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Physical Exercise on Physiological Adaptation Capacity and Chronic Pain in Individuals With Cardiovascular Risk

Not Applicable
Completed
Conditions
Cardiometabolic Risk Factors
Interventions
Behavioral: Resistance Training
Behavioral: High-Intensity Interval Training
Registration Number
NCT06201273
Lead Sponsor
Universidad San Sebastián
Brief Summary

This research focuses on studying the effects of a 12-week exercise program on the health of individuals at risk of heart disease. The program includes High-Intensity Interval Training (HIIT) and Muscle Endurance Resistance Exercise (ERE). The researchers aim to observe the impact of these exercises on physiological adaptability, physical capacity, cardiovascular risk factors, metabolism, body composition, and chronic pain.

The participants will be inactive adults with a Body Mass Index (BMI) between 25 and 39.9, who are enrolled in a cardiovascular health program. Individuals with certain serious conditions, such as bone or heart problems, pulmonary diseases, cancer, or those who do not adequately understand instructions or Spanish, are ineligible to participate.

Patients will be selected by the program team and divided into three groups: one will perform HIIT, another will engage in ERE, and a control group will continue their usual treatment. Participants will be assessed at different times: before starting, at 4 weeks, at 8 weeks, and at the end of the program. Various health aspects will be measured, including physical activity, quality of life, physical capacity, cardiovascular risk factors, metabolism, body composition, and pain level.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
192
Inclusion Criteria
  • Physically inactive: Not engaging in 300 minutes of moderate or 150 minutes of vigorous physical activity per week, measured with the IPAQ questionnaire.
  • BMI between 25 and 39.9 kg/m².
  • Belonging to the cardiovascular health program of External Family Health Center Valdivia.
  • Presenting or not presenting chronic non-cancerous pain.
Exclusion Criteria
  • Bone disease.
  • Ischemic disease or arrhythmia.
  • Chronic obstructive pulmonary disease (COPD) or asthma.
  • Uncontrolled chronic diseases.
  • Individuals unable to understand instructions.
  • Individuals who do not speak Spanish.
  • History of previous oncological disease or under investigation for suspected neoplastic disease in any part of the body.

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Resistance TrainingResistance TrainingThis training protocol, spanning a duration of 12 weeks, consists of three weekly sessions. In each session, participants will engage in Elastic Resistance Exercises (ERE) using Theraband elastic bands (CLX). The focus will be on both concentric and eccentric contractions, maintaining an intensity level of 8 to 10 as per the Resistance Exercise Scale (OMNI-RES). Each exercise will be conducted for 1 minute, followed by a 2-minute rest period. Each exercise will be repeated three times within the session. The specific exercises include bicep curls, seated horizontal rows, and wide squats. To ensure proper progression and adaptation, the exercise load will be adjusted biweekly. This adjustment will be based on the physiological adaptations of the subjects to the training, aiming to recalibrate the loads to new resistance thresholds and maintain a consistent intensity of 8 to 10 on the OMNI-RES scale for each exercise.
High-Intensity Interval TrainingHigh-Intensity Interval TrainingThis High-Intensity Interval Training (HIIT) program, structured to span 12 weeks, incorporates three sessions per week. Each session comprises 8 to 10 exercise intervals on a cycle ergometer. During these intervals, participants are required to reach an intensity level between 8 and 10 points, based on the modified Borg scale, which ranges from 1 to 10 points. A typical interval involves 1 minute of intensive pedaling, followed by a 2-minute rest period without any activity. To facilitate progressive development, the resistance of the cycle ergometer will be adjusted biweekly to increase the pedaling challenge. Despite these adjustments, participants should consistently maintain their effort intensity within the 8 to 10 point range on the modified Borg scale for each interval.
Primary Outcome Measures
NameTimeMethod
Pain Intensity:Pre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

The Chronic Pain Grade Scale is a self-report instrument assessing the intensity and disability associated with chronic pain. It comprises 8 items, 7 of which are in an 11-point Likert format, totaling a range from 0 to 70 points. The final score is derived from summing items 2 to 8.

Items 2, 3, and 4 address pain intensity, while items 5, 6, 7, and 8 pertain to disability related to chronic pain.

Chronic pain grading based on this scale is classified as:

Grade I (low intensity): considering less than 15 points in pain intensity items and less than 17 points in disability items.

Grade II (high intensity): 15 points or more in pain intensity items and less than 17 points in disability items.

Grade III (moderately limiting): 17 to 24 points in disability items.

