High Intensity Training to Treat Chronic Nonspecific Low Back Pain: Effectiveness of Various Exercise Modes.

Jonas Verbrugghe,Anouk Agten,Sjoerd Stevens,Annick Timmermans,Frank Vandenabeele,Bert O Eijnde,Dominique Hansen,Christophe Demoulin

doi:10.3390/jcm9082401

Jonas Verbrugghe, Anouk Agten + Show 6 more

Open Access

https://doi.org/10.3390/jcm9082401

Copy DOI

Abstract

High-intensity training (HIT) improves rehabilitation outcomes such as functional disability and physical performance in several chronic disorders. Promising results were also found in chronic nonspecific low back pain (CNSLBP). However, the impact of different exercise modes on HIT effectiveness in CNSLBP remains unclear. Therefore, this study evaluated the effectiveness of various HIT exercise modes and compared differences between these modes, on pain intensity, disability, and physical performance, as a therapeutic intervention for persons with CNSLBP. In a randomized comparative trial, consisting of a 12-week program, persons with CNSLBP were divided into four HIT groups, i.e., cardiorespiratory interval training coupled with either general resistance training, core strength training, combined general resistance and core strength training, or mobility exercises. Before and after the program, the Numeric Pain Rating Scale (NPRS), Modified Oswestry Disability Index (MODI), and Patient Specific Functioning Scale (PSFS) were recorded, and a cardiopulmonary exercise test (VO2max, cycling time) and isometric trunk strength test (maximum muscle torque) were performed. Eighty participants (mean age: 44.0 y, 34 males) were included. Improvements were found within all groups after the HIT programs and ranged from −39 to −57% on the NPRS, +27 to +64% on the MODI, +38 to +89% on the PSFS, +7 to +14% on VO2max, and +11 to +18% on cycling time. No differences between groups were found. High-intensity cardiorespiratory interval training improves CNSLBP rehabilitation outcomes when performed with other HIT exercise modes or mobility exercises. Hence, when setting up an exercise therapy program in CNSLBP rehabilitation, various HIT modes can be considered as therapy modalities.

Highlights

Chronic low back pain is one of the most common musculoskeletal disorders worldwide [1,2,3,4], with a point prevalence of around 20% [5]
The present randomized comparative trial is part of a larger project entitled “High intensity training in chronic nonspecific low back pain”, which evaluates the effects of training intensity and various training modes in CNSLBP rehabilitation through a prospectively registered, five-arm, RCT organized at REVAL (Hasselt University, Diepenbeek, Belgium)
80 participants were randomized into the four High-intensity training (HIT) training groups: high-intensity general resistance and core strength program (HITCOM): n = 19; high-intensity general resistance training (HITSTRE): n = 21; HITSTAB: n = 20; and HITMOB: n = 20

Summary

Introduction

Chronic low back pain is one of the most common musculoskeletal disorders worldwide [1,2,3,4], with a point prevalence of around 20% [5]. It is currently ranked as the number-one cause of long-term disability, leads to more than 10% of all work absenteeism, and is a considerate financial burden for healthcare systems [6,7,8,9]. The management of chronic nonspecific low back pain (CNSLBP) consists of a multidimensional treatment approach that includes exercise therapy as an important part [10,11]. Overall effect sizes of exercise therapy in CNSLBP treatment remain only small to moderate [16]

Objectives

Methods

Results

Discussion

Conclusion