Multivariable Recovery After Exercise-induced Muscle Pain in the Forearm Muscles

Study Overview
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Brief Summary
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This study investigates the evolution of sensory, motor and tissue variables following exercise-induced pain in wrist extensor muscles in healthy subjects.

Detailed Description
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The aim of this study is to determine how is the normalization process of sensory (pressure pain thresholds, subjective pain sensation, self-recovery perception), motor (maximal isometric strength, active range of motion, manual dexterity) and tissue (myotonometer) variables after an experimental pain model in the extensor forearms muscles, by delayed onset muscle soreness after an eccentric exercise in healthy subjects. This way will be possible to establish 1) if there are differences in the time of normalization for each variable; 2) if there is a correlation between each variable and self-recovery perception. Seven assessment sessions are performed in a 14-days period. Day 0 (baseline assessment 1), Day 7 (baseline assessment 2, pre exercise), Day 7 (post exercise), Day 8 (24-hours post exercise), Day 9 (48-hours post exercise), Day 10 (72-hours post exercise), Day 14 (1-week post exercise).

Official Title
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Temporal Relationship in Recovery of Sensory, Motor and Tissue Variables in an Experimental Exercise-induced Muscle Pain Model of the Wrist Extensor Muscles

Conditions
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Musculoskeletal Pain, Healthy, Delayed Onset Muscle Soreness

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult healthy subjects of both sexes. Age: 18-50. Being free from any pain specific to the upper limb and/or in general. Exclusion Criteria: History of acute or chronic painful condition in the previous 3 months. Regular medication intake for any reason. History of severe injury in the upper extremity (e.i. fracture). Prior surgery in the upper limb. Diagnosed of any chronic pain syndrome (fibromyalgia, migraine, etc.) or severe disease. Withdrawal Criteria: Being involved in new physical stimulus, which volunteer is not used to. Micronutrient supplementation intake. NSAIDs or other medication intake.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Healthy subjects<br>Participants free from any pain specific to the upper limb during the past 3 months, chronic pain or other disease. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Pressure Pain Thresholds: pressure algometry | Changes in pressure pain thresholds will be determined with pressure algometry bilaterally over the forearm, leg and shoulder. Pressure Pain Threshold is defined as the exact time point where the pressure is first being perceived at painful. | Day-1 (baseline assessment 1), Day-7 (baseline assessment 2, pre exercise), Day-7 (post-exercise), Day-8 (24 hours post-exercise), Day-9 (48 hours post-exercise), Day-10 (72 hours post-exercise), Day-14 (1-week post-exercise). | 
| Changes in subjective perception of pain and recovery: Likert Scale | A modified 7-item Likert Scale for pain (0 No pain - 6 Severely disabling pain) and a visual analogue scale (0-10 cm) for self-recovery perception will be filled up to show subjective perception along the follow-up period. | Day-1 (baseline assessment 1), Day-7 (baseline assessment 2, pre exercise), Day-7 (post-exercise), Day-8 (24 hours post-exercise), Day-9 (48 hours post-exercise), Day-10 (72 hours post-exercise), Day-14 (1-week post-exercise). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in mechanical properties of the muscle | Changes in mechanical properties of the muscle will be determined with myotonometer bilaterally over the forearm. | Day-1 (baseline assessment 1), Day-7 (baseline assessment 2, pre exercise), Day-7 (post-exercise), Day-8 (24 hours post-exercise), Day-9 (48 hours post-exercise), Day-10 (72 hours post-exercise), Day-14 (1-week post-exercise). | 
| Changes in manual dexterity | Changes in manual dexterity of both upper limbs will be assessed by the Nine Hole Peg Test. Participants will had to place 9 pegs in a specifically designed board as fast as possible. | Day-1 (baseline assessment 1), Day-7 (baseline assessment 2, pre exercise), Day-7 (post-exercise), Day-8 (24 hours post-exercise), Day-9 (48 hours post-exercise), Day-10 (72 hours post-exercise), Day-14 (1-week post-exercise). | 
| Changes in maximal isometric force | Changes in wrist extensors maximal isometric strength will be assessed with hand-held dynamometry. | Day-1 (baseline assessment 1), Day-7 (baseline assessment 2, pre exercise), Day-7 (post-exercise), Day-8 (24 hours post-exercise), Day-9 (48 hours post-exercise), Day-10 (72 hours post-exercise), Day-14 (1-week post-exercise). | 
| Changes in active range of motion | Changes in active range of motion of the wrist will be assessed in both sides using a digital inclinometer. | Day-1 (baseline assessment 1), Day-7 (baseline assessment 2, pre exercise), Day-7 (post-exercise), Day-8 (24 hours post-exercise), Day-9 (48 hours post-exercise), Day-10 (72 hours post-exercise), Day-14 (1-week post-exercise). | 
| Level of catastrophizing | Punctuation obtained in Pain Catastrophizing Scale (PCS). It comprises 13 items which focus on thoughts and feelings encountered while experiencing pain. Each item is scored from 0 (not at all) to 4 (all the time) with a total PCS score range from 0-52 points, where higher scores indicating higher levels of pain catastrophizing. | Day-1 (baseline), Day-14 (1-week post-exercise). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Musculoskeletal pain, Delayed Onset Muscle Soreness, Pain mechanisms, Pressure Pain Threshold, Myotonometer, Maximal isometric strength, Manual dexterity