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

Abstract

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.

Evidence-Based Effects of High-Intensity Interval Training on Exercise Capacity and Health: A Review with Historical Perspective

“…Growing evidence-based research, both original research and meta-analysis studies, shows that interval training programs ranging from 5 days to 12 months are effective in improving O 2max [ 37 ], endurance capacity [ 38 , 39 ], resting metabolic rate [ 40 ], substrate metabolism [ 41 , 42 ], body composition [ 43 ], insulin sensitivity [ 44 , 45 ], and cognitive functions [ 46 , 47 , 48 ]. Besides, interval training has been shown to decrease the risk for cardiovascular diseases [ 15 , 25 ], breast cancer [ 49 ], metabolic syndrome [ 50 ], osteoarthritis [ 51 , 52 ], and rheumatoid arthritis known to cause lower back pain [ 53 , 54 , 55 , 56 , 57 ] ( Figure 1 ). In the following subheadings, the definition, as well as health and performance benefits, of different interval trainings models are presented.…”

Chronic musculoskeletal pain, catastrophizing, and physical function in adult women were improved after 3-month aerobic-resistance circuit training

“…Furthermore, the cutoff point was 25 times greater in the 3-month period, equivalent to twice a week. In a randomized comparative trial of combined training for adults with chronic nonspecific low back pain, participants exercised twice a week for 1.5 h 49 . This contrasts with the present study, in which a sufficient effect was obtained even with 30-min exercise sessions twice a week.…”

High Intensity Training Is an Effective Modality to Improve Long-Term Disability and Exercise Capacity in Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial

“…The authors would like to express their gratitude to F. Vandenabeele, A. Agten, and Sjoerd Stevens from the Faculty of Rehabilitation Sciences of UHasselt, for their contribution to the conceptualisation of, and/or data-collection within the original RCT study [9,10]. The authors would like to thank all the persons with CNSLBP that participated in this study.…”

“…It produces notably greater decreases in functional disability and improves exercise capacity more in the short term [9]. Also, different HIT protocol modalities have been shown to be equally effective to each other in CNSLBP [10]. Indeed, HIT might be better adapted on a physiological level to increase the physical fitness levels in this population [5,11].…”