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V. Peacock1, M. Wochatz1, T. Engel1, A. Schraplau1, M. Zecher1, F. Mayer1
1University of Potsdam, Department of Health and Human Sciences, Potsdam, Germany
Background: Eccentric exercises are a potential treatment for chronic low back pain with lower cardiovascular demand and higher load compared to concentric training. However, eccentric exercises consistently induce muscle soreness, and their feasibility as a treatment has not been studied in connection with chronic low back pain.
Purpose: This study investigated the feasibility of eccentric training on Quality of Life (QoL), pain intensity and disability, and muscle soreness in participants with and without chronic low back pain.
Methods: 28 participants (12 in the Control Group (CG); 16 in the Low Back Pain Group (LBPG)) participated in trunk and hip-focused eccentric training (18 sessions over 6 weeks, intensity 13–17 on the Borg scale (6–20). QoL was assessed before (M1) and after (M2) intervention via the EuroQol (EQ-5D; Health Scale (0–100) and EQ-5D Index Score (0–1). Low back pain was assessed at M1 and M2 by the Chronic Pain Grade Scale (CPGS) subscales Pain Intensity and (pain-related) Disability (0–100). Pain and muscle soreness were recorded per session via the Numeric Rating Scale (NRS: 0–10) and the averaged first and last week’s sessions were compared. Program satisfaction (exercises, equipment, time commitment) was rated via a 5-point Likert Scale at M2. Data was analysed descriptively and via Wilcoxon Signed Rank or Paired T test for Intervention effects (adjusted alpha level </= 0.025).
Results: All in the CG (12/12) completed at least 2/3 of the sessions, as did all but four (12/16) in the LBPG. QoL increased descriptively in both groups as per the Health Scale (M1: LBPG:80.0±2.7/CG:87.3±1.8; M2: LBPG:83.0±2.8/CG:90.0±2.0, p>0.025) and EQ5D Index (M1: LBPG:0.88±0.01/CG:0.97±0.02; M2: LBPG:0.92±0.01/CG:0.98±0.01, p>0.025). CPGS pain intensity decreased significantly in both groups (M1: 42.0±3.1/CG:8.9±2.1; M2: LBPG:28.4±4.2/CG:1.7±1.2, p<0.025). Pain disability decreased in the CG (M1: 0.8±0.6, M2: 0.0±0.0, p>0.025) but increased in the LBPG (M1: 25.6±5.0, M2: 32.5±6.6, p>0.025). Pain during intervention decreased in the LBPG (First week: 1.9±0.4, Last week: 1.4±0.3, p>0.025) and remained absent from the CG. Mean muscle soreness was <2/10 throughout for both groups (NRS: First week: LBPG:1.4±0.4/CG:0.8±0.2; Last week: LBPG:1.2±0.4/CG:0.5±0.2, p>0.025) with no difference between groups (p>0.025). All participants in the CG and 14/16 in the LBPG “agreed” or “mostly agreed” with the program satisfaction items.
Conclusion(s): A 6-week eccentric trunk and hip exercise program was safe and feasible for chronic low back pain. This investigation proved the potential of eccentric training to improve QoL and reduce low back pain intensity. Individual effects on pain-related disability should be considered in future investigations. With 24 out of 28 completing it, the program had a high completion rate, along with high participant satisfaction, and low muscle soreness.
Implications: Eccentric trunk exercises could potentially be safely and effectively utilized as a treatment for chronic low back pain.
Funding, acknowledgements: Joint funding scheme by the University of Potsdam (UP) and the Tel Aviv University (TAU) as a joint research workshop.
Keywords: Eccentric, Strengthening, Low back pain
Topic: Musculoskeletal: spine
Did this work require ethics approval? Yes
Institution: University of Potsdam
Committee: Ethics Committee of the University of Potsdam
Ethics number: 44/2019
All authors, affiliations and abstracts have been published as submitted.
