Abstract

BackgroundWe investigated the feasibility of a 16-week supervised heavy resistance training program with weekly undulating periodization for individuals with persistent non-specific low-back pain (LBP).MethodsTwenty-five adults with persistent non-specific LBP participated in this mixed methods feasibility study. Participants trained a whole-body program consisting of squat, bench press, deadlift and pendlay row two times per week for 16 weeks. We assessed pain intensity, pain-related disability, pain self-efficacy and one-repetition maximum strength at baseline, 8 weeks and 16 weeks. Three focus group interviews were conducted at the end of the program. Linear mixed models were used to assess changes in outcomes, and the qualitative data was assessed using systematic text condensation.ResultsWe observed clinically meaningful reductions in pain intensity after 8 and 16 weeks of training. The mean difference on the numeric pain rating scale (0–10) in the last 2 weeks from baseline to 8 weeks was 2.6 (95% CI: 1.8–3.6) and from baseline to 16 weeks 3.4 (95% CI: 2.5–4.4). In addition, there were improvements in pain-related disability (3.9, 95% CI: 2.3–5.5), pain self-efficacy (7.7, 95% CI: 5.4–10.1) and muscle strength. In the focus group interviews, participants talked about challenges regarding technique, the importance of supervision and the advantages of periodizing the training. Perceived benefits were improved pain, daily functioning, energy level and sleep, and changes in views on physical activity.ConclusionPeriodized resistance training with weekly undulating periodization is a feasible training method for this group of individuals with persistent non-specific LBP. A randomized clinical trial should assess the efficacy of such an intervention.Trial registrationclinicaltrials.gov/ Identifier – NCT04284982, Registered on February 24th 2020.

Highlights

  • We investigated the feasibility of a 16-week supervised heavy resistance training program with weekly undulating periodization for individuals with persistent non-specific low-back pain (LBP)

  • Exercise in general can improve pain and function in individuals with persistent LBP [6, 7], and it has been suggested that resistance training in combination with flexibility training can be especially beneficial compared to aerobic exercise, passive treatments and coordination training [8]

  • Some participants mentioned that in addition to the resistance training they wanted to add some other exercise modalities to maintain their motivation. In this mixed methods feasibility study, we investigated the feasibility of heavy periodized resistance training with weekly undulating periodization for individuals with persistent non-specific LBP

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Summary

Introduction

We investigated the feasibility of a 16-week supervised heavy resistance training program with weekly undulating periodization for individuals with persistent non-specific low-back pain (LBP). Exercise in general can improve pain and function in individuals with persistent LBP [6, 7], and it has been suggested that resistance training in combination with flexibility training can be especially beneficial compared to aerobic exercise, passive treatments and coordination training [8]. A systematic review from 2012 concluded that heavy resistance training with intensities above 70% of onerepetition maximum (1RM) may be more effective than training with lower intensities in reducing pain and improving function in individuals with persistent LBP [7]. The review indicated that heavy resistance training is well tolerated by individuals with LBP and does not increase risk of injury if the training is increased gradually and carried out in a periodized manner [7]

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