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HealthyChronicPA-PAINNCT06207422

The Effects of a Moderate Intensity Training Program Versus a High Intensity Training Program on Central Pain Processing

A study testing Moderate intensity training program and High intensity training program in people with Healthy, run by University Ghent at 1 site in Belgium.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Previous studies have shown that healthy individuals who take more steps per day and who spend more time on moderate- to vigorous-intensity activities exhibit better pain inhibition and less pain facilitation. Read more about this study

Who is it for?
Ages 18 to 55 yearsHealthy volunteers can take part
Conditions the study is for
Healthy
What is being tested?
Moderate intensity training program and High intensity training program
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteBelgium
Study dates
27 Nov 2023to 23 Aug 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 55 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • age between 18 and 55 years
  • BMI between 20 and 25 kg/m²
  • Dutch-speaking
  • sedentary job and performing less than 3 hours of moderate physical activity per week

Who cannot join

  • current pain complaints or other (medical and/or psychological) health problems
  • history of serious pain complaints or (medical and/or psychological) health problems
  • history of serious conditions (e.g. cancer, cardiovascular disease, epilepsy, diabetes, depression, etc.)
  • being pregnant
  • pregnant in the past 12 months
  • currently breastfeeding

Trial locations and contacts

1 site in 1 country.

Belgium1 site
  • Ghent University

    Ghent, 9000

Other trials in Belgium

About this study

Previous studies have shown that healthy individuals who take more steps per day and who spend more time on moderate- to vigorous-intensity activities exhibit better pain inhibition and less pain facilitation. Furthermore, exercise training (i.e., exercise performed over a number of sessions) can result in reduced pain sensitivity (increased pressure pain threshold). However, the optimal exercise prescription required to achieve pain sensitivity reduction is currently unclear. The next step is to determine experimentally whether increasing physical fitness will lead to positive effects on central pain processing (i.e., pain sensitivity, pain modulation, spinal nociception). The aim of this study is to examine the effects of two exercise programs on central pain processing in healthy sedentary individuals. In case of positive effects, this would provide a rationale for the future to investigate this in chronic pain patients with impaired pain modulation.

Read the detailed description

Objectives:

Since research on the effects of chronic exercise interventions on pain modulation is scarce and since there is no optimal exercise prescription to reduce pain sensitivity, the effects of a moderate intensity training (MIT) program versus a high intensity training (HIT) program on central pain processing will be examined in healthy sedentary individuals.

Study population:

Thirty healthy sedentary adults between 18 and 55 years of age and with a body mass index (BMI) between 20 and 25 kg/cm² will be recruited. Sedentary is defined as "having a sedentary job and performing less than three hours of moderate physical activity per week". Moderate physical activity is defined as "an activity that requires at least three times the amount of passively expended energy". The sample size was calculated based on a similar previously conducted study.

Study Protocol:

The participants will be invited for a first contact moment (T0) at Ghent University Hospital or at the participant's homes. During T0, participants will be asked to sign an informed consent form. Furthermore, the procedure of the intervention will be explained and a general questionnaire on sociodemographic and health-related characteristics will be administered. Participants will then receive an ActiGraph accelerometer to take home and wear for seven consecutive days to monitor physical activity (i.e., number of steps, moderate and vigorous physical activity, and sedentary behavior).

After wearing the Actigraph accelerometer for seven consecutive days, participants will be invited for a first test moment (T1) at Ghent University Hospital. During T1, three questionnaires will be administered, namely a day survey (intake of medication, caffeine, alcohol and nicotine in the past 24 hours and performance of extreme physical exertion in the past 48 hours), the International Physical Activity Questionnaire (IPAQ) and the Hospital Anxiety and Depression Scale (HADS). Before the start of the experimental pain measurements, blood pressure will be measured with a blood pressure monitor and resting heart rate will be measured using a heart rate belt around the chest.

Next, central pain processing will be assessed:

  1. to evaluate pain sensitivity, pressure algometry will be performed using a digital algometer to determine the pressure pain threshold (PPT) bilaterally on the muscle belly of the extensor carpi radialis and the rectus femoris.
  2. to evaluate pain inhibition, a conditioned pain modulation (CPM) paradigm will be performed in which the measurement of the PPT (= test stimulus (TS)) will be repeated on the dominant body side during (at minute two) and two minutes after immersion of the non-dominant hand in a warm water bath (= conditioning stimulus (CS)) of 45.5°C for six minutes.
  3. to evaluate exercise-induced hypoalgesia (EIH), the PPT measurements will be repeated before (bilaterally) and after (on the dominant body side) a submaximal exercise test (Aerobic Power Index test) performed on an electrically braked bicycle ergometer. Cycling will start at a load of 25 W. Then the load will be increased by 25 W every minute until the submaximal level, defined as 75% of the predicted maximum heart rate (= 220 - age), is reached. Heart rate will be measured before, during, and after the test with a heart rate belt around the chest.
  4. to evaluate spinal nociception, transcutaneous electrical neurostimulation (TENS) of the n. suralis of the dominant leg will be performed using a bar electrode. The nociceptive flexion reflex (NFR) threshold will be determined, as well as the pain intensity during repetitive stimulation at the intensity of the NFR threshold to evaluate temporal summation of the NFR. The elicitation of the NFR will be evaluated by measuring the involuntary contraction of the ipsilateral biceps femoris, which will be recorded using electromyography (EMG).

