A1 Journal article (refereed)
Exercise for the intervertebral disc : a 6-month randomised controlled trial in chronic low back pain (2020)
Owen, P. J., Miller, C. T., Rantalainen, T., Simson, K. J., Connell, D., Hahne, A. J., Trudel, G., Ford, J. J., & Belavy, D. L. (2020). Exercise for the intervertebral disc : a 6-month randomised controlled trial in chronic low back pain. European Spine Journal, 29(8), 1887-1899. https://doi.org/10.1007/s00586-020-06379-7
JYU authors or editors
Publication details
All authors or editors: Owen, Patrick J.; Miller, Clint T.; Rantalainen, Timo; Simson, Katherine J.; Connell, David; Hahne, Andrew J.; Trudel, Guy; Ford, Jon J.; Belavy, Daniel L.
Journal or series: European Spine Journal
ISSN: 0940-6719
eISSN: 1432-0932
Publication year: 2020
Volume: 29
Issue number: 8
Pages range: 1887-1899
Publisher: Springer
Publication country: Germany
Publication language: English
DOI: https://doi.org/10.1007/s00586-020-06379-7
Publication open access: Not open
Publication channel open access:
Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/68358
Abstract
Muscle, bone and tendon respond anabolically to mechanical forces. Whether the intervertebral disc (IVD) can benefit from exercise is unclear.
Purpose
To examine whether exercise can beneficially affect IVD characteristics.
Study design/setting
This is a single-blinded 6-month randomised controlled trial (ACTRN12615001270505) in an exercise and physiotherapy clinic.
Patient sample
Forty patients with chronic non-specific low back pain (NSCLBP) are included in this study.
Outcome measures
The primary outcome was lumbar IVD T2 time (MRI). Secondary outcomes included IVD diffusion coefficient and IVD expansion with short-duration lying.
Methods
Twenty patients progressively loaded their lumbar IVDs (exercise) via an exercise programme involving progressive upright aerobic and resistance exercises targeting the trunk and major muscle groups and were compared to twenty patients who performed motor control training and manual therapy (control). Testing occurred at baseline, 3 months and 6 months.
Results
Seventeen exercise and fifteen control patients completed the interventions. There were no group-by-time differences in T2 time of the entire IVD (exercise 94.1 ± 10.0 ms vs. control 96.5 ± 9.3 ms, p = 0.549). Exercise patients had shorter T2 time in the posterior annulus at 6 months (82.7 ± 6.8 ms vs. 85.1 ± 8.0 ms, p = 0.028). Exercise patients showed higher L5/S1 apparent diffusion coefficients and decreased IVD height at 3 months (both p ≤ 0.050). After adjustments for multiple comparisons, differences lost statistical significance. Per-protocol and intent-to-treat analyses yielded similar findings.
Conclusions
This trial found that 6 months of exercise did not benefit the IVD of people with NSCLBP. Based on this index study, future studies could investigate the effect of exercise on IVD in different populations, with different types, durations and/or intensities of exercise, and using different IVD markers.
Keywords: rehabilitation; physiotherapy; spine; magnetic resonance imaging; physical activity; physical training; intervertebral disk; chronic pain; exercise therapy
Free keywords: rehabilitation; physical therapy; physiotherapy; spine; magnetic resonance imaging; physical activity; intervertebral disc
Contributing organizations
Ministry reporting: Yes
VIRTA submission year: 2020
JUFO rating: 1
