The Effect of Strength Training Methods on Middle-Distance and Long-Distance Runners' Athletic Performance: A Systematic Review with Meta-analysis.

BACKGROUND: The running performance of middle-distance and long-distance runners is determined by factors such as maximal oxygen uptake (VO2max), velocity at VO2max (vVO2max), maximum metabolic steady state (MMSS), running economy, and sprint capacity. Strength training is a proven strategy for improving running performance in endurance runners. However, the effects of different strength training methods on the determinants of running performance are unclear. OBJECTIVE: The aim of this systematic review with meta-analysis was to compare the effect of different strength training methods (e.g., high load, submaximal load, plyometric, combined) on performance (i.e., time trial and time until exhaustion) and its determinants (i.e., VO2max, vVO2max, MMSS, sprint capacity) in middle-distance and long-distance runners. METHODS: A systematic search was conducted across electronic databases (Web of Science, PubMed, SPORTDiscus, SCOPUS). The search included articles indexed up to November 2022, using various keywords combined with Boolean operators. The eligibility criteria were: (1) middle- and long-distance runners, without restriction on sex or training/competitive level; (2) application of a strength training method for ≥ 3 weeks, including high load training (≥ 80% of one repetition maximum), submaximal load training (40-79% of one repetition maximum), plyometric training, and combined training (i.e., two or more methods); (3) endurance running training control group under no strength training or under strength training with low loads (< 40% of one repetition maximum); (4) running performance, VO2max, vVO2max, MMSS and/or sprint capacity measured before and after a strength training intervention program; (5) randomized and non-randomized controlled studies. The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. A random-effects meta-analysis and moderator analysis were performed using Comprehensive meta-analysis (version 3.3.0.70). RESULTS: The certainty of the evidence was very low to moderate. The studies included 324 moderately trained, 272 well trained, and 298 highly trained athletes. The strength training programs were between 6 and 40 weeks duration, with one to four intervention sessions per week. High load and combined training methods induced moderate (effect size = - 0.469, p = 0.029) and large effect (effect size = - 1.035, p = 0.036) on running performance, respectively. While plyometric training was not found to have a significant effect (effect size = - 0.210, p = 0.064). None of the training methods improved VO2max, vVO2max, MMSS, or sprint capacity (all p > 0.072). Moderators related to subject (i.e., sex, age, body mass, height, VO2max, performance level, and strength training experience) and intervention (i.e., weeks, sessions per week and total sessions) characteristics had no effect on running performance variables or its determinants (all p > 0.166). CONCLUSIONS: Strength training with high loads can improve performance (i.e., time trial, time to exhaustion) in middle-distance and long-distance runners. A greater improvement may be obtained when two or more strength training methods (i.e., high load training, submaximal load training and/or plyometric training) are combined, although with trivial effects on VO2max, vVO2max, MMSS, or sprint capacity.

The Mexican dataset of a repetitive transcranial magnetic stimulation clinical trial on cocaine use disorder patients: SUDMEX TMS.

Cocaine use disorder (CUD) is a global health problem with severe consequences, leading to behavioral, cognitive, and neurobiological disturbances. While consensus on treatments is still ongoing, repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising approach for medication-resistant disorders, including substance use disorders. In this context, here we present the SUDMEX-TMS, a Mexican dataset from an rTMS clinical trial involving CUD patients. This longitudinal dataset comprises 54 CUD patients (including 8 females) with data collected at five time points: baseline (T0), two weeks (T1), three months (T2), six months (T3) follow-up, and twelve months (T4) follow-up. The clinical rTMS treatment followed a double-blinded randomized clinical trial design (n = 24 sham/30 active) for 2 weeks, followed by an open-label phase. The dataset includes demographic, clinical, and cognitive measures, as well as magnetic resonance imaging (MRI) data collected at all time points, encompassing structural (T1-weighted), functional (resting-state fMRI), and multishell diffusion-weighted (DWI-HARDI) sequences. This dataset offers the opportunity to investigate the impact of rTMS on CUD participants, considering clinical, cognitive, and multimodal MRI metrics in a longitudinal framework.

Weekly Programming of Hamstring-Related Training Contents in European Professional Soccer.

