{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T14:11:45Z","timestamp":1788617505568,"version":"build-2803163510"},"reference-count":52,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Exercise therapy is a core treatment for knee osteoarthritis (KOA), but the effects of different exercise modalities on endogenous pain modulation remain unclear. This trial will compare a cycling\u2010based aerobic exercise program with a resistance and neuromuscular exercise program on exercise\u2010induced hypoalgesia (EIH) in people with KOA and altered baseline EIH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomized, two\u2010arm, controlled, single\u2010blind trial will include 90 participants aged 40\u201375\u00a0years with symptomatic KOA, knee pain intensity of at least 3 points on the Numerical Pain Rating Scale, and altered baseline EIH. Participants will be randomized 1:1 to the Cycling\u2010Based Aerobic Exercise Group (CAEG) or the Resistance and Neuromuscular Exercise Group (RNEG). Both groups will receive 30 supervised sessions over 10\u00a0weeks. The primary treatment effect will be the adjusted mean between\u2010group difference in within\u2010session change in pressure pain threshold at the most symptomatic knee, averaged across weeks 1, 4, 7, and 10. Secondary outcomes include EIH at other sites, conditioned pain modulation, pain, self\u2010efficacy, function, performance, strength, global perceived effect, adherence, and enjoyment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This trial will evaluate whether the two exercise programs differ in their capacity to elicit EIH in KOA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This trial may clarify whether different exercise modalities produce distinct effects on acute endogenous pain modulation in KOA and may support a more precise exercise prescription for pain management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      , identifier NTC07302204\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70341","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T13:19:27Z","timestamp":1788614367000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of a Cycling\u2010Based Aerobic Exercise Program Versus a Resistance and Neuromuscular Exercise Program on Exercise\u2010Induced Hypoalgesia in Knee Osteoarthritis: A Study Protocol for a Randomized Clinical Trial"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6726-337X","authenticated-orcid":false,"given":"Bruno Ruocco","family":"Verengue","sequence":"first","affiliation":[{"name":"Postgraduate Program in Rehabilitation Sciences Nove de Julho University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6167-897X","authenticated-orcid":false,"given":"Lisa C.","family":"Carlesso","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0494-374X","authenticated-orcid":false,"given":"Barbara Greco","family":"Miura","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Rehabilitation Sciences Nove de Julho University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4281-2616","authenticated-orcid":false,"given":"Aron Charles Barbosa da","family":"Silva","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Rehabilitation Sciences Nove de Julho University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6945-0603","authenticated-orcid":false,"given":"Patr\u00edcia Gabrielle dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Rehabilitation Sciences Nove de Julho University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5403-8248","authenticated-orcid":false,"given":"Almir Vieira","family":"Dibai\u2010Filho","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Physical Education Universidade Federal do Maranh\u00e3o  S\u00e3o Lu\u00eds Maranh\u00e3o Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6627-7537","authenticated-orcid":false,"given":"Cid Andr\u00e9","family":"Fidelis\u2010de\u2010Paula\u2010Gomes","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Rehabilitation Sciences Nove de Julho University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,5]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u201011\u2010126"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010022\u201006911\u2010w"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780290816"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11332\u2010018\u20100516\u20104"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.70141"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1519\/JPT.0000000000000213"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38317"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2019.05.001"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102024\u2010081477"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296\u2010016\u20103620\u20102"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584\u2010025\u201001332\u20108"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181849dbe"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.22939"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2013.05.002"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000000972"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304\u20103959(01)00349\u20109"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000418"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2015.03.013"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pri.1957"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2024.02.890"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102018\u2010099683"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1687"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102024\u2010081123"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2018.04.001"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1179\/jmt.2009.17.3.163"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102024\u2010093163"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25524"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215515610039"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1159\/000091824"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocarto.2020.100098"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010023\u201006831\u2010x"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2022.10727"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u201015\u2010157"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ard.2026.03.006"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.01.041"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107525\u20101\u201064"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/smi.1135"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen\u20102025\u2010006275"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2023.07.005"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1080\/09593985.2021.2023929"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010025\u201000594\u20106"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0b013e31829a68cf"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421\u2010006\u20100238\u20101"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14228086"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102017\u2010018471"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpain.2026.1717540"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1607\u2010551X(09)70521\u20102"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2020.04.003"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.3389\/fragi.2025.1458983"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102025\u2010085242"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.605"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.113100"}],"container-title":["Physiotherapy Research International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pri.70341","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pri.70341","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pri.70341","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T13:19:28Z","timestamp":1788614368000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pri.70341"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,5]]},"references-count":52,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/pri.70341"],"URL":"https:\/\/doi.org\/10.1002\/pri.70341","archive":["Portico"],"relation":{},"ISSN":["1358-2267","1471-2865"],"issn-type":[{"value":"1358-2267","type":"print"},{"value":"1471-2865","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,5]]},"assertion":[{"value":"2026-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70341"}}