Exercise Induced Hypoalgesia in Pain-free Stroke and Healthy Populations: a Cohort Study

Neuron, Spain

Status: Not yet enrolling

Conditions: Stroke; Exercise Induced Hypoalgesia; Pain

Treatments: Other: Cardiovascular training

Study type: Interventional

Funder types: Other

Identifiers

NCT07327593

NeuronRehab

Details and patient eligibility

About

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.

Enrollment: 60 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Healthy cohort: Age > 18 years; no neurological damage; no medical conditions that could affect the test; no pain
• Post-stroke cohort: : Ischemic or hemorrhagic stroke (> 3 months); age > 18 years; no pain

Exclusion criteria

• Healthy cohort: Any medical condition that could affect the test; 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

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

60 participants in 2 patient groups

Healthy cohort

Active Comparator group

Description:

Age \> 18 years; no neurological damage; no medical conditions that could affect the test; no pain of duration \> 1 week in the 3 months preceding the enrollment. No serious medical conditions. First, pressure pain thresholds and conditioned pain modulation will be assessed. Then, participants will conduct a cardiovascular training for 30 minutes, and will be reassessed inmediately post-training and 30 minutes after.

Treatment:

Other: Cardiovascular training

Post-stroke pain free cohort

Experimental group

Description:

Ischemic or hemorrhagic stroke (\> 3 months); older than 18 years old; of duration \> 1 week in the 3 months preceding the enrollment. No other serious medical conditions. Post-stroke participants will get the same study protocol than healthy cohort.

Treatment:

Other: Cardiovascular training