Hamstring injuries in soccer continue to be a challenge for professionals who work with soccer players daily. Although its origin is multifactorial, the proper management of neuromuscular fatigue during the training microcycle is a very important factor to consider. There are no clear guidelines regarding the weekly distribution of certain exercises that demand the hamstrings. The main objective of this study was to describe the usual training practices of professional European soccer teams. An international observational survey design was applied to some of the strength and conditioning coaches of professional soccer teams. The survey included different neuromuscular demanding exercises for the hamstrings. For each exercise, the strength and conditioning coaches had to respond in relation to their frequency of use and timepoint depending on the day of the weekly microcycle. Although there is no strong consensus in this regard, there does seem to be a trend when applying certain exercises, especially on the days matchday-4 and matchday-3.

Consistent spatial lesion-symptom patterns: A comprehensive analysis using triangulation in lesion-symptom mapping in a cohort of stroke patients.

INTRODUCTION: The relationship between brain lesions and stroke outcomes is crucial for advancing patient prognosis and developing effective therapies. Stroke is a leading cause of disability worldwide, and it is important to understand the neurological basis of its varied symptomatology. Lesion-symptom mapping (LSM) methods provide a means to identify brain areas that are strongly associated with specific symptoms. However, inner variations in LSM methods can yield different results. To address this, our study aimed to characterize the lesion-symptom mapping variability using three different LSM methods. Specifically, we sought to determine a lesion symptom core across LSM approaches enhancing the robustness of the analysis and removing potential spatial bias. MATERIAL & METHODS: A cohort consisting of 35 patients with either right- or left-sided middle cerebral artery strokes were enrolled and evaluated using the NIHSS at 24 h post-stroke. Anatomical T1w MRI scans were also obtained 24 h post-stroke. Lesion masks were segmented manually and three distinctive LSM methods were implemented: ROI correlation-based, univariate, and multivariate approaches. RESULTS: The results of the LSM analyses showed substantial spatial differences in the extension of each of the three lesion maps. However, upon overlaying all three lesion-symptom maps, a consistent lesion core emerged, corresponding to the territory associated with elevated NIHSS scores. This finding not only enhances the spatial accuracy of the lesion map but also underscores its clinical relevance. CONCLUSION: This study underscores the significance of exploring complementary LSM approaches to investigate the association between brain lesions and stroke outcomes. By utilizing multiple methods, we can increase the robustness of our results, effectively addressing and neutralizing potential spatial bias introduced by each individual method. Such an approach holds promise for enhancing our understanding of stroke pathophysiology and optimizing patient care strategies.

Effects of Sand Surface Plyometric and Sprint Training on Physical and Technical Skill Performance in Beach Handball Players.

This study compared the effects of a 6-week combined plyometric and sprint-training program on the sand to regular preseason training, on the athletic performance and technical actions of beach handball (BH) players. Athletes were randomly assigned either to the control (CG, n = 12; BH training only) or the experimental group (EG, n = 12; plyometric + sprint + BH training). Assessments conducted before and after the training period included a squat jump, a countermovement jump, the Abalakov jump, a 15-m sprint, a modified Course-Navette endurance test, and four sport-specific BH throwing speed tests: a standing penalty throw, a 3-step running throw, a jump throw, and a 360º jump throw. The training intervention enhanced all athletic performance measures (all, p < 0.05). In contrast, the only improvement in the CG included endurance performance (p< 0.05). Significant time-group differences were noted in favor of the EG compared to the CG (p< 0.05) in the squat jump, the countermovement jump, the Abalakov jump, the jump throw velocity and 360º jump throw velocity. In conclusion, compared to BH regular training, 6 weeks of sand surface preseason plyometric and sprint training combined with regular BH training induced greater improvements in athletic performance and specific skills in BH players.

Cortical and subcortical microstructure integrity changes after repetitive transcranial magnetic stimulation therapy in cocaine use disorder and relates to clinical outcomes.

