Periodized Resistance Training Works Better than Aerobic Training for Chronic Low Back Pain

A comparison of two forms of periodized exercise rehabilitation programs in the management of chronic nonspecific low-back pain. J Strength Cond Res. 2009 Mar;23(2):513-23. Kell RT, Asmundson GJ.

From the study:

The purpose of this study was to determine the influence of 2 different periodized exercise rehabilitation programs (resistance training [RT] and aerobic training [AT]) on musculoskeletal health, body composition, pain, disability, and quality of life (QOL) in chronic (>or=3 months; >or=3 d.wk) nonspecific low-back pain (CLBP) persons. Twenty-seven CLBP subjects were randomly assigned to 1 of 3 groups, 1) RT (n = 9), 2) AT (n = 9), or 3) control (C; n = 9). Subjects were tested at baseline and at weeks 8 and 16 of training. Intensity and volume were periodized in the training groups. Significance was set at p <or= 0.05. No significant differences were noted among the groups at baseline. The RT group significantly decreased body fat percent from baseline to week 8 and from baseline to week 16, whereas the AT group significantly decreased body fat percent and body mass from baseline to week 16. The RT group significantly improved most musculoskeletal fitness, pain, disability, and QOL outcomes from baseline to week 8, baseline to week 16, and weeks 8 to 16. However, the AT group showed significant improvements in flexibility from baseline to week 8 and in cardiorespiratory and peak leg power from baseline to week 8 and baseline to week 16. The AT groups showed no significant improvements in pain, disability, or QOL. The primary finding was that periodized RT was successful at improving many fitness, pain, disability, and QOL outcome measures, whereas AT was not. This study indicates that whole-body periodized RT can be used by training and conditioning personnel in the rehabilitation of those clients suffering with CLBP.

Chad’s comments:

This is another great study by the same authors as my prior blog, but was published two years earler using largely the same exercise program, focusing on total body strength rather than just core stabilization. Subjects also had chronic low back pain but were a little younger, averaging 35-40 years. Rather than compare to a control group that just stayed active, the other experimental group did periodized aerobic training. As the abstract states, group that lifted weights improved their low back disability scores and decreased pain considerably more than the aerobic and control group. Reading the entire did a good job in explaining their exercise selection and helps to dispel some of the errors you continue to hear from the biopsychosocial proponents, many of whom seem to think that all activity/exercise is of equal benefit or consequence to the spine. Rather, movements matter, postures matter, fitness matters, exercise selection matters, and so does your physical therapist if they are not keeping up with the latest in rehabilitation science.

As always, if you have any further questions or need for clarifications, please don’t hesitate to ask. Being aware that some of my blog ideas are contentious and occasionally a bit out of the field of my expertise, I encourage my readers to come forth with any questions/comments that are of interest or concern. Your comments are valued and welcomed.

Chad Reilly is a licensed physical therapist, located in North Phoenix, practicing science based medicine with treatment protocols unique and effective enough to proudly serve patients from Phoenix, Scottsdale, Mesa, Chandler, Tempe, Peoria, and Glendale.

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