Effectiveness of a Group-Based Progressive Strength Training in Primary Care to Improve the Recurrence of Low Back Pain Exacerbations and Function: A Randomised Trial

Abstract

Low back pain (LBP) is the leading cause of disability and one of the most common reasons for physician visits in primary care, with a 33% rate of recurrence during the first year. However, the most optimal exercise program in this context remains unknown. The objective was to evaluate the effectiveness of a group-based progressive strength training program in non-specific chronic LBP (CLBP) patients in primary care on pain recurrence and physical function. Eighty-five patients with non-specific CLBP were separated into two groups (Intervention group: completed a progressive strength training program 3 days per week for 8 weeks; Control group: received the usual care). The intervention group showed a recurrence rate of 8.3%, while the control group had a recurrence rate of 33.3% and a shorter time until the first recurrent episode. The intervention group showed increased lumbar extensor strength, left-hand handgrip strength, and reduced the number of pain sites compared with the control group. Results also showed greater odds for reducing LBP intensity and disability in the intervention group. In conclusion, a group-based progressive strength training program is a more effective and efficient alternative than Back-School programs and can easily be carried out in the primary health care context.

Effects of Different Trunk Training Methods for Chronic Low Back Pain: A Meta-Analysis

“…Only three of the included studies used ST in comparing MC and IM [ 21 , 34 ] and only two included studies comparing IT to IM [ 63 , 71 ]. Standardisation and use of a select set of objective outcomes would provide better comparison in future meta-analyses.…”

“…Due to the non-specific nature of the CLBP diagnosis given to the 19–60 year population group, recent meta-analyses on CLBP intervention [ 26 , 27 , 28 ] have focused on this population as a whole. Many intervention studies have either used a similar age range [ 21 , 23 ] or do not specify any age range [ 33 , 34 ] in their subject recruitment criteria. CLBP is defined as persistent low back pain for at least 12 weeks [ 3 , 35 ] or as diagnosed by a clinician.…”

“…Patients under 40 may have a 3.7 times higher chance of pain and disability reduction than older patients [ 58 ]. Some intervention studies recruited patients with an age range that overlapped 40 [ 21 , 34 ]. Patient mean age was used to group the included studies.…”

“…Existing primary studies comparing different types of trunk training have resulted in inconsistent findings. MC could be more [ 20 ] or less effective [ 21 ] than IM in pain reduction based on the Numerical Pain Rating Scale (NPRS); more [ 22 ] or less effective [ 23 ] than IT in pain reduction; or just as [ 24 ] or more [ 25 ] effective than the control group in disability reduction based on the Roland Morris Disability Questionnaire (RMDQ). In some cases, combining different training methods also yielded inconclusive results [ 26 , 27 ].…”

Influence of Stabilization Techniques Used in the Treatment of Low Back Pain on the Level of Kinesiophobia

“…More fear being related to pain may increase the susceptibility to the formation of new pain episodes. Even in currently healthy people, the risk of further ailments increases, which leads to the chronicity of the phenomenon [ 13 ]. It has been proven that people suffering from chronic lower back pain avoid risky situations, and if they decide to engage in any activity, it is performed with a very high level of caution, which directly affects the quality of a given motor task [ 14 ].…”