Effects induced by 8 weeks of postural and aerobic training in people with low back pain

Purpose: Low back pain (LBP) is one of the major spine disorders which seriously impairs many daily activities and limits functional skills. The role of exercise in LBP management is well documented, even if the debate about the most effective type of training is still present. The aim of this study is to investigate the effects of an 8 weeks specific training on LBP symptoms, trunk mobility and postural control in adult people suffering from this pathology. Methods: Twenty people (age: 50-70 years old) were recruited for the study. All participants were untrained and affected from chronic non-specific LBP. Participants were divided into 2 groups composed by 10 people each one: Training Group 1 (TG-1) and Training Group 2 (TG-2). Both groups trained twice a week for 8 weeks with a duration of 60-90 minutes each session. TG-1 performed a set of exercises for the prevention and treatment of LBP (Back School Program) and TG-2 performed 30 minutes of aerobic training using bike (intensity: 70% of heart rate reserve) in addition to Back School protocol. All participants were assessed pre and post training to evaluate pain intensity (Numerical Rating Scale – NRS), functional disability (Roland and Morris Disability Questionnaire - RMQ), trunk mobility (Spinal Mouse) and postural control (Nintendo Balance Board® and MyPerfectPosture® Software - BAL). Spinal Mouse tested thoracic (THR), lumbar (LUM), sacral (SAC) mobility and spine length (LENGTH) of sagittal and frontal plane. BAL evaluated center of pressure during 30” static standing position in eyes open (COP-OA) and closed conditions (COP-OC). Results: NRS and RMQ significantly improved in both TG-1 and TG-2 (p<0.01) with no difference between groups. In Spinal Mouse evaluation, TG-2 significantly increased THR mobility during sagittal flexion (p<0.05) and SAC during right side bending (p<0.01) while TG-1 significantly increased THR mobility and LENGTH during sagittal standing (p<0.05) and SAC during right side bending (p<0.01) and sagittal flexion (p<0.05). In COP test, both TG-1 and TG-2 evidenced better COP-OA and COP-OC values with significance only in TG-1 for Y axis in OA condition. No difference between groups for all Spinal Mouse and BAL data. Conclusions: Previous results suggest that combination of aerobic training and Back School Program doesn’t lead to better improvement in pain perception, quality of life, trunk mobility and balance compared to Back School Program alone. Although both kind of training were effective, TG-1 evidenced better improvement in spine mobility of sagittal plane and postural control. Consequently, these findings suggest that aerobic exercise positively influences the relation between respiratory system and thoracic mobility in people suffering from LBP. Reference: Barni L., Calabretta L., Lepori L., Pasquetti P., Gulisano M., Freddolini M., “Does an Aerobic Exercise Improve Outcomes in Older Sedentary Nonspecific Low Back Pain Subjects? A Randomized Controlled Study”, Topics in Geriatric Rehabilitation 2018 Apr-Jun;34(2):88-94