis=35.4±10.8). RPE was significantly greater for Kinect Boxing (M=11.3±2.0) compared to Wii Tennis (M=9.67±1.5), p=.038. Enjoyment levels did not differ between games, p=.58 (Kinect Boxing=6.6±2.1, Kinect Tennis=7.1±1.2, Wii Boxing=5.9±0.8, Wii Tennis=6.9±0.9). In conclusion, the active games played at a self-selected intensity were perceived as moderately to highly enjoyable and were able to increase cardiovascular responses. However, the intensity of activity depended on the game. Participants achieved a moderate intensity level (i.e., 40-60% of HRR) while playing Kinect Boxing, but only achieved a light intensity level while playing the other games. Mentor: Kelly M. Naugle, Department of Kinesiology, School of Physical Education, Tourism, and Management, IUPUI
The Effect of Active Gaming on Pressure Pain Sensitivity
(Office of the Vice Chancellor for Research, 2016-04-08) Aqeel, Dania; Ohlman, Tom; Mikesky, Alan E.; Naugle, Keith E.; Naugle, Kelly M.
An acute bout of moderate to vigorous exercise temporarily reduces pain sensitivity in healthy adults, a phenomenon termed exercise-induced hypoalgesia (EIH). Recently, active gaming, which allows an individual to be physically active during video game play, has been rising in popularity as a means of light to moderate exercise. While evidence has shown that active gaming elicits positive cardiovascular and balance outcomes, no research has investigated active gaming as a modifier of pain. The purpose of this study was to determine whether an acute bout of active gaming increases pressure pain thresholds (PPT) in healthy adults. Fourteen young adults were enrolled in this study. Participants completed a training session and four experimental sessions. During each session, participants played one of the following active games for 15 minutes: Kinect Boxing, Kinect Tennis, Wii Boxing, and Wii Tennis. Pressure pain thresholds were measured on the trapezius muscle and the forearm before and immediately after a 15-minute active gaming session. Heart rate was also measured during game play. PPT data was analyzed with repeated measures ANOVA. Bivariate correlations examined the relationship between average percentage of heart rate reserve (HRR%) during game play and magnitude of pain reduction (post– pre). The results showed that PPTs 1) on the forearm and trapezius muscle significantly increased from pre to posttest during the Kinect Boxing session, 2) increased on the trapezius muscle during the Wii Boxing session, and 3) decreased on the forearm during the control session (p’s<.05). Greater HRR% during game play was associated with greater pain reduction (trapezius r=.33; forearm r=0.28; p’s<.05). In conclusion, active games played at a moderate intensity appear to be capable of temporarily reducing pressure pain sensitivity. This study was sponsored by the NIFS Student Research Fund.
Effect of different Kinesio tape tensions on experimentally-induced thermal and muscle pain in healthy adults
(PLOS, 2021-11-05) Naugle, Keith E.; Hackett, Jason; Aqeel, Dania; Naugle, Kelly M.; Kinesiology, School of Health and Human Sciences
Athletes and rehabilitation specialists have used Kinesio tape (KT) to help alleviate pain symptoms. Currently, no clear mechanism exists as to why pain is relieved with the use of KT and whether the pain relieving effect is simply a placebo effect. Additionally, the most effective taping parameters (tension of tape) for pain reduction remain unknown. We used quantitative sensory testing to address these key gaps in the KT and pain literature. Using a repeated-measures laboratory design, we examined whether KT applied at different tensions reduces experimentally-induced pain compared to a no tape condition and KT with minimal tension. Heat pain thresholds (HPT's), pressure pain thresholds (PPT's), and pressure pain suprathreshold (PPS: 125% of PPT) tests were administered to the forearm prior to and during KT and no tape conditions. Tape was applied to the ventral forearm at 25% of max tension, 75% of max tension, and no tension (placebo). Repeated measures ANOVA's evaluated the pain outcomes between conditions and across time. KT had no significant effect on PPT's and HPT's (p's >0.05). The ANOVA on PPS revealed that KT applied at 25% of tension significantly reduced pain ratings from the pretest (M = 34.4, SE = 5.5) to post-test 1 (M = 30.3, SE = 4.7) and post-test 2 (M = 30.4, SE = 4.7). No other conditions significantly reduced suprathreshold pressure pain. However, pain ratings at posttest-1 during the no-tape condition (M = 36.4, SE = 5.3) were significantly greater than pain ratings during post-test 1 and post-test 2 of all three tape conditions. In conclusion, the current study revealed that KT applied at low tension is the optimal tension to reduce pressure-evoked muscle pain. Additionally, the results suggested that KT applied at low, high, or no tension may acutely prevent increased muscle sensitivity with repeated pressure stimulation.