Cocaine use disorder (CUD) is a worldwide public health condition that is suggested to induce pathological changes in macrostructure and microstructure. Repetitive transcranial magnetic stimulation (rTMS) has gained attention as a potential treatment for CUD symptoms. Here, we sought to elucidate whether rTMS induces changes in white matter (WM) microstructure in frontostriatal circuits after 2 weeks of therapy in patients with CUD and to test whether baseline WM microstructure of the same circuits affects clinical improvement. This study consisted of a 2-week, parallel-group, double-blind, randomized controlled clinical trial (acute phase) (sham [n = 23] and active [n = 27]), in which patients received two daily sessions of rTMS on the left dorsolateral prefrontal cortex (lDLPFC) as an add-on treatment. T1-weighted and high angular resolution diffusion-weighted imaging (DWI-HARDI) at baseline and 2 weeks after served to evaluate WM microstructure. After active rTMS, results showed a significant increase in neurite density compared with sham rTMS in WM tracts connecting lDLPFC with left and right ventromedial prefrontal cortex (vmPFC). Similarly, rTMS showed a reduction in orientation dispersion in WM tracts connecting lDLPFC with the left caudate nucleus, left thalamus, and left vmPFC. Results also showed a greater reduction in craving Visual Analogue Scale (VAS) after rTMS when baseline intra-cellular volume fraction (ICVF) was low in WM tracts connecting left caudate nucleus with substantia nigra and left pallidum, as well as left thalamus with substantia nigra and left pallidum. Our results evidence rTMS-induced WM microstructural changes in fronto-striato-thalamic circuits and support its efficacy as a therapeutic tool in treating CUD. Further, individual clinical improvement may rely on the patient's individual structural connectivity integrity.

Effect of Strength Training Programs in Middle- and Long-Distance Runners' Economy at Different Running Speeds: A Systematic Review with Meta-analysis.

BACKGROUND: Running economy is defined as the energy demand at submaximal running speed, a key determinant of overall running performance. Strength training can improve running economy, although the magnitude of its effect may depend on factors such as the strength training method and the speed at which running economy is assessed. AIM: To compare the effect of different strength training methods (e.g., high loads, plyometric, combined methods) on the running economy in middle- and long-distance runners, over different running speeds, through a systematic review with meta-analysis. METHODS: A systematic search was conducted across several electronic databases including Web of Science, PubMed, SPORTDiscus, and SCOPUS. Using different keywords and Boolean operators for the search, all articles indexed up to November 2022 were considered for inclusion. In addition, the PICOS criteria were applied: Population: middle- and long-distance runners, without restriction on sex or training/competitive level; Intervention: application of a strength training method for ≥ 3 weeks (i.e., high loads (≥ 80% of one repetition maximum); submaximal loads [40-79% of one repetition maximum); plyometric; isometric; combined methods (i.e., two or more methods); Comparator: control group that performed endurance running training but did not receive strength training or received it with low loads (< 40% of one repetition maximum); Outcome: running economy, measured before and after a strength training intervention programme; Study design: randomized and non-randomized controlled studies. Certainty of evidence was assessed with the GRADE approach. A three-level random-effects meta-analysis and moderator analysis were performed using R software (version 4.2.1). RESULTS: The certainty of the evidence was found to be moderate for high load training, submaximal load training, plyometric training and isometric training methods and low for combined methods. The studies included 195 moderately trained, 272 well trained, and 185 highly trained athletes. The strength training programmes were between 6 and 24 weeks' duration, with one to four sessions executed per week. The high load and combined methods induced small (ES = - 0.266, p = 0.039) and moderate (ES = - 0.426, p = 0.018) improvements in running economy at speeds from 8.64 to 17.85 km/h and 10.00 to 14.45 km/h, respectively. Plyometric training improved running economy at speeds ≤ 12.00 km/h (small effect, ES = - 0.307, p = 0.028, ß1 = 0.470, p = 0.017). Compared to control groups, no improvement in running economy (assessed speed: 10.00 to 15.28 and 9.75 to 16.00 km/h, respectively) was noted after either submaximal or isometric strength training (all, p > 0.131). The moderator analyses showed that running speed (ß1 = - 0.117, p = 0.027) and VO2max (ß1 = - 0.040, p = 0.020) modulated the effect of high load strength training on running economy (i.e., greater improvements at higher speeds and higher VO2max). CONCLUSIONS: Compared to a control condition, strength training with high loads, plyometric training, and a combination of strength training methods may improve running economy in middle- and long-distance runners. Other methods such as submaximal load training and isometric strength training seem less effective to improve running economy in this population. Of note, the data derived from this systematic review suggest that although both high load training and plyometric training may improve running economy, plyometric training might be effective at lower speeds (i.e., ≤ 12.00 km/h) and high load strength training might be particularly effective in improving running economy (i) in athletes with a high VO2max, and (ii) at high running speeds. PROTOCOL REGISTRATION: The original protocol was registered ( https://osf.io/gyeku ) at the Open Science Framework.

Paternal Prenatal and Lactation Exposure to a High-Calorie Diet Shapes Transgenerational Brain Macro- and Microstructure Defects, Impacting Anxiety-Like Behavior in Male Offspring Rats.

