High Intensity Training With Non-specific Chronic Low Back Pain
High Intensity Training With Non-specific Chronic Low Back Pain
Low back pain is a common disorder, occurring worldwide in both males and females in all age
 groups1. The prevalence is higher in females and the incidence peaks between 30 and 65 years.
 It is currently the most frequent musculoskeletal cause of functional disability and it has a
 major socio-economic impact on today's society. Although a small percentage of persons with
 low back pain can be diagnosed with a specific underlying cause, almost 90% of persons with
 low back pain present with symptoms of nonspecific origin. A part of these symptoms are only
 of short duration, but 23% of all people will develop nonspecific chronic low back pain
 (NSCLBP).

 Exercise therapy (ET) is currently an important component in the treatment of NSCLBP.
 Previous studies analysed the effects of various modes of exercise therapy, such as motor
 control therapy, core stability training and aerobic conditioning training. However, therapy
 outcomes can be low, and guidelines in favour of using a specific program are contradictory.
 It thus still remains unclear which therapy modality is best suited. Furthermore, no
 recommendations are available about optimal training intensities during rehabilitation of
 persons with NSCLBP.

 Since as well aerobic as muscular deconditioning are apparent in persons with chronic low
 back pain and improvements in overall physical fitness can affect therapy outcomes in this
 population, ET specifically focussing on physical fitness can be advocated for NSCLBP
 rehabilitation. High Intensity Training (HIT), has been promoted as an effective and
 efficient training method for improving physical fitness and health related parameters in
 healthy persons. Also, HIT resulted in successful reconditioning and improvement of
 functional and disease related outcomes in persons with other chronic diseases such as
 multiple sclerosis, heart failure, COPD and cardiometabolic diseases. Although some studies
 showed promising results for the effect of HIT on low back pain such as high intensity
 isolated, evidence is still scarce and study results are unclear because of methodological
 shortcomings.To evaluate HIT for the rehabilitation of persons with NSCLBP, a therapy program
 was developed consisting of high intensity interval cardio and high load whole body strength
 training.

 The aim of this pilot study is 1) to evaluate the feasibility of a HIT program for the
 rehabilitation of persons with NSCLBP, and 2) to evaluate the effects of a HIT program on
 disease related outcomes and physical fitness compared to a conventional rehabilitation
 program in persons with NSCLBP.
Inclusion Criteria:

 1. medically diagnosed with non-specific chronic low back pain4,

 2. over 18 years old,

 3. able to understand Dutch (spoken and written).

 Exclusion Criteria:

 1. invasive surgery at the lumbar spine in the last 18 months (arthrodesis was excluded,
 microsurgery was allowed),

 2. radiculopathy (uni- or bilateral),

 3. co-morbidities: paresis and/or sensory disturbances by neurological causes, diabetes
 mellitus, rheumatoid arthritis, an increase of pain of 3 points with a result of >
 8/10 on the Numeric Pain Rating Scale (NPRS) in the last 48 hours, pregnancy,

 4. ongoing compensation claims and/or (work)disability > 6 months,

 5. rehabilitation/exercise therapy program for LBP in the past 6 months.