Spatiotemporal Patterns of Pain During Exercise
Condition: Pain
Study type: Interventional
Phase: Early Phase 1

Summary: 
      The purpose of this study will be to study the individual spatiotemporal structure and
      dynamics of topologically defined areas of perceived body discomfort and pain during
      exercise. Participants will perform two constant tests (cycling and running) at an intensity
      corresponding to Borg's scale of Rating of Perceived Exhaustion (RPE) (6-20) = 15 (i.e.,
      hard). Using a body map template, participants will report every 15s the perceived locations
      with discomfort and pain independently of the magnitude of the discomfort and pain.
    

Detailed description: 
      1. Intro Pain recently was defined as distressing experience associated with actual or
           potential tissue damage with sensory, cognitive, emotional, and social components. Pain
           can be seen as perceptual marker within physical exercise. Individuals can report on a
           number of perceptual markers such as the changes in exertive pain which was shown to be
           a distinct source of information than reports of PE during cycling for instance. The
           perceptual markers of pain are still little investigated within exercise settings.

           From another side, to best understand exertive pain, one needs to consider several
           dimensions of pain including the sensory-discriminative, affective-motivational, and the
           cognitive-evaluative dimensions. Several number of studies within the exercise science
           have focused on the sensory-discriminative dimension of pain. Results from these have
           suggested a linear relationship between pain perception and the power output in diverse
           effort settings including cycling, static and dynamic handgrip squeezing, and
           incremental treadmill running. Indeed, the comparison of ratio of leg pain to arm pain
           during cycling and running has also demonstrated that the ratio of leg to arm pain
           increases across higher intensities.

           Most of the extant work however centred on pain and PE from a group-based standpoint to
           lead to group-based conclusions. Traditionally, within exercise science, variables are
           measured at distinct, low-frequency time points, and then are either averaged over the
           course of the trial or reported at the measured time. In turn, such practices make it
           difficult to measure dynamic feed-forward and feedback control mechanisms inherent in
           these variables. Taken these together, studying pain and discomfort from an individual,
           case-by-case standpoint, in a high-frequency time points setting, may present unique
           benefits. Considering that the physiological and psychological variables (e.g., PE)
           present fluctuations during heavy constant-power cycling when reporting at a measurement
           frequency of 15s it seems plausible to assume that pain locations can also fluctuate.
           Consequently, it may be useful to distinguish amongst differential types of
           spatiotemporal pain fluctuations patterns during exercise. Mapping these dynamics can
           help predict individual-specific fatigue in the course of exercise. The functional role
           of fluctuating dynamics has already been studied in psychological (e.g., volitional
           states, thought processes) and kinematic variables during constant-power exercise
           performed until volitional exhaustion. These approaches are important in that the
           suppression of the intra- individual variability performed by a statistical averaging
           may hide the properties of individual systems.

           In this vein, we tend to study and delineate individualized pain and discomfort patterns
           in exercise. The purpose of this study will be to study the individual spatiotemporal
           structure and dynamics of topologically defined areas of perceived body discomfort and
           pain during exercise.

        2. Methods 2.1 Participants To determine the sample size for this study a power analysis
           was conducted using G*Power 3.1. In studies of thought processes larger effect sizes
           have been reported. Thus, using an effect size of d = 1.0, α < 0.05, power (1 - β) =
           0.80, a sample size of n = 11 emerged. Caucasian physical education students (age range:
           18 - 30 years) undergoing regular aerobic exercise will be recruited to participate
           voluntarily in the study. Students will receive oral and written information regarding
           the study. They will be additionally encouraged to ask questions if there would still
           any ambiguities.

      2.2 Materials and procedure Completion of this study will took a total of three sessions,
      separated by one-week intervals, and each of approximately 30 minutes. At week one,
      participants will complete a baseline incremental cycling and running tests to determine the
      workload and velocity values corresponding to their RPE (6-20 Borg's scale) = 15 (i.e.,
      heavy). At this time, participants also will be familiarized with the use of body maps and
      reporting procedures. At week two and three, participants will complete the constant-power
      cycling and constant velocity running tasks, respectively, in a counter-balanced assigned
      order.

      2.2.1. Monitoring for Discomfort and Pain Every 15s during exercise, upon the researcher's
      prompts, participants will report bodily locations with discomfort and pain on a body map
      scale.

      2.2.2. Constant-power Cycling Task The task will include an incremental warm-up session and a
      constant-power cycling which will be performed up to volitional exhaustion. The
      constant-power cycling will begin when participants will report RPE = 15 during the
      incremental warm-up and the cycling task will last up to volitional exhaustion. The end will
      be set when participants won't be able to cycle longer at the fixed cadence for five
      consecutive seconds at the sitting position.

      2.2.3. Constant-velocity Running Task The task will include an incremental warm-up (identical
      to the running baseline test) and a constant velocity run which will be performed up to
      volitional exhaustion. The constant velocity run will start when participants will achieve
      and report RPE = 15 during the incremental warm-up and will last up to volitional exhaustion
      when they could no longer be able to maintain the imposed velocity.

      2.2.4. Commitment check Upon the completion of all testing procedures participants will
      answer questions about complete commitment to measure their commitment levels to the
      reporting tasks (a) and commitment to task (b), on an 11-point Likert-type scale with anchors
      ranging from 0 (not at all) to 10 (greatly).

      2.3 Data collection and analysis All the locations for each participant will be transformed
      to binary vectors. Investigators will analyse the effects of the time steps using repeated
      measures ANOVAs. Principal component analysis (PCA) will be used to reduce the dimensionality
      of the local discomfort and/or pain data (that will be obtained from the 50-item pain map).
      The data and time of each testing session will be reported in a list. All data can be
      reconstructed for each participants.
    

Intervention name(s): Exercise
Intervention type(s): Other
Intervention description(s): Completion of this study will took a total of three sessions, separated by one-week intervals. At week one, participants will complete a baseline incremental cycling and running tests to determine the workload and velocity values corresponding to their RPE (6-20 Borg's scale) = 15 (i.e., heavy). Participants also will be familiarized with the use of body maps and reporting procedures. At week two and three, participants will complete the constant-power cycling and constant velocity running tasks. The constant-power cycling and running will last up to volitional exhaustion. The end will be set when participants won't be able to cycle longer at the fixed cadence.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: Patterns; Pain; Cycling; Running; Exhaustion