Prenatal exposure to high-energy diets (HED) increases the susceptibility to behavioral alterations in the male offspring. We addressed whether prenatal HED primes the transgenerational inheritance of structural brain changes impacting anxiety/depression-like behavior in the offspring. For this, we used female Wistar rats exposed to a HED [cafeteria (CAF) diet, n = 6] or chow [control (CON) n = 6] during development. Anxiety and depression-like behavior were evaluated in filial 1 (F1), filial 2 (F2), and filial 3 (F3) male offspring using the open field (OFT), elevated plus maze, novelty suppressed feeding (NSFT), tail suspension (TST), and forced swimming tests. Structural brain changes were identified by deformation-based morphometry (DBM) and diffusion tensor imaging using ex vivo MRI. We found that the F1, F2, and F3 offspring exposed to CAF diet displayed higher anxious scores including longer feeding latency during the NSFT, and in the closed arms, only F1 offspring showed longer stay on edges during the OFT versus control offspring. DBM analysis revealed that CAF offspring exhibited altered volume in the cerebellum, hypothalamus, amygdala, and hippocampus preserved up to the F3 generation of anxious individuals. Also, F3 CAF anxious exhibited greater fractional anisotropy and axial diffusivity (AD) in the amygdala, greater apparent diffusion coefficient in the corpus callosum, and greater AD in the hippocampus with respect to the control. Our results suggest that prenatal and lactation exposure to HED programs the transgenerational inheritance of structural brain changes related to anxiety-like behavior in the male offspring.

Effects of Combined Uphill-Downhill Sprinting Versus Resisted Sprinting Methods on Sprint Performance: A Systematic Review and Meta-analysis.

BACKGROUND: Two specific sprint training methods that are present to varying degrees in research and practice are combined uphill-downhill sprinting (UDS) and resisted sprint training methods (RS). Both methods seem to improve sprint performance, but to the author's knowledge a comparison does not exist investigating the differences between the two training protocols and traditional sprinting. OBJECTIVE: The present systematic review and meta-analysis investigated sprint performance changes between combined uphill-downhill sprinting and resisted sprinting methods (sleds, cables/bands, vests, uphill) and how these compared with traditional sprinting. METHODS: A literature search was performed on 19 December 2022, in the databases PubMed, SPORTDiscus, Web of Science and SCOPUS, which from 22 studies yielded a total of 24 eligible groups (UDS, n = 6; RS, n = 18). Studies that measured sprint performance, had a traditional sprinting control, and used either training intervention in healthy individuals of any age for ≥ 4 weeks were eligible for the meta-analysis. The change in sprint performance from baseline to post intervention was compared between the interventions and their traditional sprinting control group. Outcomes were expressed as standardized mean differences (SMD). RESULTS: The standardized changes in sprint performance between intervention groups and traditional-sprinting controls (negative in favour of intervention, positive in favour of traditional sprint) and 95% confidence interval (CI) were as follows: small for UDS (SMD - 0.41 [- 0.79, - 0.03]; p = 0.03), trivial for RS (SMD - 0.14 [- 0.36, 0.07]; p = 0.19). CONCLUSION: Combined uphill-downhill sprinting was more effective than traditional sprinting, while resisted sprinting was not. It appears that resisted sprint interventions do not increase sprint performance any more than traditional sprinting. Subgroup analysis and meta-regression appear to show differences between sled loads and possible differences across distances tested. The results of this review and meta-analysis seem to warrant further investigations into the possibility that UDS may be a superior sprint training method to resisted and traditional sprinting.

Dopamine dysregulation in Parkinson's disease flattens the pleasurable urge to move to musical rhythms.

The pleasurable urge to move to music (PLUMM) activates motor and reward areas of the brain and is thought to be driven by predictive processes. Dopamine in motor and limbic networks is implicated in beat-based timing and music-induced pleasure, suggesting a central role of basal ganglia (BG) dopaminergic systems in PLUMM. This study tested this hypothesis by comparing PLUMM in participants with Parkinson's disease (PD), age-matched controls, and young controls. Participants listened to musical sequences with varying rhythmic and harmonic complexity (low, medium and high), and rated their experienced pleasure and urge to move to the rhythm. In line with previous results, healthy younger participants showed an inverted U-shaped relationship between rhythmic complexity and ratings, with preference for medium complexity rhythms, while age-matched controls showed a similar, but weaker, inverted U-shaped response. Conversely, PD showed a significantly flattened response for both the urge to move and pleasure. Crucially, this flattened response could not be attributed to differences in rhythm discrimination and did not reflect an overall decrease in ratings. For harmonic complexity, PD showed a negative linear pattern for both the urge to move and pleasure while healthy age-matched controls showed the same pattern for pleasure and an inverted U for the urge to move. This contrasts with the pattern observed in young healthy controls in previous studies, suggesting that both healthy aging and PD also influence affective responses to harmonic complexity. Together, these results support the role of dopamine within cortico-striatal circuits in the predictive processes that form the link between the perceptual processing of rhythmic patterns and the affective and motor responses to rhythmic music.

