Periodized resistance training for persistent non-specific low back pain: a mixed methods feasibility study

Abstract

Background: We investigated the feasibility of a 16-week supervised heavy resistance training program with weekly undulating periodization for individuals with persistent non-specific low-back pain (LBP). Methods: Twenty-five adults with persistent non-specific LBP participated in this mixed methods feasibility study. Participants trained a whole-body program consisting of squat, bench press, deadlift and pendlay row two times per week for 16 weeks. We assessed pain intensity, pain-related disability, pain self-efficacy and one-repetition maximum strength at baseline, 8 weeks and 16 weeks. Three focus group interviews were conducted at the end of the program. Linear mixed models were used to assess changes in outcomes, and the qualitative data was assessed using systematic text condensation. Results: We observed clinically meaningful reductions in pain intensity after 8 and 16 weeks of training. The mean difference on the numeric pain rating scale (0-10) in the last 2 weeks from baseline to 8 weeks was 2.6 (95% CI: 1.8-3.6) and from baseline to 16 weeks 3.4 (95% CI: 2.5-4.4). In addition, there were improvements in pain-related disability (3.9, 95% CI: 2.3-5.5), pain self-efficacy (7.7, 95% CI: 5.4-10.1) and muscle strength. In the focus group interviews, participants talked about challenges regarding technique, the importance of supervision and the advantages of periodizing the training. Perceived benefits were improved pain, daily functioning, energy level and sleep, and changes in views on physical activity. Conclusion: Periodized resistance training with weekly undulating periodization is a feasible training method for this group of individuals with persistent non-specific LBP. A randomized clinical trial should assess the efficacy of such an intervention. Trial registration: clinicaltrials.gov/ Identifier-NCT04284982, Registered on February 24th 2020.

Water-Based Exercise in Patients With Nonspecific Chronic Low-Back Pain: A Systematic Review With Meta-Analysis

“…However, a greater number of program sessions and a greater total volume of training minutes per week did not translate into greater reduction in pain. Interestingly, interventions ≤8 weeks induced greater pain reduction than those of >8 weeks (ES = −6.12 vs. ES = −0.94, respectively), contrary to previous research (24,45,51,86) that demonstrated a decrease in pain when higher volumes of training (i.e., higher weekly frequency and appropriate training periodization) were performed.…”

Exercise Technique: The Landmine Row

“…Meadows row also can use greater loads because of a widened stance, support through the contralateral upper extremity, and favorable mechanical advantage. Compared with free-weight variations such as the Pendlay row (70) and dumbbell wide row (27), Meadows row guides glenohumeral horizontal abduction, a movement more difficult to control than extension, particularly for athletes with shoulder instability (75).…”

“…The row is a multi-joint exercise that involves pulling resistance toward the body via actions of the shoulder complex and elbow (27,57). The usefulness of rowing exercises is wellestablished for training muscles of the back (14,17,50,56), assessing pulling strength and power (19,51), differentiating between sport skill level (e.g., pace bowling in cricket) (39), potentiating pushing power in contrast training (2), and rehabilitating injuries (13,54,55,70).…”

Isokinetic trunk training on pain, disability, and strength in non-specific low back pain patients: A systematic review and meta-analysis

“…Despite this, multiple factors have been associated with the occurrence of NSLBP [9,10], including deconditioning the lumbar musculature [11,12], reduced trunk muscle mass [13], imbalance, and decreased trunk strength [14,15]. Thus, trunk strengthening has been proposed for manage LBP patients [16][17][18]. Furthermore, different trunk training methods have been investigated, such as motor control exercises [19], core stabilization [20,21], and strengthening exercises using an isokinetic dynamometer [22].…”