None listed
Conditions
Brief summary
While evidence in healthy individuals demonstrates that exercise improves health outcomes and exerts biological effects, the effects in individuals with chronic pain are poorly understood. Exercise interventions have been suggested useful in reducing pain, however evidence shows that effects vary in magnitude and direction. This project aims to improve the understanding of the central neurobiological and immunological effects of exercise in individuals with chronic pain. Individuals with chronic whiplash will participate in either an aerobic or resistance exercise intervention, allowing for a direct comparison informing on the type and dosage considerations of exercise prescription. Magnetic resonance scans and immunological factor concentrations will inform on the underlying effects of exercise. A single-case experimental design with sixteen participants allows for an evaluation of the feasibility, as well as the effectiveness of isolated elements of this intervention. Determining the underlying mechanisms is the first step in understanding the effects of exercise in individuals with chronic pain. Outcomes will therefore benefit researchers and clinicians aiming to improve health outcomes in individuals with chronic pain.
Interventions
Participants will be randomised into a staggered baseline of 5, 8, 11, or 14 days. In order to gain an understanding of the variability in clinical outcomes, during this baseline phase three daily questions will assess pain intensity, pain bothersomeness, and disability. The eight-week exercise intervention commences following the completion of the staggered baseline. Through randomisation, participants will be allocated to either the aerobic exercise (intervention) or resistance exercise (compa
Participants will be randomised into a staggered baseline of 5, 8, 11, or 14 days. In order to gain an understanding of the variability in clinical outcomes, during this baseline phase three daily questions will assess pain intensity, pain bothersomeness, and disability. The eight-week exercise intervention commences following the completion of the staggered baseline. Through randomisation, participants will be allocated to either the aerobic exercise (intervention) or resistance exercise (comparator) program. Both eight-week programs follow the American College for Sports Medicine Guidelines for Exercise Testing and Prescription. Aerobic: For the aerobic exercise program, participants will engage in three exercise sessions per week of at least 20 min, focussing on self-chosen, whole-body exercises such as walking, cycling, etc. The target intensity is 40-60% of maximum heart rate (MHR = 220-age) and will be determined using a heart rate monitor (the participant will be provided with one for the study). Participants are asked to refrain from resistance training for the duration of the study. The total duration of participation in this study is the baseline duration (5, 8, 11, 14 days) + 8 weeks of exercise intervention. For both study arms, adherence to the exercise intervention will be monitored with weekly phone calls.
Sponsors
The University of Queensland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
18 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria – WAD - Chronic whiplash associated disorder (>12 weeks duration) - Aged between 18 and 55 years o The lower age limit of 18 years will be applied as the brain in children is still in development which could potentially affect the MR outcomes. An upper age limit of 55 years will be applied to limit the possible effect of degenerative changes in the aging brain. - Moderate neck pain intensity (at least 4/10 on a 0-10 numeric rating scale) - Pain moderately interferes with daily activities (assessed using one item* from the SF-36 questionnaire) - Currently low level of physical activity (assessed with the Godin-Shephard activity questionnaire) - Motivated to commit to an eight-week exercise program - Able to lie in an MRI scanner on their back for one hour - Free from metal implants or pacemaker * During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)? Inclusion criteria – healthy controls - No current neck pain, nor having had treatment for neck/shoulder complaints in the past 5 years - No history of injury or trauma to the neck or head - No current musculoskeletal pain in any body area - Aged between 18 and 55 years o The lower age limit of 18 years will be applied as the brain in children is still in development which could potentially affect the MR outcomes. An upper age limit of 55 years will be applied to limit the possible effect of degenerative changes in the aging brain. - Currently low level of physical activity (assessed with the Godin-Shephard activity questionnaire) - Motivated to commit to an eight-week exercise program - Able to lie in an MRI scanner on their back for one hour - Free from metal implants or pacemaker - Matched to an individuals with WAD based on sex and age
Exclusion criteria
Exclusion criteria – WAD and healthy individuals - History of migraine headaches - Surgery to the neck - Diabetes - Posttraumatic stress symptoms (assessed on the PCL-5) o Individuals with substantial posttraumatic stress symptoms will be excluded from this study as psychological stress may interfere with adherence to the exercise program,58 the neurobiological effects of exercise, and the effects of exercise on health outcomes. - Currently receiving treatment for their neck pain (e.g., physiotherapy, chiropractic, or similar) - Comorbidities preventing regular exercise - Pregnant or breastfeeding - Claustrophobic
Outcome results
None listed