Abnormal functional neurocircuitry underpinning emotional processing in fibromyalgia.

Fibromyalgia, a condition characterized by chronic pain, is frequently accompanied by emotional disturbances. Here we aimed to study brain activation and functional connectivity (FC) during processing of emotional stimuli in fibromyalgia. Thirty female patients with fibromyalgia and 31 female healthy controls (HC) were included. Psychometric tests were administered to measure alexithymia, affective state, and severity of depressive and anxiety symptoms. Next, participants performed an emotion processing and regulation task during functional magnetic resonance imaging (fMRI). We performed a 2 × 2 ANCOVA to analyze main effects and interactions of the stimuli valence (positive or negative) and group (fibromyalgia or HC) on brain activation. Generalized psychophysiological interaction analysis was used to assess task-dependent FC of brain regions previously associated with emotion processing and fibromyalgia (i.e., hippocampus, amygdala, anterior insula, and pregenual anterior cingulate cortex [pACC]). The left superior lateral occipital cortex showed more activation in fibromyalgia during emotion processing than in HC, irrespective of valence. Moreover, we found an interaction effect (valence x group) in the FC between the left pACC and the precentral and postcentral cortex, and central operculum, and premotor cortex. These results suggest abnormal brain activation and connectivity underlying emotion processing in fibromyalgia, which could help explain the high prevalence of psychopathological symptoms in this condition.

Maturity Offset, Anthropometric Characteristics and Vertical Force-Velocity Profile in Youth Basketball Players.

This work aimed to analyze the relationships between maturity offset, anthropometric variables and the vertical force-velocity profile in youth (12-18 years old) male basketball players. The vertical force-velocity profile was measured in 49 basketball players, grouped in competitive-age categories, i.e., under 14, 16 and 18 years of age (U-14, U-16 and U-18, respectively). A bivariate correlational analysis was carried out between maturity offset, anthropometric variables (height, body mass, % fat, muscle mass, bone mass and body mass index (BMI)) and vertical force-velocity profile (theoretical maximal force [F0], theoretical maximal velocity [V0], theoretical maximal power [Pmax], force-velocity imbalance [Fvimb] and force-velocity profile orientation). The results showed significant correlations (p < 0.05) between Fvimb and maturity offset at early ages of training (12-15 years). The anthropometric profile was correlated (p < 0.05) with F0 in U-14, V0 in U-16, and Pmax in U-18 basketball players. The current findings suggest a relationship between the vertical force-velocity imbalance and maturity offset and the main vertical force-velocity profile variables. The vertical force-velocity profile is hypothesized as a useful index to correct vertical force-velocity deficits according to the maturity offset of male basketball players.

Effect of Foam Roll recovery method on performance in water polo players: a randomized controlled trial.

OBJECTIVES: This intervention study aimed to evaluate how the use of Foam Roller (FR) as a recovery strategy affects water polo performance after a seven-week (28-session) program. DESIGN: A randomized controlled trial. METHODS: Thirty water polo players (14 male amateur players and 16 female sub-elite players) were assigned by means of sealed opaque envelopes to the control group (CG) or Foam Roller Group (FRG) and performed the same total number and intensity of training sessions. Test protocols were performed before (pretest), in-test (week 5), and after the intervention period (posttest). These included water polo-specific performance tests such as in-water boost, throwing speed, and 20 m sprint swimming tests. In addition, during the intervention, heart rate (HR), the scale of perceived exertion of the session (sRPE), and total quality recovery scale (TQR) data were recorded. RESULTS: There were no differences in the baseline values in any of the variables analyzed between CG and FRG. A small decrease in in-water boost was observed in CG (-2%, ES = -0.35 [-0.95: 0.26], p = 0.016, very likely small) and in FRG (-2%, ES = -0.33 [-0.93: 0.27], p = 0.021, likely small). No significant changes were found in either the 20 m swim test or the throwing test in CG and FRG. No clear differences among groups and weeks were found in sRPE, TQR and HR. CONCLUSION: The findings indicate that the use of FR as a recovery tool after training and matches is not useful in water polo players.

