EFFECTS OF HIGH INTENSITY TRAINING IN PATIENTS WITH NON-SPECIFIC CHRONIC LOW BACK PAIN: A CLINICAL PILOT TRIAL

Abstract

Introduction Nonspecific chronic low back pain (NSCLBP), is the most common musculoskeletal cause of disability and has a major socio-economic impact on today’s western society1. The rehabilitation of chronic low back pain requires a multidisciplinary approach with both education and exercise therapy. Since physical deconditioning is often observed in patients with chronic low back pain, physical reconditioning is an important component of the exercise therapy during rehabilitation2. High Intensity Training (HIT) has been recently promoted as an effective and efficient training method for improving physical fitness and health related parameters in healthy persons. HIT already resulted in successful reconditioning of patients with different other chronic diseases (e.g. multiple sclerosis)3.

Purpose/Aim The aim of this study was to test the effects of a HIT program on pain, functionality and physical capacity compared to a conventional exercise therapy program in NSCLBP patients.

Materials and Methods A clinical pilot was conducted with 20 NSCLBP patients (Jessa Hospital, Belgium). The experimental group (n=10) followed a HIT program consisting of high intensity interval cardio training and high load whole body strength training, while the control group (n=10) participated in a conventional exercise therapy program consisting of low to average load cardiovascular training and low to average load stabilization training. Both groups attended 12 training sessions (2x2 hours/week) during 6 weeks. At baseline and after 6 weeks of therapy, an exercise test to volitional fatgue was performed to determine the endurance capacity. Also self-reported measures were collected to assess pain (Numeric Pain Rating Scale), disability (Roland Morris Disability Questionnaire), physical activity in daily life (Physical Activity Scale for Individuals with Physical Disabilities) and kinesiophobia (TAMPA).

Results Disability improved in both groups (HIT: p=0.035, CON: p=0.047), but no differences were noted between groups (p= 0.964). Maximum wattage (HIT: p=0.014; CON: p=0.055), time to exhaustion (HIT: p=0.004; CON: p=0.074), lean mass (HIT: p=0.032; CON: p=0.074) and activity level (HIT: p=0.024; CON: p=0.055) improved significantly in the intervention group, while it remained unchanged in the control group. No significant differences between both groups were noted for any of the physical fitness or disease related outcomes.

Discussion These preliminary data of a pilot trial suggest that a HIT program, could have positive effects on physical activity, exercise capacity, and disease related outcomes in NSCLBP patients. However, no significant differences with conventional exercise therapy were noted. A short study duration and small sample sizes are thought to be the main issue.

Conclusions A HIT program was shown to be effective in improving physical activity of NSCLBP patients in daily life as well as disease related outcomes. Furthermore, the exercise capacity of low back pain patients could also be improved by a HIT program. However, the added value of a HIT program compared to a conventional exercise program on these outcomes is still indecisive and further research is necessary to confirm these data.