Oral Presentation 50th International Society for the Study of the Lumbar Spine Annual Meeting 2024

EXPLORING THE EFFICACY, FEASIBILITY AND OPTIMAL TRAINING PARAMETERS FOR RUNNING IN ADULTS WITH NON-SPECIFIC CHRONIC LOW BACK PAIN: THE ASTEROID RANDOMISED CONTROLLED TRIAL (#MP-4f)

Christopher Neason 1 2 , Claire L Samanna 1 2 , Daniel L Belavy 3 , Steven J Bowe 2 4 , Matthew J Clarkson 5 , David Conell 6 , Romina Gollan 2 , Emma A Craige 7 , Luana C Main 2 , Clint T Miller 2 , Ulrike H Mitchell 8 , Niamh L Mundell 2 , David Scott 1 2 , Scott D Tagliaferri 9 10 , Jamie L Tait 2 , Grace E Vincent 7 , Patrick J Owen 1 2
  1. School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
  2. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
  3. Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
  4. Victoria University of Wellington, Wellington, New Zealand
  5. Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
  6. Imaging @ Olympic Park, AAMI Park, Victoria, Australia
  7. Central Queensland University, Rockhampton, Queensland, Australia
  8. Brigham Young University, Provo, Utah, United States of America
  9. Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
  10. Orygen, Parkville, Victoria, Australia

INTRODUCTION:  Running is common and one of the most accessible forms of exercise training, yet the suitability for adults with chronic low back pain is unknown. This study assessed the efficacy and feasibility of running in adults with chronic low back pain and explored the relationship between training parameters and pain intensity.

METHODS: This two-arm parallel (1:1) individually randomised controlled trial allocated 40 participants (mean [SD] age: 33 [6] years, female: 50%) with non-specific chronic low back pain to a 12-week intervention or waitlist control. The intervention was a progressive run-walk interval program comprising three 30-minute sessions per week, that were digitally delivered and remotely supported by an exercise physiologist. Efficacy outcomes were self-reported pain intensity (visual analogue scale) and disability (Oswestry Disability Index) at baseline and 12 weeks. Feasibility outcomes were attrition, adherence and adverse events. Additionally, participants randomised to the exercise intervention recorded pain intensity every two weeks and the following training parameters for each session: run distance, speed, gradient and surface (grass, gravel, paved, trail or mixed).

RESULTS: At the 12-week follow-up, the intervention improved average pain intensity (mean net difference [95%CI]: -15.30 [-25.33, -5.27] points, P=0.003), current pain intensity (-19.35 [‑32.01, -6.69] points, P=0.003) and disability (-5.20 [-10.12, -0.24] points, P=0.038), compared to control. There was no attrition and mean (SD) training adherence was 70% (20%; i.e. 2.1 of 3 sessions per week). Nine non-serious adverse events deemed likely study-related were reported (lower limb injury/pain: n=7, cardiac syncope associated with an underlying condition: n=1, low back pain: n=1). Results exploring the association between training parameters and fortnightly pain intensity are pending and will be available prior to the scientific meeting.

CONCLUSIONS: An individualised and conservative running program was feasible and improved pain intensity and disability in adults aged 18-45 years with non-specific chronic low back pain when compared to control. The pending analysis will identify optimal training parameters to reduce pain intensity. There were limited reports of low back pain ‘flare up’; however, due to the increased risk of lower limb pain and soreness, care should be taken when prescribing a new run-walk intervention.