EFFECT OF PRE-EXERCISE EDUCATION ON PAIN RESPONSES TO A SINGLE EXERCISE SESSION IN PEOPLE WITH KNEE OSTEOARTHRITIS: A RANDOMISED CONTROLLED TRIAL

Abstract

INTRODUCTION & AIMS In pain-free individuals, pre-exercise education about exercise-induced hypoalgesia (EIH) reduces experimental pain following a single exercise session. However, its effect in people with chronic pain remains unexplored. This study aimed to determine if EIH education influences pain during and following exercise in people with knee osteoarthritis (OA). METHODS Participants were randomised into an intervention group (INT) who received 15-minutes of explicit EIH education or a control group (CON) who received 15-minutes of general information about knee OA. Following education, participants’ knowledge and beliefs about exercise and pain were assessed using five questions scored on a Likert scale. Participants then undertook a single 15-minute, low-moderate intensity home-based strength exercise session delivered online. Pain was assessed on a 0-10 scale before, during, and immediately following exercise. RESULTS 40 people with knee OA (67 ± 10.8 years old; BMI: 27.6 ± 6.5) completed the study. Education did not significantly influence participants’ knowledge or beliefs about exercise and pain. Pain reduced during exercise in both groups (mean difference [95% CI]; INT = -0.50 [-1.39 to 0.39]; CON = -1.58 [-2.55 to -0.62]), with a moderate effect (Cohen’s d) in favour of CON (-1.08 [-2.35 to 0.18], d = 0.54). Pain also reduced following exercise in both groups (INT = -0.95 [-1.77 to -0.12]; CON = -0.98 [-1.74 to -0.22]), with no difference between groups (0.03 [-1.06 to 1.12], d = 0.02). CONCLUSION A single exercise session reduces pain in people with knee OA, but this was not influenced by pre-exercise education about EIH. Given the chronic nature of OA pain, any intervention that can potentiate the benefits of exercise, even if marginal, may be beneficial. Therefore, further research is needed to understand if and how EIH can be modulated in people with knee OA.