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

Article type: Research Article

Authors: Verbrugghe, Jonas^{a; *} | Agten, Anouk^a | O. Eijnde, Bert^a | Olivieri, Enzo^b | Huybrechts, Xavier^b | Seelen, Henk^c | Vandenabeele, Frank^a | Timmermans, Annick^a

Affiliations: [a] Hasselt University, REVAL – Rehabilitation Research Center, BIOMED, Hasselt, Belgium | [b] Department of Rehabilitation and Physical Medicine, Jessa Ziekenhuis, Hasselt, Belgium | [c] Adelante – Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands

Correspondence: [*] Corresponding author: Jonas Verbrugghe, Agoralaan 5, Gebouw A, 3590, Diepenbeek, Belgium. Tel.: +32 11269239; Fax: +32 11269329; E-mail: Jonas.verbrugghe@uhasselt.be.

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, rehabilitation, high intensity, exercise therapy

DOI: 10.3233/BMR-170810

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 31, no. 4, pp. 657-666, 2018