Do different types of exercise help educational messages provided to people with chronic low back pain?

Progressive full-body resistance training combined with pain neuroscience education, underpinned by principles of cognitive behavioural therapy. This will involve one session per week for a duration of 8-weeks. The sessions will be one hour in duration and contain 45mins of exercise, 10mins of education, and 5mins of questions/reflections. Topics covered in the education will focus around the physiology of pain and how this can be used to understand persistent pain. Moreover, the education will include understanding of how the emotional state can influence pain manifestation, as per the biopsychosocial model. This will be done in small groups (1 facilitator, with 4 participants). No physical information will be used - these will be discussion based format. Resistance training component (in the same 1:4 group ratio). Sessions will commence with a dynamic warm up such as walking/jogging/rowing. Sessions will be a full-body design with exercise selection based around the following movements: - Squat (option to box squat) - Bench press - Deadlift (option to rack pull) Pin Pendlay - (option for cable row) - Lat pull down - Leg press (horizontal or vertical). Session intensity for week 1 will be low, as it will primarily be used to 'teach' exercises. Weeks 2-5 will have a higher session volume (repetition range 12-15) with lower overall intensity as gauged initially by an RPE scale (6-8/10) or working approximately 2-4-repetitions from failure. Week 6 will see a decrease in repetitions (5) & concomitant increase in load (1RIR). Week 7 will see a decrease in repetitions (3) & concomitant increase in load (1RIR). Week 8 will see a decrease in repetitions (1) & concomitant increase in load (0-1RIR) These sessions will be facilitated in a gym environment by Accredited Exercise Scientists/Physiologists who are also dual qualified as strength and conditioning coaches. Home-based sessions will be prescribed for 2-other days per week. Home-based sessions will contain the same movement patterns as the supervised session, however, without loading due to not being in a gym-based environment. Where external loading is needed (e.g. a vertical pull), a light resistance band will be used. Adherence to supervised sessions will be monitored with attendance. Adherence to home-based sessions will be monitored through training diaries.