Poster Presentation Sydney Spinal Symposium 2023

Is a twelve-week running program appropriate for people with chronic low back pain? Efficacy and feasibility data from a randomised controlled trial (#21)

Christopher Neason 1 , Claire L Samanna 1 , Daniel L Belavy 2 , Steve J Bowe 3 , Matthew J Clarkson 4 , David Connell 5 , Emma A Craige 6 , Romina Gollan 1 , Clint T Miller 1 , Ulrike H Mitchell 7 , Niamh L Mundell 1 , David Scott 1 , Scott D Tagliaferri 1 , Jamie L Tait 1 , Grace E Vincent 8 , Patrick J Owen 1
  1. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
  2. Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
  3. Victoria University of Wellington, Wellington, New Zealand
  4. Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
  5. Imaging @ Olympic Park, AAMI Park, Victoria, Australia
  6. Central Queensland University, Rockhampton, Queensland, Australia
  7. Brigham Young University, Provo, Utah, United States of America
  8. Central Queensland University, Adelaide, South Australia, Australia

Aims: We assessed the efficacy (subjective pain intensity and disability) and feasibility (attrition, adherence and safety) of a 12-week running intervention in individuals with chronic low back pain compared to waitlist control.

Methods: Participants (n=40, mean [SD] age: 33 [6] years, female: 50%) with non-specific chronic low back pain were randomised to the intervention or waitlist control group. Following initial assessment, the intervention group completed a 12-week progressive run-walk interval training program comprising three 30-minute digitally-delivered community-based exercise sessions per week under the supervision of an exercise physiologist. At baseline and 12 weeks, low back pain intensity (100-point visual analogue scale) and disability (Oswestry Disability Index; 0-100 points) were assessed. Feasibility outcomes included attrition at follow-up, training session adherence and the number and seriousness of adverse events. Linear mixed models with an intention-to-treat approach were used to evaluate between-group differences.

Results: There was no attrition, mean [SD] training adherence was 70 [20%] (2.1 of 3 sessions per week) and running distance increased from 2.9 [1.3] to 5.6 [5.3] km per week from baseline to 12 weeks. Nine adverse events deemed likely study-related were reported in the intervention group, of which all were non-serious; seven were related to lower limb injury/pain (knee or ankle), one to pre-existing cardiac syncope and only one to an increase of low back pain. When compared to control, running decreased both pain intensity (mean between-group difference [95%CI]: -15.30 [-25.33, -5.27] points, P=0.003) and disability (-5.20 [-10.12, -0.24] points, P=0.038) at 12 weeks.

Conclusions: A 12-week run-walk intervention appears acceptable, safe, and effective in individuals with non-specific chronic low back pain, although the between-group differences did not reach minimal clinically meaningful cut-off scores. Clinicians should monitor for lower limb pain or injury and consider cardiac risk factors when prescribing a run-walk program to individuals with low back pain, but our findings indicate interval running is feasible in this population.