Abstract

Chronic pain is defined as persistent pain for more than three months, resulting in changes in the functional synaptic network of the brain and its gray matter dimensions, causing hypersensitivity to a nociceptive stimulus and increased excitability of the nodal stress mechanism, causing the individual to remain in a state of alert (hyperactivation of the sympathetic nervous system) in normal daily activities, increasing their level of stress, anxiety, and fear.

It can be classified as primary with no known etiology or secondary pertinent to a specific pathological process and clinical diagnosis. Despite the high relevance of studies addressing the importance of exercise for these individuals, their understanding of the correct assessment and prescription during clinical practice remains unclear.

Scientific evidence focuses on establishing which exercise modality is most suitable; however, we observed a lack of information on recurrent neurofunctional and biomechanical changes in this population, which we can classify as a pathological pattern that should not be neglected.

In previous studies, we observed that it directly impacts cardiac rehabilitation and adherence to physical exercise, significantly increasing disability and mortality in the population. We also observed that individuals with chronic pain present patterns of changes in motor control and kinesiophobia, with chronic low back pain and knee osteoarthritis being the most frequent causes of disability, directly impacting cardiac rehabilitation due to the difficulty in obtaining adequate adherence to physical exercise. Both pathologies mentioned are very relevant in the literature and clinical practice. However, any chronic musculoskeletal pain can lead to functional disability, as musculoskeletal pain in the lower and upper limbs directly impacts gait, work activities, and physical activities, including exercise and activities of daily living.

In previous studies, it has been possible to observe the pathophysiology of chronic pain, which is responsible for altering the neuromuscular reflex and causing changes in motor control due to several factors, including muscular inhibition, muscular rigidity, body perception deficit, and changes in the sensorimotor system.