Exercise Induced Hypoalgesia in Pain-free Stroke and Healthy Populations: a Cohort Study
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Cardiovascular training.
- Who it may be relevant to
- Registry conditions: Stroke, Pain, Exercise Induced Hypoalgesia. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Spain
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
Exercise has shown multiple beneficial effects in both healthy and post-stroke populations. One of these is the acute reduction in sensitivity to painful stimuli, called exercise-induced hypoalgesia (EIH). This phenomenon has been studied since 1979 and has shown improvements in pain thresholds with both aerobic and resistance training in healthy, pain-free populations and different chronic pain conditions. Although there has been extensive research on EIH in healthy populations and those with chronic musculoskeletal pain, surprisingly little attention has been given to individuals with neurological pathologies. Chronic pain is found in more than 50% of patients after stroke, and 70% of affected individuals experience pain on daily activities. Reported prevalences of post-stroke pain (PSP) between different studies, but there is a general consensus that it is an underreported phenomenon. Patients with pain experience greater cognitive and functional decline, fatigue, depression and lower quality of life. Multiple factors contribute to PSP, and various approaches exist to treat all the variables influencing it. This study aims to compare the effects of exercise on pain perception in healthy individuals and stroke patients without pain, using the same cardiovascular training protocol, to better understand the mechanisms of EIH and its maintenance after stroke, ultimately aiming to improve the treatment of people with stroke.
Interventions
- Other Cardiovascular training
The cardiovascular training protocol will consist of a 5-minute warm-up aimed at reaching 70% of maximum heart rate (MHR) followed by 20 minutes of sustained work at this intensity (since maintaining this intensity is difficult, especially in the stroke cohort, we will allow for a margin of ±2-3% of MHR and provide feedback to increase or decrease the heart rate). We will aim to keep the heart rate below 73% of maximum heart rate, maintain blood pressure within safe ranges, and keep the effort l
Primary outcome measures
- Pressure pain thresholds [Time frame: Before the cardiovacular training, inmediately after the training, and 30 minutes after]
- Conditioned pain modulation [Time frame: Before the cardiovascular training, inmediately after the training and 30 minutes after]
Eligibility criteria
Inclusion criteria
Healthy cohort:
- Age > 18 years
- No neurological damage
- No medical conditions that could affect the test
Post-stroke cohort:
- Age > 18 years
- Ischemic or hemorrhagic stroke (time since onset > 3 months)
Exclusion criteria
Healthy cohort:
- Any medical condition that could affect the test (respiratory, cardiovascular, metabolic diseases, for example)
- Pain in any location, of duration > 1 week in the 3 months preceding the trial.
Post-stroke cohort:
- Unable to participate in the test (no possibility of transfer or active pedaling)
- Medical contraindication to cardiovascular training for any reason
- Inability to follow instructions or communicate sensations during training
- Other neurological pathology, cardiac pathology (unstable angina, arrhythmias, aortic or left ventricular problems, myocarditis, pericarditis), pulmonary pathology that affects the test (pulmonary embolisms, pulmonary hypertension, etc.), renal or metabolic problems (severe renal dysfunction, uncontrolled diabetes, etc.), acute infection or fever, neurosurgery within 6 weeks prior to inclusion in the study
- Pain in any location, lasting > 1 week in the 3 months prior to the trial.
- Use of beta-blockers, antidepressants, or any medication that may alter heart rate measurements
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Non-randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Treatment
Study locations
Spain · 2 centers
- Neuron Madrid Río — Madrid
- Neuron Nuevos Ministerios — Madrid
Identifiers
NCT: NCT07327593 · NeuronRehab