Pain Clinical Trial
Official title:
Spatiotemporal Patterns of Pain and Discomfort During Exhausting Exercise
The purpose of this study will be to study the individual spatiotemporal structure and dynamics of topologically defined areas of perceived body discomfort and pain during exercise. Participants will perform two constant tests (cycling and running) at an intensity corresponding to Borg's scale of Rating of Perceived Exhaustion (RPE) (6-20) = 15 (i.e., hard). Using a body map template, participants will report every 15s the perceived locations with discomfort and pain independently of the magnitude of the discomfort and pain.
1. Intro Pain recently was defined as distressing experience associated with actual or
potential tissue damage with sensory, cognitive, emotional, and social components. Pain
can be seen as perceptual marker within physical exercise. Individuals can report on a
number of perceptual markers such as the changes in exertive pain which was shown to be
a distinct source of information than reports of PE during cycling for instance. The
perceptual markers of pain are still little investigated within exercise settings.
From another side, to best understand exertive pain, one needs to consider several
dimensions of pain including the sensory-discriminative, affective-motivational, and
the cognitive-evaluative dimensions. Several number of studies within the exercise
science have focused on the sensory-discriminative dimension of pain. Results from
these have suggested a linear relationship between pain perception and the power output
in diverse effort settings including cycling, static and dynamic handgrip squeezing,
and incremental treadmill running. Indeed, the comparison of ratio of leg pain to arm
pain during cycling and running has also demonstrated that the ratio of leg to arm pain
increases across higher intensities.
Most of the extant work however centred on pain and PE from a group-based standpoint to
lead to group-based conclusions. Traditionally, within exercise science, variables are
measured at distinct, low-frequency time points, and then are either averaged over the
course of the trial or reported at the measured time. In turn, such practices make it
difficult to measure dynamic feed-forward and feedback control mechanisms inherent in
these variables. Taken these together, studying pain and discomfort from an individual,
case-by-case standpoint, in a high-frequency time points setting, may present unique
benefits. Considering that the physiological and psychological variables (e.g., PE)
present fluctuations during heavy constant-power cycling when reporting at a
measurement frequency of 15s it seems plausible to assume that pain locations can also
fluctuate. Consequently, it may be useful to distinguish amongst differential types of
spatiotemporal pain fluctuations patterns during exercise. Mapping these dynamics can
help predict individual-specific fatigue in the course of exercise. The functional role
of fluctuating dynamics has already been studied in psychological (e.g., volitional
states, thought processes) and kinematic variables during constant-power exercise
performed until volitional exhaustion. These approaches are important in that the
suppression of the intra- individual variability performed by a statistical averaging
may hide the properties of individual systems.
In this vein, we tend to study and delineate individualized pain and discomfort
patterns in exercise. The purpose of this study will be to study the individual
spatiotemporal structure and dynamics of topologically defined areas of perceived body
discomfort and pain during exercise.
2. Methods 2.1 Participants To determine the sample size for this study a power analysis
was conducted using G*Power 3.1. In studies of thought processes larger effect sizes
have been reported. Thus, using an effect size of d = 1.0, α < 0.05, power (1 - β) =
0.80, a sample size of n = 11 emerged. Caucasian physical education students (age
range: 18 - 30 years) undergoing regular aerobic exercise will be recruited to
participate voluntarily in the study. Students will receive oral and written
information regarding the study. They will be additionally encouraged to ask questions
if there would still any ambiguities.
2.2 Materials and procedure Completion of this study will took a total of three sessions,
separated by one-week intervals, and each of approximately 30 minutes. At week one,
participants will complete a baseline incremental cycling and running tests to determine the
workload and velocity values corresponding to their RPE (6-20 Borg's scale) = 15 (i.e.,
heavy). At this time, participants also will be familiarized with the use of body maps and
reporting procedures. At week two and three, participants will complete the constant-power
cycling and constant velocity running tasks, respectively, in a counter-balanced assigned
order.
2.2.1. Monitoring for Discomfort and Pain Every 15s during exercise, upon the researcher's
prompts, participants will report bodily locations with discomfort and pain on a body map
scale.
2.2.2. Constant-power Cycling Task The task will include an incremental warm-up session and
a constant-power cycling which will be performed up to volitional exhaustion. The
constant-power cycling will begin when participants will report RPE = 15 during the
incremental warm-up and the cycling task will last up to volitional exhaustion. The end will
be set when participants won't be able to cycle longer at the fixed cadence for five
consecutive seconds at the sitting position.
2.2.3. Constant-velocity Running Task The task will include an incremental warm-up
(identical to the running baseline test) and a constant velocity run which will be performed
up to volitional exhaustion. The constant velocity run will start when participants will
achieve and report RPE = 15 during the incremental warm-up and will last up to volitional
exhaustion when they could no longer be able to maintain the imposed velocity.
2.2.4. Commitment check Upon the completion of all testing procedures participants will
answer questions about complete commitment to measure their commitment levels to the
reporting tasks (a) and commitment to task (b), on an 11-point Likert-type scale with
anchors ranging from 0 (not at all) to 10 (greatly).
2.3 Data collection and analysis All the locations for each participant will be transformed
to binary vectors. Investigators will analyse the effects of the time steps using repeated
measures ANOVAs. Principal component analysis (PCA) will be used to reduce the
dimensionality of the local discomfort and/or pain data (that will be obtained from the
50-item pain map). The data and time of each testing session will be reported in a list. All
data can be reconstructed for each participants.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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