An Exploratory Study of Endogenous Pain Modulatory Function in Patients Following Mild Traumatic Brain Injury
(Oxford University Press, 2019-11-01) Carey, Christopher; Saxe, Jonathan; White, Fletcher A.; Naugle, Kelly M.; Kinesiology, School of Health and Human Sciences
Background: Recent animal research suggests that mild traumatic brain injury (mTBI) facilitates abnormal endogenous modulation of pain, potentially underlying the increased risk for persistent headaches following injury. However, no human studies have directly assessed the functioning of endogenous facilitory and inhibitory systems in the early stages after an mTBI. Objective: The purpose of this exploratory study was to examine trigeminal sensitization and endogenous pain inhibitory capacity in mTBI patients in the acute stage of injury compared with matched controls. We also examined whether post-traumatic headache pain intensity within the mTBI sample was related to sensitization and pain inhibitory capacity. Methods: Twenty-four mTBI patients recruited from emergency departments and 21 age-, race-, and sex-matched controls completed one experimental session. During this session, participants completed quantitative sensory tests measuring trigeminal sensitization (pressure pain thresholds and temporal summation of pain in the head) and endogenous pain inhibition (conditioned pain modulation). Participants also completed validated questionnaires measuring headache pain, depression, anxiety, and pain catastrophizing. Results: The results revealed that the mTBI group exhibited significantly decreased pressure pain thresholds of the head and decreased pain inhibition on the conditioned pain modulation test compared with the control group. Furthermore, correlational analysis showed that the measures of trigeminal sensitization and depression were significantly associated with headache pain intensity within the mTBI group. Conclusions: In conclusion, mTBI patients may be at risk for maladaptive changes to the functioning of endogenous pain modulatory systems following head injury that could increase risk for post-traumatic headaches.
Exploring actual and perceived levels of physical activity intensity during virtual reality active games
(Frontiers Media, 2024-02-09) Naugle, Keith E.; Cervantes, Xzaliya A.; Boone, Carolyn L.; Wind, Brandon; Naugle, Kelly M.; Exercise & Kinesiology, School of Health and Human Sciences
Background: Research suggests that engaging in active virtual reality (VR) video games can elicit light to moderate levels of physical activity (PA), making it a novel and fun mode of exercise. Further research is needed to understand the influence of VR on perceptions of exertion and enjoyment during PA. Objective: The objectives of this study are (1) to compare actual and perceived exertion within and between active VR games with varying levels of difficulty and (2) to determine how playing active VR games influences PA enjoyment during gameplay. Methods: A total of 18 participants completed four separate study sessions, during which they engaged in either a 15-min bout of traditional exercise (stationary cycling) or played one VR game. Heart rate (HR) and ratings of perceived exertion (RPE) using the Borg CR10 scale were assessed during VR gameplay and cycling. Enjoyment was measured after gameplay. VR games included playing Holopoint at level 2 and level 3 and Hot Squat. Repeated measures ANOVAs were used to examine (1) changes in HR and RPE across time within games and (2) differences in actual and perceived levels of intensity and enjoyment between games. Bivariate correlations examined the relationship between the degree of change in actual intensity and the degree of change in perceived intensity during each VR game and cycling. Results: The analyses revealed that RPE and HR significantly increased from baseline during each condition and generally increased across the 15-min of gameplay. Hot Squat and cycling elicited a significantly higher percentage of heart rate reserve (%HRR) than Holopoint at levels 2 and 3. Holopoint level 3 elicited a higher %HRR than Holopoint level 2. The participants reported greater average and max RPE during Hot Squat and cycling compared with Holopoint at levels 2 and 3. The correlations revealed a significant positive correlation between the degree of change in HR and RPE for cycling, but no significant correlations were observed for any of the VR conditions. The physical activity during Holopoint at both levels was rated as more enjoyable than Hot Squat and cycling. Conclusion: Our data support the notion that VR has the potential to alter individuals' perceptions of exertion during PA and, in particular, may reduce their awareness of increases in actual exertion.
Greater functional aerobic capacity predicts more effective pain modulation in older adults
(Office of the Vice Chancellor for Research, 2016-04-08) Ohlman, Tom; Naugle, Keith; Keith, NiCole; Riley, Zachary; Naugle, Kelly M.
Endogenous pain inhibitory and facilitory function deteriorates with age, potentially placing older adults at greater risk for chronic pain. Prior research shows that self-reported physical activity predicts endogenous pain inhibitory capacity and facilitation of pain on quantitative sensory tests (QST) in healthy adults. Purpose: To investigate whether functional aerobic capacity and lower extremity strength in older adults cross-sectionally predicts pain sensitivity, pain inhibition following isometric exercise, and facilitation of pain during heat pain temporal summation (TS) tests. Methods: 42 subjects (10 male, 32 female, age=67.5±5.1) completed the 6-minute walk test (6MWT), 30-second chair stand test, and several QSTs. QSTs included: 1) Pain ratings (0-100 scale) during the submersion of the hand in a cold water bath (CWB), 2) heat pain threshold tests, 3) the amount of pain reduction following submaximal isometric exercise, and 4) degree of pain facilitation during temporal summation tests conducted at 44, 46, and 48°C. Responses on the QSTs were analyzed using hierarchical linear regression with meters on 6MWT and number of chair stands as final predictors. Results: After controlling for demographic and psychological factors, aerobic capacity on 6MWT significantly predicted CWB pain ratings (R2 change= 22.5%, Beta= -0.491), pain facilitation during TS trials at 44°C (R2 change= 16.7%, Beta= -0.446), and the amount of pain reduction following isometric exercise (R2 change= 20.7%, Beta= 0.393). All other analyses were not significant (P>0.05). Conclusions: Older adults exhibiting greater functional aerobic capacity displayed reduced cold pain sensitivity, reduced pain facilitory function, and increased pain inhibition following exercise. These findings suggest that increased aerobic fitness in older adults may be associated with more effective endogenous modulation of pain. This study was funded by the IUPUI School of PETM Faculty Research Opportunity Grant.

Browsing by Author "Naugle, Kelly M."

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