Education Time Influence on Exercise-Induced Hypoalgesia
Phase: NA
Conditions: Exercise
Sponsor: University of South Dakota

Education Time Influence on Exercise-Induced Hypoalgesia 
 
NCT05658224 
 
 
7/10/23 

Procedures 
 
Following informed consent and screening for inclusion/exclusion criteria, participants were 
randomly assigned into two groups. These groups consisted of a short educational group (SEG), 
in which participants were provided 1 minute of education on EIH before performing the 
activity, or a long education group (LEG) who were given 10-15 minutes of education on EIH 
before performing the activity. The SEG and LEG scripts are provided below in Appendices 1 
and 2.11 
After group allotment, participant demographic information was collected. Demographic 
information of interest included age, gender, history of injuries, athletic participation history, and 
Knowledge and Beliefs about Exercise and Pain Questionnaire (KBAEPQ) (questions 1-5). 
Education and data collection were performed by the same two personnel for every round of 
participants, while the other two investigators, who were blinded to group allotment, were 
responsible for testing. After demographic data collection and education were provided, testing 
personnel were brought into the treatment room to introduce PPT. Hand-held algometers were 
used to assess PPTs, which was initially done on the participant’s first web space, between the 
thumb and index finger, of the dominant hand. The algometer, which has a small, 1cm2 probe, 
was applied perpendicular to the participant's skin. Pressure was applied with an increasing rate 
of 1kg of force per second until the pressure turned to pain. A verbal command was given by the 
participant to cue the tester to stop applying pressure and record the PPT measurement. After the 
initial introduction of PPT was delivered, baseline PPTs were delivered to the dominant 
quadriceps, 15 cm from the base of the patella and to the non-dominant upper trapezius muscle 
10 cm proximal to the acromion, in line with the 7th vertebra. Determining the dominant limb 
was done by asking what hand a participant writes with and what leg would they use to kick a 

ball. Before starting the wall squat, participants were asked to rate the pain in their legs using the 
NPRS ranging from 0 (no pain at all) to 10 (the worst pain imaginable). After baseline PPTs 
were measured and pain in the legs was recorded, participants were instructed to perform an 
isometric wall squat. The wall squat exercise consisted of standing upright with the participant’s 
back against the wall with feet 45 cm from the wall, feet parallel and shoulder width apart, and 
hands at their side. Participants were then instructed to slide down the wall bending at the hips 
and knees, keeping their back against the wall and feet in place until their knee joint angle 
reaches 100 degrees of flexion, which was measured by the study personnel. A picture of the 
isometric wall squat was provided to the participants for familiarization. Participants were then 
asked to hold the wall squat position until fatigue or up to 3 minutes, whichever came first. 
Additional NPRS and RPE values were assessed by study personnel at the 1-, 2-, and 3-minute 
marks. The NPRS and RPE have been identified as having good reliability and validity in many 
different clinical trials.12-14 Immediately following cessation of the wall squat, PPTs were 
measured again in the dominant quadriceps and the non-dominant trapezius muscles. All PPTs 
were assessed 3 times with no less than 15 seconds in between. The average of the three trials 
was utilized for data analysis. Lastly, participants were asked to rate their expectation of exercise 
on PPTs using a -10 to 10 expectation scale. A score of -10 would indicate that much less 
pressure is needed to reach the PPT, a score of 0 indicates no change, and a score of 10 would 
indicate that much more pressure is needed to reach the PPT. 
Data Analysis 
 
All statistics will be performed using IBM SPSS Statistics for Windows, version 27.0 (IBM 
Corp., Armonk, N.Y., USA) using the significance threshold of 𝝰<0.05. Descriptive statistics of 
means, standard deviations, and frequencies will be calculated for the sample participants. An 

independent samples t-test was calculated to compare differences between PPT at the two 
locations sites for the SEG and LEG before and after exercise as well as the change in PPT from 
the exercise. NPRS and RPE will be reported for each group with an independent sample t-test 
performed between groups.