Modeling vulnerability and intervention targets in the Borderline Personality Disorder system: A network analysis of in silico and in vivo interventions.

Modeling psychopathology as a complex dynamic system represents Borderline Personality Disorder (BPD) as a constellation of symptoms (e.g., nodes) that feedback and self-sustain each other shaping a network structure. Through in silico interventions, we simulated the evolution of the BPD system by manipulating: 1) the connectivity strength between nodes (i.e., vulnerability), 2) the external disturbances (i.e., stress) and 3) the predisposition of symptoms to manifest. Similarly, using network analysis we evaluated the effect of an in vivo group psychotherapy to detect the symptoms modified by the intervention. We found that a network with greater connectivity strength between nodes (more vulnerable) showed a higher number of activated symptoms than networks with less strength connectivity. We also found that increases in stress affected more vulnerable networks compared to less vulnerable ones, while decreases in stress revealed a hysteresis effect in the most strongly connected networks. The in silico intervention to symptom alleviation revealed the relevance of nodes related to difficulty in anger regulation, nodes which were also detected as impacted by the in vivo intervention. The complex systems methodology is an alternative to the common cause model with which research has approached the BPD phenomenon.

Effect of individualised strength and plyometric training on the physical performance of basketball players.

The aims of this study were to examine the effects of eight weeks of individualised force-velocity imbalance (F-Vimb) training on physical performance in basketball players and to analyse the differences in physical performance between two periods of time (four to eight weeks) with this training. Thirty male players (age, 22.8 ± 5.68 years; height, 1.87 ± 0.07 m; body mass, 86.3 ± 11.1 kg) were divided into an intervention group (INT, n = 15), who performed an individualised training based on individual F-Vimb; and a control group (CON, n = 15), who underwent a non-individualised training programme; both groups performed two days/week of intervention and the same pre-season basketball training. At baseline, at four weeks, and at eight weeks of intervention, an assessment was performed including countermovement-jumps, unilateral drop jumps, triple hop test, force-velocity profile, sprint and change of direction (COD). At four weeks, the INT showed improvements in sprint and vertical jumping actions (≥3.76%, ES ≥0.44, p ≤ 0.02). At eight weeks, the INT continued to improve vertical jumping actions (p < 0.05) and showed improvements in horizontal jumping (6.80%, ES = 0.45, p < 0.01) and COD (≥2.99%, ES ≥0.96, p < 0.01). A significant reduction in F-Vimb was observed for INT (ES = 0.77, p = 0.01). In contrast, none of these changes were observed in CON. Thus, an individualised F-Vimb training intervention improved physical performance after eight weeks, with changes in sprint and vertical jump after first four weeks. Basketball coaches should optimise the force-velocity profile and improve the performance in sport-related actions as jumping and changing direction.

An individualised F-Vimb training programme improved sport-specific actions after eight weeks in basketball athletes.Improvements were specific to the orientation worked on, with vertical jumping and sprint actions being the most sensitive to change after just four weeks of individualised F-Vimb intervention.In complex actions such as COD, it would be recommended to optimise the F-V profile, emphasising a vertical force-orientation for at least 8 weeks.

Case Report: "I got my brain back" A patient's experience with music-induced analgesia for chronic pain.

Listening to music has progressively been proposed as a complementary alternative for chronic pain; understanding its properties and its neurobiological bases is urgent. We show a phenomenological investigation of a woman who has lived 20 years with chronic pain. The inquiry involved her experience of the context in which she listens to music, the intensity and quality of pain, body mapping, memories, emotions, and cognition. The participant listens to music for different reasons, such as pain and anxiety relief, motivation to exercise, and quality of sleep, but all seem to revolve around different strategies for pain management. Experiences in physiological and cognitive aspects included perceived restorative sleep that may have improved the participant's general wellbeing and improved cognitive and motor performance as well as communication skills. The music enabled the participant not only to relieve pain but also withdrawal effects after discontinuing her opioid-based treatment. These effects may encompass endogenous opioid and dopamine mechanisms involving natural analgesia associated with pleasurable experiences. Future studies could consider phenomenological case studies and therapeutic accompaniment to reorient subjective properties of pain and expand quantitative and qualitative knowledge for more comprehensive reports on music and analgesia.