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

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% VO ${}_{\text{2Max}}$ ) and high load resistance (80% 1RM) training (HIT, $n=$ 10) and compared to average intensity/load (60% VO ${}_{\text{2max}}$ ) 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.