After the experimental pain measurements, the test subjects will receive a Fitbit smartwatch to measure weekly step count during the 10-week exercise program.

After T1, the participants will be randomly assigned to one of two 10-week intervention programs, namely a MIT or a HIT program based on a 1:1 ratio.

Upon completion of the intervention, participants' physical activity will be monitored again for 7 consecutive days using an Actigraph accelerometer. After these 7 days, participants will be invited again for a second test moment (T2) at Ghent University Hospital. During T2, the day survey and the IPAQ will be administered again, blood pressure will be measured and the pain measurements will be repeated.

Conditions
Healthy
Being tested
Moderate intensity training program, High intensity training program
Keywords
moderate intensity training, high intensity training, pressure pain threshold, conditioned pain modulation, exercise induced hypoalgesia, nociceptive flexion reflex, quantitative sensory testing

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Moderate intensity training programOther

    A 10-week intervention program performed at 60-70% of the heart rate reserve. Heart rate reserve will be calculated using the Karvonen formula (target heart rate = [(predicted maximum heart rate (= 220 - age) - resting heart rate) x %intensity] + resting heart rate). The intervention program will consist of three exercise sessions per week, of which one guided group session at Ghent University Hospital and two sessions to be carried out at home.

  • High intensity training programOther

    A 10-week intervention program performed at ≥80% of the predicted maximum heart rate (target heart rate = predicted maximum heart rate (= 220 - age) x %intensity). The intervention program will consist of three exercise sessions per week, of which one guided group session at Ghent University Hospital and two sessions to be carried out at home.

Study groups in NCT06207422
Study groupRoleWhat they receive
Moderate intensity training programExperimentalNot described
Receives: Other: Moderate intensity training program
High intensity training programExperimentalNot described
Receives: Other: High intensity training program

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pressure pain threshold

    Pressure algometry will be performed using a digital algometer to determine the pressure pain threshold bilaterally on the muscle belly of the extensor carpi radialis and the rectus femoris.

    Measured: Change from baseline (T1) at 1 week after intervention (T2)

  2. Conditioned pain modulation

    A conditioned pain modulation paradigm will be performed in which the measurement of the pressure pain threshold (= test stimulus) will be repeated on the dominant body side during (at minute two) and two minutes after immersion of the non-dominant hand in a warm water bath (= conditioning stimulus) of 45.5°C for six minutes.

    Measured: Change from baseline (T1) at 1 week after intervention (T2)

  3. Exercise-induced hypoalgesia

    To evaluate exercise-induced hypoalgesia, the pressure pain threshold measurements will be repeated before (bilaterally) and after (on the dominant body side) a submaximal exercise test (Aerobic Power Index test) performed on an electrically braked bicycle ergometer.

    Measured: Change from baseline (T1) at 1 week after intervention (T2)

  4. Nociceptive flexion reflex - threshold

    The nociceptive flexion reflex will be elicited by performing transcutaneous electrical nerve stimulation of the sural nerve of the dominant leg in its retromalleolar path using a bar electrode. The elicitation of the NFR will be evaluated by measuring the involuntary contraction of the ipsilateral biceps femoris, which will be recorded using electromyography.

    Measured: Change from baseline (T1) at 1 week after intervention (T2)

  5. Nociceptive flexion reflex - temporal summation

    Five 1ms rectangular wave pulse train will be administered 3 times at a frequency of 2 Hz at a constant stimulation intensity. This procedure will be repeated 5 times.

    Measured: Change from baseline (T1) at 1 week after intervention (T2)

Secondary outcomes (11)
  1. Hospital anxiety and depression scale

    Self-report measure assessing anxiety and depression

    Measured: Baseline (T1)

  2. International physical activity questionnaire

    Self-report measure assessing physical activity during the previous 7 days

    Measured: Change from baseline (T1) at 1 week after intervention (T2)

  3. Moderate physical activity

    Moderate physical activity will be measured with an ActiGraph accelerometer during 7 consecutive days.

    Measured: Change from baseline (T1) at 1 week after intervention (T2)

  4. Vigorous physical activity

    Vigorous physical activity will be measured with an ActiGraph accelerometer during 7 consecutive days.

