Comparing the Effects of Upper and Lower Body Aerobic Exercise on Pain in Individuals With Chronic Knee Pain

A Comparison of the Effects of Upper Versus Lower Body Aerobic Exercise on the Experience of Pain in Individuals With Chronic Knee Pain

The investigators want to compare the effects of upper versus lower body moderate aerobic exercise on the experience of pain in individuals with chronic knee pain. Participants will attend the laboratory on 4 separate occasions to complete a series of exercise tests and experimental pain tests.

Study Overview

• Status: Completed
• Conditions: Chronic Knee Pain
• Intervention / Treatment: Other: Upper body aerobic exercise; Other: Lower body aerobic exercise

Detailed Description

Pain has a multifaceted nature encompassing peripheral drivers (i.e. loading), peripheral and central nervous systems (peripheral and central sensitisation) and cognition (i.e. fear). Most recently, evidence supports that chronic pain in OA may cause alterations to the peripheral and central nervous systems. Despite this, current research has mainly targeted peripheral drivers (usually weight reduction) and cognition (educational programmes) with results highlighting that such methods are not always effective in reducing pain. It would be useful to provide a wider range of choice when prescribing exercise for OA for those which the current prescription is ineffective or un-desirable.

Acutely, both localised and generalised exercise involving the knee joint in individuals with KOA is known to increase symptomatic pain in some. However, research suggests that diverting exercise away from the affected joint may improve pain perception and pain experience in a subset of individuals by targeting cognition (attention away from the joint) and alleviating peripheral drivers of pain (reduced loading) while still presenting systemic physiological benefits that come with acute aerobic exercise which target peripheral and central sensitisation. Currently, there is only one study (Burrows et al, 2014) which has compared the effects of acute upper vs. lower body exercise on pain perception in KOA patients and this was employing resistance exercise. Although this study found positive effects of upper body exercise on pain, this pain was experimentally induced, and symptomatic pain was not measured.

The investigators aim is to determine the effects of a single bout of upper body aerobic exercise on experimentally induced and symptomatic pain in individuals with chronic knee pain in comparison with lower body aerobic exercise.

• Study Type: Interventional
• Enrollment (Actual): 19
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Kingdom
  • Bath, United Kingdom, BA27AY
    • University of Bath

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 45 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Aged ≥45 years
• Male or female
• Knee pain for ≥3 months
• Activity related joint pain
• No joint related morning stiffness, or morning stiffness lasting less than 30 minutes.

Exclusion Criteria:

• Specific joint injury within the last 6 months
• Inability to undertake cycling exercise
• Use of anti-inflammatory medication
• Smoker (or having quit <6 months ago)
• Osteoarthritis at any upper body sites that would affect ability to complete arm-cycling exercise.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Upper Body Aerobic Exercise; Participants will perform 30 minutes of arm-crank cycling at a moderate exercise intensity based off the participants perceived RPE13	Other: Upper body aerobic exercise; Participants will perform 30 minutes of continuous exercise on the arm-crank ergometer.
Experimental: Lower Body Aerobic Exercise; Participants will perform 30 minutes of static cycling at a moderate exercise intensity based off the participants perceived RPE13	Other: Lower body aerobic exercise; Participants will perform 30 minutes of continuous exercise on the cycle ergometer.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acute Symptomatic Pain	Change in symptomatic pain measured via Visual Analogue Scale (VAS) from pre- to post-exercise on a 0-10 scale where 0 is no pain at all and 10 is the worst pain imaginable	Immediately pre and immediately-post exercise

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acute Experimental Pain	Change in experimental pain via Pressure pain threshold and Mechanical detection threshold from pre- to post- exercise	Immediately pre and immediately-post exercise
Follow up Symptomatic Pain	Average symptomatic pain in the 7 days following each trial visit measured on a 0-10 Visual Analogue Scale (VAS) where 0 indicates no pain at all and 10 indicates worst pain imaginable	1-7 days post exercise

Collaborators and Investigators

• Sponsor: University of Bath

Study record dates

Study Major Dates

• Study Start (Actual): February 4, 2020
• Primary Completion (Actual): January 2, 2022
• Study Completion (Actual): January 2, 2022

Study Registration Dates

• First Submitted: May 17, 2020
• First Submitted That Met QC Criteria: March 29, 2022
• First Posted (Actual): April 7, 2022

Study Record Updates

• Last Update Posted (Actual): July 29, 2022
• Last Update Submitted That Met QC Criteria: July 26, 2022
• Last Verified: July 1, 2022

More Information

Terms related to this study

• Other Study ID Numbers: EP 18/19 088

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Anonymous individual data for all outcomes may be made available.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No