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 editorsOwen, 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 seriesEuropean Spine Journal



Publication year2020


Issue number8

Pages range1887-1899


Publication countryGermany

Publication languageEnglish


Publication open accessNot open

Publication channel open access

Publication is parallel published (JYX)https://jyx.jyu.fi/handle/123456789/68358


Background context
Muscle, bone and tendon respond anabolically to mechanical forces. Whether the intervertebral disc (IVD) can benefit from exercise is unclear.
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.
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.
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.
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.

Keywordsrehabilitationphysiotherapyspinemagnetic resonance imagingphysical activityphysical trainingintervertebral diskchronic painexercise therapy

Free keywordsrehabilitation; physical therapy; physiotherapy; spine; magnetic resonance imaging; physical activity; intervertebral disc

Contributing organizations

Ministry reportingYes

Reporting Year2020

JUFO rating1

Last updated on 2024-22-04 at 12:58