# Project 1:  Impaired Exercise Induced Hypoalgesia

> **NIH NIH U19** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2024 · $450,984

## Abstract

ABSTRACT Project 1: Exercise-Induced Hypoalgesia
The overarching objective of this project is to examine the neurobiological mechanisms related to and impact of
impaired exercise-induced hypoalgesia (EIH) in people with knee osteoarthritis (OA). While physical activity,
including structured exercise, is the first line intervention for people with chronic pain due to knee OA, over half
of people do not respond to exercise interventions. Some people with knee OA have an abnormal acute response
to exercise characterized by worsened or no change in pain sensitivity, i.e., an impaired EIH response. Impaired
EIH may serve as a risk factor for negative response to first-line treatments involving physical activity and
exercise, inadvertently exacerbating pain acutely. Whether this impaired EIH is related to previously
characterized pain-related nervous system dysfunction in people with chronic pain is not known. Specifically,
dysfunction of ascending pain facilitation or descending pain inhibition, heightened generalized nervous system
sensitivity assessed self-reported multisensory sensitivity, and altered autonomic nervous system functioning
assessed as low heart rate variability will be examined as potential factors related to impaired EIH. It is also not
known whether impaired EIH represents the biological underpinnings of key physical (movement-evoked pain,
muscle weakness, impaired physical function, limited physical activity) and psychological (fear of movement,
negative beliefs about exercise) impairments seen in people with knee OA. This project will leverage the next
cycle of the Multicenter Osteoarthritis (MOST) Study to comprehensively examine the degree of impaired EIH in
a cohort of adults with or at risk of knee OA, the inter-relations between nervous system dysfunction and impaired
EIH, and their impacts on key physical and psychological outcomes. The first aim of this project is to determine
the relation of nervous system dysfunction, i.e., abnormalities in ascending pain facilitation and descending pain
inhibition, elevated multisensory sensitivity, and low heart rate variability to degree of EIH. The second aim is to
examine relation of EIH to movement-evoked pain, quadriceps strength, and physical function. The third aim is
to evaluate the relation of EIH to fear of movement, beliefs and outcome expectations related to exercise, and
daily physical activity. This project addresses several knowledge gaps about impaired EIH in knee OA, the most
common form of arthritis and leading cause of disability worldwide. We will obtain novel insights into the relations
of EIH with several hypothesized associated mechanisms or markers and key knee OA outcomes. Alternate first-
line therapies may need to be considered for those with impaired EIH, whereas those with strong EIH responses
may respond better to exercise interventions. Novel treatment avenues can be tested if the underlying nervous
system impairments are found to contribute to impaired E...

## Key facts

- **NIH application ID:** 10843728
- **Project number:** 5U19AG076471-02
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** TUHINA NEOGI
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $450,984
- **Award type:** 5
- **Project period:** 2023-06-01 → 2028-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10843728

## Citation

> US National Institutes of Health, RePORTER application 10843728, Project 1:  Impaired Exercise Induced Hypoalgesia (5U19AG076471-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10843728. Licensed CC0.

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