#48 Local and remote exercise induced hypoalgesia in knee osteoarthritis patients a randomized crossover

<p>In this special bite-sized episode, recorded live at the <b>Pain Science in Motion Congress</b> in Brussels, we sit down with <b>Mark van Loo</b>. Mark is a physical therapist and researcher at the <b>University of Applied Sciences Rotterdam</b>, specializing in knee osteoarthritis and physical activity behavior. Mark shares insights from his PhD poster presentation, focusing on a fascinating physiological mechanism to help patients overcome the pain barrier when exercising.</p><p><br /></p><p>A major clinical hurdle in treating knee osteoarthritis is that movement is inherently painful for these patients, making it incredibly difficult to increase their physical activity levels. Mark’s research investigates a potential workaround known as exercise-induced hypoalgesia. This phenomenon involves a temporary decrease in pain sensitivity immediately following an exercise session, creating a window of pain reduction that typically lasts anywhere from 5 to 30 minutes.</p><p><br /></p><p>The ongoing crossover study explores whether utilizing non-painful areas of the body can reduce pain in the affected joints. The study design includes:</p><p><br /></p><p><b>Upper Body Interventions</b>: Participants perform a rowing exercise using elastic bands, tested at both high and lower intensities.</p><p><br /></p><p><b>Lower Body Comparison</b>: A high-intensity cycling condition is used as a standard comparison.</p><p><br /></p><p><b>Objective Pain Tracking</b>: Pain thresholds are measured globally at the shoulder and locally at the knee using a pressure algometer.</p><p><br /></p><p><b>Timing</b>: These pressure measurements are taken before the exercise and immediately after to capture the temporary pain-relief window.</p><p><br /></p><p>The research focuses on individuals suffering from knee osteoarthritis. So far, the feasibility of the study is highly promising. The research team has successfully recruited 37 out of their target 45 participants, noting excellent adherence and zero dropouts related to adverse events or the exercise protocols.</p><p><br /></p><p>Data collection is utilizing a strong crossover design, where participants are their own control group, and is expected to conclude before the summer. The team hopes to publish their findings by the end of the year.</p><p><br /></p><p>If the systemic effects of exercise-induced hypoalgesia are proven effective, it could revolutionize behavioral change strategies for this population. Clinicians could potentially use high-intensity upper body exercises as a strategic "warm-up" to induce temporary pain relief, opening a vital window to safely load and exercise the painful lower body without triggering the patient's alarm system.</p><p><br /></p><p>Are you a clinician struggling to get patients with severe knee osteoarthritis active? Consider the systemic effects of movement. While waiting for the final publication of this study, you can start thinking about how to integrate upper body conditioning into your treatment plans to help desensitize the nervous system before moving on to targeted lower extremity exercises.</p><p><br /></p><p><b>Event</b>: Pain Science in Motion Congress in Brussels</p><p><b>Featured Mechanism</b>: Exercise-Induced Hypoalgesia</p><p><b>Collaborating Entities</b>: University of Applied Sciences Rotterdam, Physio Global &amp; Pain in Motion</p><p><br /></p><p>Do you want to know more about Physio Global? Visit our website: <a href="www.physioglobal.nl" rel="ugc noopener noreferrer" target="_blank">⁠www.physioglobal.nl</a>⁠</p><p><br /></p><p>Or do you have other ideas or a question? Please send us an email: ⁠<a href="info@physioglobal.nl" rel="ugc noopener noreferrer" target="_blank">info@physioglobal.nl⁠</a></p><p><br /></p><p>Mark’s Research: Exercise-Induced HypoalgesiaThe Study Design and MeasurementsTarget Population and Study StatusClinical Implications: A Gateway to MovementCall to Action for CliniciansReferences &amp; Resources</p><p><br /></p><p>F