Effects of high intensity training on pain, disability, exercise capacity and muscle strength in persons with nonspecific chronic low back pain: Preliminary RCT results

Objective: The present study aimed to verify the influence of training intensity in the aquatic environment on pain, disability, physical capacity, and quality of life in patients with chronic low back pain. Design/Setting: A randomized clinical trial. Subjects: Twenty-two patients with chronic low back pain of both sexes (13 women and 9 men) participated in the study. Material and method: One group performed deep-water walking/running training at moderate intensity (MIT) and a second group performed deep-water walking/running training at high intensity (HIT). Pain, disability, peak oxygen uptake (VO2peak), and quality of life were assessed before and after an intervention. Results: Decreases in pain and disability were observed within both groups, without differences in these parameters between training groups. VO2peak did not change in either group after the training intervention. The results of the HIT group showed more significant improvements in quality of life than that of the MIT group, highlighting the social domain, psychological domain, and general quality of life. Both groups presented significant improvements in the physical and environmental domains of quality of life. Conclusions: Deep-water aerobic exercise training seems to be effective for improving pain symptoms and reducing the disability of people with chronic low back pain. These improvements seem to be independent of the intensity at which the training is performed. In addition, improving pain and disability does not directly reflect all areas of quality of life. In this case, the group that performed the intervention at high intensity achieved more significant improvements in quality of life.

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

Journal of Clinical Medicine ◽

10.3390/jcm9082401 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2401

Author(s):

Jonas Verbrugghe ◽

Anouk Agten ◽

Sjoerd Stevens ◽

Dominique Hansen ◽

Christophe Demoulin ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

High Intensity ◽

Interval Training ◽

Low Back ◽

Core Strength ◽

High Intensity Training ◽

Rehabilitation Outcomes ◽

Intensity Training ◽

Cycling Time

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.

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A Pilot Study of the Effects of High-Intensity Aerobic Exercise Versus Passive Interventions on Pain, Disability, Psychological Strain, and Serum Cortisol Concentrations in People With Chronic Low Back Pain

Physical Therapy ◽

10.2522/ptj.20060080 ◽

2007 ◽

Vol 87 (3) ◽

pp. 304-312 ◽

Cited By ~ 67

Author(s):

Dimitris Chatzitheodorou ◽

Chris Kabitsis ◽

Paraskevi Malliou ◽

Vassilis Mougios

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Aerobic Exercise ◽

Chronic Low Back Pain ◽

High Intensity ◽

Serum Cortisol ◽

Control Group ◽

Low Back ◽

Psychological Strain ◽

Pain Disability

Background and Purpose Given the complex nature of chronic pain, the effects of high-intensity aerobic exercise on pain, disability, psychological strain, and serum cortisol concentrations in people with chronic low back pain were investigated. Subjects Twenty subjects receiving primary health care were randomly allocated into exercise and control groups. Methods Subjects in the exercise group received a 12-week, high-intensity aerobic exercise program. Subjects in the control group received 12 weeks of passive modalities without any form of physical activity. Results Data analysis identified reductions in pain (41%, t10=8.51, P<.001), disability (31%, t10=7.32, P<.001), and psychological strain (35%, t10=7.09, P<.001) in subjects in the exercise group and no changes in subjects in the control group. High-intensity exercise failed to influence serum cortisol concentrations. Discussion and Conclusion Regular high-intensity aerobic exercise alleviated pain, disability, and psychological strain in subjects with chronic low back pain but did not improve serum cortisol concentrations.

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Faculty Opinions recommendation of A pilot study of the effects of high-intensity aerobic exercise versus passive interventions on pain, disability, psychological strain, and serum cortisol concentrations in people with chronic low back pain.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1071737.524650 ◽

2007 ◽

Author(s):

Marie Hoeger Bement

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pilot Study ◽

Aerobic Exercise ◽

Chronic Low Back Pain ◽

High Intensity ◽

Serum Cortisol ◽

Low Back ◽

Psychological Strain ◽

Pain Disability

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High Intensity Training Increases Muscle Area Occupied by Type II Muscle Fibers of the Multifidus Muscle in Persons with Non-Specific Chronic Low Back Pain: A Pilot Trial

Applied Sciences ◽

10.3390/app11083306 ◽

2021 ◽

Vol 11 (8) ◽

pp. 3306

Author(s):

Anouk Agten ◽

Jonas Verbrugghe ◽

Sjoerd Stevens ◽

Bert O. Eijnde ◽

Annick Timmermans ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Training Program ◽

Muscle Fiber ◽

High Intensity ◽

Low Back ◽

Type Ii ◽

Muscle Area ◽

High Intensity Training ◽

Intensity Training

Low back pain is a prevalent musculoskeletal disorder with high disability. Although exercise therapy is an important part of the multidisciplinary treatment of non-specific chronic low back pain (NSCLBP), the impact of exercise therapy on muscle morphology of the paraspinal muscles is largely unknown. The main aim of this study is to evaluate the effects of a high intensity training (HIT) program on muscle fiber characteristics of the multifidus (MF) and the erector spinae (ES) musculature in persons with NSCLBP and to compare these results with the effects of a moderate intensity training (MIT) program, which is used as a control group. In total, 38 participants with NSCLBP were randomly assigned to a HIT or MIT intervention group. Participants performed a 12-week training program. At baseline and after the training program, biopsy samples from the lumbar MF and ES were obtained. Muscle fiber characteristics were analyzed by immunofluorescence. For the ES, no significant changes were found in muscle fiber CSA and distribution of muscle fiber types in response to a training program at moderate or at high intensity. For the MF, a significant higher muscle area occupied by type II muscle fibers, referred to as the relative cross-sectional area (RCSA), was found in the HIT group. Based on muscle fiber characteristics in biopsy samples, a HIT program of 12 weeks seems to result in a more glycolytic profile in the MF.

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