Aasa U.1, Aasa B.2
1Umea University, Community Medicine and Rehabilitation, Umeå, Sweden, 2Umea University, Umeå, Sweden
Background: Generally, during the last two decades, the choice of exercise therapy for patients with mechanical low back pain appears to have somewhat shifted from focusing on strength/hypertrophy training including high-load exercises targeting the global muscles, to low-load exercises focusing more on neuro-muscular motor control of the stabilizing muscles (i.e., motor control training). The reason for this is likely that research has shown that patients with low back pain have impairments related to the function of their stabilizing muscles, and that low-load motor control training can retrain these functions. Specifically, it has been shown that the timing and activation of the lumbar multifidus , transversus abdominus and oblique muscles are altered. Additionally, imaging studies have shown smaller lumbar multifidus muscle cross-sectional area in patients with low back pain.
Physiotherapists working at outpatient physiotherapy clinics in Sweden treat patients with mechanical low back pain. They are also often asked to evaluate the lifting capacity of their patients with mechancial low back pain. They then use the Isoinertial Lifting Evaluation Test (PILE). Whether low- or high load exercises are effective in increasing the lifting capacity was not yet known.
Physiotherapists working at outpatient physiotherapy clinics in Sweden treat patients with mechanical low back pain. They are also often asked to evaluate the lifting capacity of their patients with mechancial low back pain. They then use the Isoinertial Lifting Evaluation Test (PILE). Whether low- or high load exercises are effective in increasing the lifting capacity was not yet known.
Purpose: The aim of this study was therefore to compare the effects of low load motor control exercises and an high load exercise, on lifting capacity measured with PILE among patients with nociceptive mechanical LBP.
Methods: Seventy patients were randomized to low- och high-load motor control traiing (using the dead-lift exercise with optimal technique). Before and after the training period they performed PILE, static two-hand lift test and movement control tets. Repeated measures ANOVA was used to analyse results between and within groups. Spearman´s correlation analysis was used to analyse the relationships between PILE, static two-hand lift and movement control tests.
Results: No significant improvements were seen within (low load motor control exercises, p=0.60, high load exercise, p=0.77) or between groups (p=0.15). PILE was significantly correlated with the static two-hand lift test (rs=0.42, p 0.001), but not with number of passed movement control tests (rs=-0.12, p=0.33).
Conclusion(s): The patients performed better at baseline and follow-up compared to the lifting performance reported in earlier studies including participants with non-specific low back pain. A high load exercise was not more effective than low-load motor control training for improvement in lifting capacity.
Implications: Other factors than having mechanical low back pain might affect PILE results.
Funding acknowledgements: No funding
Topic: Occupational health & ergonomics
Ethics approval: The study protocol was approved by The Regional Ethical Review Board in Umeå (No. 09-200M).
All authors, affiliations and abstracts have been published as submitted.
