Feasibility of high intensity training in nonspecific chronic low back pain: A clinical trial

J Back Musculoskelet Rehabil. 2018;31(4):657-666. doi: 10.3233/BMR-170810.

Abstract

Background: Although low to moderate intensity exercise therapy is a predominant part of rehabilitation in nonspecific chronic low back pain (NSCLBP), effect sizes are small and optimal exercise modalities/intensities are unclear. Conversely, effects of high intensity training have not yet been investigated in this population.

Objective: The aim of this study is to investigate the feasibility of high intensity training (HIT) and to explore the magnitude of the effects of a HIT program on exercise capacity and disease related outcome measures compared to conventional therapy for persons with NSCLBP.

Methods: In this non-randomized controlled feasibility study, treatment satisfaction, adherence, disability, pain, physical activity, body composition, exercise capacity and self-reported motivation, were assessed in persons with NSCLBP, before (PRE) and after (POST) 6 weeks (12 sessions, 1.5 hours/session, 2 x/week) of high intensity cardiovascular (100% VO2Max) and high load resistance (80% 1RM) training (HIT, n= 10) and compared to average intensity/load (60% VO2max) conventional physical therapy (CON, n= 10).

Results: At PRE, CON and HIT did not differ, except for gender ratio and lean mass. Compared to CON, HIT retained motivation to rehabilitate better (HIT: +3%; CON: -25%) and had higher therapy adherence (+16%) during the study course. No adverse events were noted in both groups. Whereas disability reduced in both groups (HIT: -10.4%; CON: -8.3%), peak workload (+7.0%), time to exhaustion (+9.5%), and activity level (+5.6%) only improved in HIT.

Conclusions: High intensity exercise therapy appears to be a feasible rehabilitation approach in NSCLBP. Outcomes improved following the HIT protocol, warranting the investigation of its effectiveness in future large scale RCT studies.

Keywords: Low back pain; exercise therapy; high intensity; rehabilitation.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Chronic Pain / physiopathology
  • Chronic Pain / rehabilitation*
  • Exercise / physiology*
  • Exercise Therapy / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Low Back Pain / physiopathology
  • Low Back Pain / rehabilitation*
  • Male
  • Middle Aged
  • Self Report