Effects of Acute Exercise on Pain and Human Movement

Study Overview
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Brief Summary
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The aim of this research project is to evaluate the effect of an acute exercise intervention on pain intensity and movement control. It also aims to investigate potential differences in movement con-trol between patients with chronic musculoskeletal pain compared to healthy controls.

Detailed Description
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The aim of this research project is to evaluate the effect of an acute exercise intervention on pain intensity and movement control. It also aims to investigate potential differences in movement control between patients with chronic musculoskeletal pain compared to healthy controls. All tests will be conducted at Dalarna University. After the initial baseline tests, participants will be randomised to either acute exercise intervention group or to a control group not performing any intervention groups (both patients and controls will be randomised to intervention or control). If randomised to the control group, participants rests corresponding to the time it takes to perform the intervention (30 min), and then preform the post-intervention tests similar as the intervention group.

Official Title
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Effects of Acute Exercise on Pain and Human Movement - a Randomised Controlled Study in Patients With Chronic Pain and Healthy Controls

Conditions
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Chronic Musculoskeletal Disease, Chronic Pain, Widespread

Intervention / Treatment
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* Other: Acute exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Inclusion criteria for participants with chronic pain: Men and women, age 18-67 years, good ability to understand written and verbal information and instruction given in Swedish, chronic (>3 months) musculoskeletal pain or chronic widespread pain. Inclusion criteria for healthy controls: Men and women, age 18-67 years, good ability to understand written and verbal information and instruction given in Swedish. Exclusion Criteria: For participants with chronic pain chronic pain caused by malignancies or systemic diseases, other physical conditions that affects functional abilities and implies use of walking aid in-door, pregnancy after week 12, childbirth within the last 3 months or spinal surgery. For healthy controls: chronic (>3 months) or acute pain of any cause, other physical conditions that affects functional abilities, and implies use of walking aids in-door, pregnancy after week 12, childbirth in the last 3 months or spinal surgery.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 67 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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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: A randomised controlled study in patients with chronic pain and healthy controls
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Acute exercise<br>Acute exercise (bicycle at stationary cycle). | Other: Acute exercise<br>* 30 min acute exercise (bicycle at stationary cycle)<br>|
| No Intervention: Rest<br>Rest (lying down or sitting in a chair) for 30 minutes, i.e. same time duration as in experimental arm. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Kinematic measures of human movement during functional gait sequences | Objective measures of movement control using sophisticated wearable sensors (accelerometer-based APDM-sensors applied at participants wrists, ankles, chest and head) during walking in 1) self-selected normal gait speed, 2) a brisk gait speed, 3) self-selected normal gait speed with a concurrent cognitive task (1-back test: participants listens to a recording of a voice that presents random series of digits between 1 to 9 with two seconds apart. The participants will be instructed to respond as quickly and accurately as possible, repeating the digit before the last one in the sequence.). Lumbar trunk rotations (degrees) will specifically be evaluated while many other kinematic variables (walking speed, step length, step width etc) will be analyzed with factor analyz-es to reduce data variables to relevant data domains, such as gait stability. Data will be aggregated as means and variances. | 30 minutes (before and after the acute exercise intervention) | 
| Muscle activity | Evaluation of back muscle activity using electromyographics (EMG) during walking as in outcome 1, i.e. in 1) self-selected normal gait speed, 2) a brisk gait speed, 3) self-selected normal gait speed with a concurrent cognitive task (1-back test). Participants will be instrumented with surface-EMG (Delsys Incorporated, Massachusetts) electrodes applied bilateral at participants back and neck muscles. Back and neck spatial and temporal muscle activity (EMG amplitudes) representing repeated gait cycles will be aggregated to one cycle; factor analyzes may be applied to reduce data variables to relevant data domains. Data will be presented as means and variances. | 30 minutes (before and after the acute exercise intervention) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Self-rated pain using the Visual Analogue Scale (VAS scale). | Self-rated pain will be measured using a horizontal 10-cm line Visual Analogue Scale (VAS) with the statement 'no pain at all' at the extreme left-hand end, and 'the worst possible pain' or 'unbearable' at the right-hand extreme. | 30 minutes (before and after the acute exercise intervention) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chronic musculoskeletal pain, Acute exercise, Movement control, Muscle activity