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Variability in strength, pain and disability changes in response to an isolated lumbar extension resistance training intervention in participants with chronic low back pain

Variability in strength, pain and disability changes in response to an isolated lumbar extension resistance training intervention in participants with chronic low back pain
Variability in strength, pain and disability changes in response to an isolated lumbar extension resistance training intervention in participants with chronic low back pain
Strengthening the lumbar extensor musculature is a common recommendation for chronic low back pain (CLBP). Although reported as effective, variability in response in CLBP populations is not well investigated. This study investigated variability in responsiveness to isolated lumbar extension (ILEX) resistance training in CLBP participants by retrospective analysis of three previous randomized controlled trials. Data from 77 participants were available for the intervention arms (males = 43, females = 34) 37 participants data (males = 20, females = 17) from the control arms. Intervention participants had all undergone 12 weeks of ILEX resistance training and changes in ILEX strength, pain (visual analogue scale; VAS), and disability (Oswestry disability index; ODI) measured. True inter-individual (i.e., between participants) variability in response was examined through calculation of difference in the standard deviation of change scores for both control and intervention arms. Intervention participants were classified into responder status using k-means cluster analysis for ILEX strength changes and using minimal clinically important change cut-offs for VAS and ODI. Change in average ILEX strength ranged 7.6 Nm (1.9%) to 192.1 Nm (335.7%). Change in peak ILEX strength ranged −12.2 Nm (−17.5%) to 276.6 Nm (169.6%). Participants were classified for strength changes as low (n = 31), medium (n = 36), and high responders (n = 10). Change in VAS ranged 12.0 mm to −84.0 mm. Participants were classified for VAS changes as negative (n = 3), non-responders (n = 34), responders (n = 15), and high responders (n = 19). Change in ODI ranged 18 pts to −45 pts. Participants were classified for ODI changes as negative (n = 2), non-responders (n = 21), responders (n = 29), and high responders (n = 25). Considerable variation exists in response to ILEX resistance training in CLBP. Clinicians should be aware of this and future work should identify factors prognostic of successful outcomes
2227-9032
Steele, James
83e525dd-7733-41b0-afbe-10f56f66a38e
Brucel-Low, Stewart
d3360cfa-b2d3-4452-9b02-ea5db63b2305
Fisher, James
3c8f6b37-39f0-4950-a0ec-637b6c4b3bc3
Smith, Dave
e3869dde-7a38-41b6-8973-dfffea0f0d6f
Osborne, Niel
53760eda-5459-4eef-93c8-7fdaaccfdf7b
Newell, David
f1a21938-9604-4f10-aac2-bb19337a638e
Steele, James
83e525dd-7733-41b0-afbe-10f56f66a38e
Brucel-Low, Stewart
d3360cfa-b2d3-4452-9b02-ea5db63b2305
Fisher, James
3c8f6b37-39f0-4950-a0ec-637b6c4b3bc3
Smith, Dave
e3869dde-7a38-41b6-8973-dfffea0f0d6f
Osborne, Niel
53760eda-5459-4eef-93c8-7fdaaccfdf7b
Newell, David
f1a21938-9604-4f10-aac2-bb19337a638e

Steele, James, Brucel-Low, Stewart, Fisher, James, Smith, Dave, Osborne, Niel and Newell, David (2017) Variability in strength, pain and disability changes in response to an isolated lumbar extension resistance training intervention in participants with chronic low back pain. Healthcare, 5 (4), [75]. (doi:10.3390/healthcare5040075).

Record type: Article

Abstract

Strengthening the lumbar extensor musculature is a common recommendation for chronic low back pain (CLBP). Although reported as effective, variability in response in CLBP populations is not well investigated. This study investigated variability in responsiveness to isolated lumbar extension (ILEX) resistance training in CLBP participants by retrospective analysis of three previous randomized controlled trials. Data from 77 participants were available for the intervention arms (males = 43, females = 34) 37 participants data (males = 20, females = 17) from the control arms. Intervention participants had all undergone 12 weeks of ILEX resistance training and changes in ILEX strength, pain (visual analogue scale; VAS), and disability (Oswestry disability index; ODI) measured. True inter-individual (i.e., between participants) variability in response was examined through calculation of difference in the standard deviation of change scores for both control and intervention arms. Intervention participants were classified into responder status using k-means cluster analysis for ILEX strength changes and using minimal clinically important change cut-offs for VAS and ODI. Change in average ILEX strength ranged 7.6 Nm (1.9%) to 192.1 Nm (335.7%). Change in peak ILEX strength ranged −12.2 Nm (−17.5%) to 276.6 Nm (169.6%). Participants were classified for strength changes as low (n = 31), medium (n = 36), and high responders (n = 10). Change in VAS ranged 12.0 mm to −84.0 mm. Participants were classified for VAS changes as negative (n = 3), non-responders (n = 34), responders (n = 15), and high responders (n = 19). Change in ODI ranged 18 pts to −45 pts. Participants were classified for ODI changes as negative (n = 2), non-responders (n = 21), responders (n = 29), and high responders (n = 25). Considerable variation exists in response to ILEX resistance training in CLBP. Clinicians should be aware of this and future work should identify factors prognostic of successful outcomes

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Accepted/In Press date: 26 September 2017
e-pub ahead of print date: 16 October 2017

Identifiers

Local EPrints ID: 416544
URI: http://eprints.soton.ac.uk/id/eprint/416544
ISSN: 2227-9032
PURE UUID: 57355115-6549-4251-95bb-c6e9fe574dec
ORCID for David Newell: ORCID iD orcid.org/0000-0003-1462-3586

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Date deposited: 21 Dec 2017 17:30
Last modified: 16 Mar 2024 04:32

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Contributors

Author: James Steele
Author: Stewart Brucel-Low
Author: James Fisher
Author: Dave Smith
Author: Niel Osborne
Author: David Newell ORCID iD

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