    Measured: Change from baseline (T1) at 1 week after intervention (T2)

  5. Sedentary behavior

    Sedentary behavior will be measured with an ActiGraph accelerometer during 7 consecutive days.

    Measured: Change from baseline (T1) at 1 week after intervention (T2)

  6. Step count

    Step count will be measured with an ActiGraph accelerometer during 7 consecutive days.

    Measured: Change from baseline (T1) at 1 week after intervention (T2)

  7. Step count

    Step count will be measured with a FitBit charge 4 during the 10-week intervention program

    Measured: During 10-week intervention program

  8. Resting heart rate

    Resting heart rate will be measured for 10 minutes using a heart rate belt around the chest.

    Measured: Baseline (T1)

  9. Blood pressure

    Systolic and diastolic blood pressure will be measured with a blood pressure monitor.

    Measured: Baseline (T1)

  10. Blood pressure

    Systolic and diastolic blood pressure will be measured with a blood pressure monitor.

    Measured: 1 week after intervention

  11. Sociodemographic and health-related characteristics

    A general questionnaire assessing sociodemographic and health-related characteristics

    Measured: Baseline (T0)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Jan 2024
  2. Study start27 Nov 2023
  3. Primary completion23 Aug 2024
  4. Study completion23 Aug 2024

Why it stopped: The study was terminated prematurely due to difficulties in participant recruitment. We reframed the project as a pilot feasibility study to better assess recruitment processes and inform the design of a future full-scale trial.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06207422
Sponsor's protocol ID
ONZ-2023-0425
Acronym
ChronicPA-PAIN
Status last verified
Sep 2025
First submitted
18 Dec 2023
Last updated
8 Sep 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Belavy DL, Van Oosterwijck J, Clarkson M, Dhondt E, Mundell NL, Miller CT, Owen PJ. Pain sensitivity is reduced by exercise training: Evidence from a systematic review and meta-analysis. Neurosci Biobehav Rev. 2021 Jan;120:100-108. doi: 10.1016/j.neubiorev.2020.11.012. Epub 2020 Nov 27.

    PubMed 33253748
  • Bernstein MS, Morabia A, Sloutskis D. Definition and prevalence of sedentarism in an urban population. Am J Public Health. 1999 Jun;89(6):862-7. doi: 10.2105/ajph.89.6.862.

    PubMed 10358676
  • Dhondt E, Danneels L, Van Oosterwijck S, Palmans T, Rijckaert J, Van Oosterwijck J. The influence of physical activity on the nociceptive flexion reflex in healthy people. Eur J Pain. 2021 Apr;25(4):774-789. doi: 10.1002/ejp.1708. Epub 2020 Dec 27.

    PubMed 33290578
  • Hakansson S, Jones MD, Ristov M, Marcos L, Clark T, Ram A, Morey R, Franklin A, McCarthy C, Carli LD, Ward R, Keech A. Intensity-dependent effects of aerobic training on pressure pain threshold in overweight men: A randomized trial. Eur J Pain. 2018 Nov;22(10):1813-1823. doi: 10.1002/ejp.1277. Epub 2018 Jul 11.

    PubMed 29956398
  • Hermans L, Van Oosterwijck J, Goubert D, Goudman L, Crombez G, Calders P, Meeus M. Inventory of Personal Factors Influencing Conditioned Pain Modulation in Healthy People: A Systematic Literature Review. Pain Pract. 2016 Jul;16(6):758-69. doi: 10.1111/papr.12305. Epub 2015 May 26.

    PubMed 26011523
  • Van Oosterwijck S, Meeus M, van Der Wekken J, Dhondt E, Billens A, Van Oosterwijck J. Physical Activity Is Predictive of Conditioned Pain Modulation in Healthy Individuals: A Cross-Sectional Study. J Pain. 2024 Nov;25(11):104639. doi: 10.1016/j.jpain.2024.104639. Epub 2024 Jul 18.

    PubMed 39029881
  • Billens A, Hamelink T, Meeus M, Van Oosterwijck J. The influence of a moderate versus high intensity training program on central pain processing: a pilot feasibility study. Pain Manag. 2026 May;16(5):445-459. doi: 10.1080/17581869.2026.2626256. Epub 2026 Feb 6.

    PubMed 41649235

Questions about this trial

What is this clinical trial studying?

A study testing Moderate intensity training program and High intensity training program in people with Healthy, run by University Ghent at 1 site in Belgium.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 8 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: The study was terminated prematurely due to difficulties in participant recruitment. We reframed the project as a pilot feasibility study to better assess recruitment processes and inform the design of a future full-scale trial.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pressure pain threshold (time frame: Change from baseline (T1) at 1 week after intervention (T2)). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06207422, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Sep 2025.

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