Resistance Exercise, Disability, and Pain Catastrophizing in Obese Adults with Back Pain

Abstract

Purpose The purpose of this study was to compare the effects of two different resistance exercise protocols on self-reported disability, fear avoidance beliefs, pain catastrophizing and back pain symptoms in obese, older adults with low back pain. Methods Obese adults (N=49; 60–85 years) with chronic low back pain (LBP) were randomized into a total body resistance exercise intervention (TOTRX), lumbar extensor exercise intervention (LEXT) or a control group (CON). Main outcomes included perceived disability (Oswestry Disability Index [ODI], Roland Morris Disability Questionnaire [RMDQ]). Psychosocial measures included the Fear Avoidance Beliefs (FAB) survey, Tampa Scale of Kinesiophobia (TSK), Pain Catastrophizing Scale (PCS). LBP severity was measured during three functional tasks: walking, stair climb and chair rise using an 11 point numerical pain rating scale (NRSpain). Results The TOTRX group had greater reductions in self-reported disability scores due to back pain (ODI, RMDQ) compared to LEXT (p<0.05). The PCS scores decreased in the TOTRX compared to CON by month four (64.3% vs 4.8%, p<0.05). Pain severity during chair rise activity, and walking pain severity was decreased in both LEXT and TOTRX relative to the CON group. Conclusions Greater reductions in perceived disability due to LBP can be achieved with TOTRX compared to LEXT. Pain catastrophizing and pain severity decreased most with TOTRX. The positive change in psychological outlook may assist obese, older adults with chronic back pain re-consider the harmfulness of the pain and facilitate regular participation in other exercise programs.

Low back pain in older adults: risk factors, management options and future directions

“…A recent randomized controlled trial among 49 obese, older adults with chronic LBP demonstrated that reduction in pain catastrophizing following 4-month resistance exercise was related to decreased self-reported LBP-related disability [184]. However, Ledoux and coworkers found that kinesiophobia, pain catastrophizing, and depression were unrelated to the functional capacity among older adults with chronic LBP [185].…”

Physical Activity Interventions for Increasing Objectively Measured Physical Activity Levels in Patients With Chronic Musculoskeletal Pain: A Systematic Review

“…Excluded full‐text articles and the primary reason for exclusion are shown in Supplementary Table 3 (see Supplementary Table 3, available on the Arthritis Care & Research web site at http://onlinelibrary.wiley.com/doi/10.1002/acr.22919/abstract). Finally, a total of 9 articles fulfilled the inclusion criteria . Two articles reported data from the same trial for short‐term and intermediate and long‐term followups .…”

“…Regarding the conditions investigated, OA was investigated in 4 trials , low back pain in 3 trials , and fibromyalgia in 1 trial . Interventions to promote physical activity varied across included trials: 1 trial investigated a cognitive‐behavioral physical activity intervention , 1 trial included a web‐based physical activity intervention program , 2 trials investigated a pedometer‐based walking program , 2 trials investigated general exercise group classes , and 2 trials investigated therapeutic exercises . Education/advice was the type of comparator most commonly used, followed by self‐management , waiting list , and sham control .…”

“…Regarding the assessment method, 5 trials used accelerometers , 2 trials used pedometers , and 1 trial used both . The physical activity measures used as outcomes were step count, time spent in various intensities of physical activity, and total vector magnitude (counts).…”

The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back

“…It has also been demonstrated that individuals with LBP and greater pain-related fear change movement patterns in an effort to reduce lumbar spine motion during some tasks 13. While the use of RT may alter the fear-related aspects of LBP,14 limited support has been presented for the ability of rehabilitation interventions to change movement patterns 15. No research into the effects of free weight RT on biomechanics in those with LBP could be found.…”