The influence of a moderate versus high intensity training program on central pain processing: a pilot feasibility study

This study evaluated the feasibility of two minimally equipped, blended supervised and tele-supported exercise programs, a moderate intensity training (MIT) and high intensity training (HIT) program, in healthy sedentary adults, and explored signals of efficacy on central pain processing. Participants were randomized to a 10-week MIT or HIT program, each comprising one supervised group session and two tele-supported home-based sessions per week. MIT involved a Start-to-Run protocol at 60–70% of heart rate reserve, while HIT involved strength exercises at > 80% of predicted maximum heart rate. Feasibility outcomes included recruitment, retention, adherence, and acceptability. Quantitative sensory testing (QST) assessed central pain processing pre- and post-intervention. Eighteen participants were enrolled (8 MIT, 10 HIT). Retention was lower in the MIT group (5 completed) than the HIT group (11 completed), with high adherence in both. Participants appreciated the blended format but noted challenges with digital tools, and suggested refinements. No significant differences in QST outcomes were observed, likely due to small sample size and inter-individual variability. Individual responses suggested reduced pain inhibition following MIT and enhanced inhibition after HIT. Both programs were feasible, supporting a larger-scale study to optimize implementation and confirm effects. ClinicalTrails.gov (ID: NCT06207422). Exercise programs are known for their ability to reduce self-reported pain severity but currently it is unknown whether these can also improve how the body processes pain. This pilot study tested whether two simple, low-cost exercise programs were feasible in healthy sedentary adults, and whether they might influence how pain is regulated by the nervous system. Eighteen sedentary adults participated in either a moderate-intensity training (MIT) program based on running or a high-intensity training (HIT) program focused on strength exercises. Both programs lasted 10 weeks and combined one supervised group session each week with two home-based sessions supported remotely. Overall, both exercise programs were feasible and well accepted. Participants attended most sessions and provided positive feedback about the blended (supervised and home-based) approach. However, recruiting participants proved challenging, and fewer participants completed the MIT program than the HIT program. Participants suggested improving the MIT program by adding strength exercises and more personalized trainer follow-up. For the HIT program, they recommended adjusting intensity levels and offering more guidance during home sessions. Difficulties with the digital tools were reported by both groups. The study also explored whether these exercise programs affected pain processing. While no statistical changes were observed and individual responses varied, some participants showed signs of altered pain regulation. These results suggest that simple, blended exercise programs are feasible for sedentary adults. Larger studies need to confirm the benefits of such programs and adapt these for people who suffer from chronic pain who are known to have dysregulated pain processing.