Grade IV (severely limiting): 25 to 40 points in disability items.

Fasting GlucosePre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Blood glucose level after a fasting period. (mg/dL)

Glycated Hemoglobin (HbA1c):Pre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Percentage of glucose-bound hemoglobin in the blood. (%)

Lipid ProfilePre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Set of tests to measure cholesterol and triglycerides. (mg/dL)

Systolic and Diastolic Blood PressurePre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Pressure in the arteries during and between heartbeats. (mmHg)

Metabolic FlexibilityPre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Indirect Calorimetry: Measurement of energy expenditure and substrates balance. (kcal)

Pressure Pain Threshold (PPT):Pre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Pressure Algometer Measurement: Minimum amount of pressure that induces pain. (kg)

Pain Characterization:Pre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

The characterization of chronic pain will be conducted using questions 15 and 16 (based on the neuropathic pain 4 questionnaire) from the 2013 validated Chilean survey of non-oncological chronic pain.

These questions allow for the categorization of pain as either somatic or neuropathic, as detailed below:

Somatic Pain: Sharp, widespread (in a nonspecific area), a specific area related to some movement, a squeeze.

Neuropathic Pain: Burning, cold pain, electric, tingling, prickling, itching, needle sensation, numbness.

Heart RatePre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Number of heartbeats per minute. (bpm)

Body CompositionPre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Percentage of Fat and Lean Mass: Proportion of fat and lean mass in the body. (%)

Cardiorespiratory fitnessPre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

6-minute walk test: The objective is to assess an individual's functional capacity and cardiorespiratory endurance. The primary measurement unit is the distance covered in meters during the 6 minutes

Handgrip strengthPre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Handgrip Dynamometry: Measurement of handgrip strength. (kgf or N)

Secondary Outcome Measures
NameTimeMethod
HeightPre-Intervention: Initial assessment before the training.

Individual's height. (cm)

Sociodemographic and Medical BackgroundPre-Intervention: Initial assessment before the training

* Gender: Biological classification of the individual. (No unit of measure)

* Age: Number of complete years since birth. (Years)

* Ancestry: Ethnic or racial origin of the individual. (No unit of measure)

* Education Level: Highest level of education achieved. (No unit of measure)

* Duration in Cardiovascular Health Program: Length of participation in the program. (Months or Years)

* Morbid Background: History of previous diseases and medical conditions. (No unit of measure)

* Medications and Dosage: Description of used medications and their dosages. (mg/day or as prescribed)

* Duration of Medication Use: Length of time medications have been used. (Months or Years)

Physical Activity LevelPre-Intervention: Initial assessment before the training.

The International Physical Activity Questionnaire (IPAQ) is a recognized instrument for assessing physical activity in adults. This survey outlines the frequency (measured in days per week) and duration (hours and minutes per day) of physical activities categorized into four intensity levels: sedentary, walking, moderate physical activity, and vigorous physical activity.

For each intensity level, the units of measurement are expressed in days per week and hours or minutes per day, with specific Metabolic Equivalent Task (METs) values assigned to each activity (Walking: 3.3 METs, Moderate Physical Activity: 4 METs, Vigorous Physical Activity: 8 METs). The responses can be converted into MET-minutes/week, enabling a quantitative and consistent comparison of total physical activity, encompassing various types and intensities.

Health-related quality of lifePre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

The (Short Form Health Survey - 36 is a questionnaire designed to measure health-related quality of life. It consists of 36 items covering eight health domains: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. Each domain is scored separately, and the scores are transformed into a 0 to 100 scale, where a higher score indicates better quality of life or less impact of the illness in that dimension.

WeightPre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Total body mass. (kg)

Body Mass IndexPre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

The Body Mass Index (BMI) is a metric used to assess the relationship between an individual's weight and height, thereby estimating their weight category, which can range from underweight to obesity. It is calculated by dividing a person's weight in kilograms by the square of their height in meters.

The formula is: BMI = weight (kg) / \[height (m)\]\^2

The unit of measurement for BMI is kg/m² (kilograms per square meter).

Waist CircumferencePre-Intervention: Initial assessment before the training. Week 4: Mid-program evaluation. Week 8: Eight-week assessment. Post-Intervention (Week 12): Final evaluation after 12 weeks.

Measurement of the abdominal circumference. (cm)

Trial Locations

Locations (1)

Universidad San Sebastián

🇨🇱

Valdivia, Región De Los Ríos, Chile

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