Exercise for the intervertebral disc: a 6-month randomised controlled trial in chronic low back pain

European spine journal

article

Patrick J. Owen¹  Clint T. Miller²  Timo Rantalainen¹  Katherine J. Simson²  David Connell¹  Andrew J. Hahne⁴  Guy Trudel⁵  Jon J. Ford⁴  Daniel L. Belavy¹ 

[1] Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences;Deakin University, School of Exercise and Nutrition Sciences;Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä;Low Back Research Team, College of Science, Health & Engineering, La Trobe University;Bone and Joint Research Laboratory, Division of Physical Medicine and Rehabilitation, The Ottawa Hospital Research Institute, University of Ottawa;Advance HealthCare

关键词: Rehabilitation;    Physical therapy;    Physiotherapy;    Spine;    Magnetic resonance imaging;    Physical activity;    Intervertebral disc;   

DOI  :  10.1007/s00586-020-06379-7

来源: Springer

【 摘 要 】

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. This is a single-blinded 6-month randomised controlled trial (ACTRN12615001270505) in an exercise and physiotherapy clinic. Forty patients with chronic non-specific low back pain (NSCLBP) are included in this study. 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. These slides can be retrieved under Electronic Supplementary Material.

【 授权许可】

Unknown