Background & Aims
The global burden of chronic primary low back pain (CPLBP), a leading cause of disability worldwide, is expected to continue growing at least until 2050. Physical activity and exercise training are consistently recommended by most clinical practice guidelines for the management of CPLBP. Nonetheless, physical exercise is not consistently prescribed, and its adherence remains a challenge. Research has shown that the use and implementation of exercise interventions through technology is feasible, acceptable, and effective among different populations. Furthermore, group training promotes long-term adherence to physical activity and provides the necessary social support. However, the effectiveness of different means of remote exercise training has not been thoroughly examined. The aim of this trial is to compare the effectiveness of group supervised and individual unsupervised remote training for CPLBP.
Methods
Seventy-one patients with chronic low back pain, based on the criteria proposed by the National Institutes of Health (NIH) Task Force, participated in a pilot randomized controlled clinical trial (NCT05895630). After assessment for the diagnosis of CPLBP, they were randomly assigned to a control wait-list group or a 12-week structured training program, delivered either via supervised group videoconferences or individual unsupervised video training sessions. The training program consisted of three weekly one-hour sessions. The exercise sessions were tailored to individual abilities and mobility profile, based on a remote physical assessment conducted at baseline. The primary outcome measure used was the NIH minimum dataset (NIHMD), evaluated at the program’s inception and termination. The levels of satisfaction, effort, fatigue, pain, and general sensations associated with both methods of exercise delivery were assessed after each training session as secondary outcome measures.
Results
The preliminary analysis of the data included 44 patients (average age 50.3 years, 27 women) that had completed the complete training regimen. Participants assigned to either of the two exercise training programs reported a significant reduction in pain intensity (average of the previous 7 days) compared with those on the wait-list control group (p=0.003). Nevertheless, the mode of exercise delivery did not significantly influence pain reduction (Bonferroni-corrected p=0.3). No significant differences were found between the three groups in other NIHMD measures, including the pain impact stratification score. Both exercise methods resulted in comparable levels of satisfaction, effort, fatigue, pain, and general sensations (p’s>0.05), suggesting that both modalities were equally acceptable to participants.
Conclusions
These preliminary findings suggest that both interactive supervised and individual unsupervised remote exercise training effectively reduced clinical pain intensity in patients with CPLBP, compared to a wait-list control group. However, the analysis also indicates that the observed benefits did not significantly extend to other pain-related aspects such as functional capacity or interference with activities of daily living. Similar levels of acceptability highlight the potential of both methods of remote training for effective CPLBP management. Further research with larger sample sizes is required in order to better understand the mechanisms behind these results and optimize remote exercise training program.
References
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Presenting Author
Carlos Gevers-Montoro
Poster Authors
Carlos Gevers Montoro
PhD
McGill University
Lead Author
M. Bergevin
Université de Montréal, Montreal, Qc, Canada
Lead Author
Florian Bobeuf
PhD
Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montreal, Qc, Canada
Lead Author
B. Pageaux
Université de Montréal, Montreal, Qc, Canada
Lead Author
Mathieu Roy
Dept. of Psychology, McGill University, Montreal, Qc., Can., H3A 1G1
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Low Back Pain