Low Back Pain
Conditions
Keywords
mechanical low back pain, HIIT, functional ability, body composition, VO₂ max
Brief summary
This randomized controlled trial evaluated the effects of a 4-week high-intensity interval training (HIIT) program on pain, functional disability, body composition, cardiorespiratory fitness, and quality of life in young women with mechanical low back pain. Participants were randomly allocated to either a supervised HIIT cycling program or a control exercise program consisting of stretching and low- to moderate-intensity treadmill walking. Outcomes were assessed at baseline and after completion of the 4-week intervention.
Detailed description
This randomized controlled trial used a two-arm parallel-group design to investigate the effects of a 4-week high-intensity interval training (HIIT) program on pain, functional disability, body composition, cardiorespiratory fitness, and quality of life in young women with mechanical low back pain. The study was conducted at the outpatient and physiotherapy clinics of MTI University. Ethical approval was obtained from the Institutional Review Board of MTI University (approval number REC/2111/MTI.PT/2411261), and the study was conducted in accordance with the principles of the Declaration of Helsinki. The trial was retrospectively registered on ClinicalTrials.gov because of administrative delays. Eligible participants were women aged 20-38 years with mild-to-moderate nonspecific mechanical low back pain persisting for more than three months. Participants were screened according to predefined eligibility criteria. Exclusion criteria included pregnancy or lactation, recent surgery, secondary causes of low back pain, osteoporosis, osteoarthritis, sciatica, generalized neuromuscular disorders, structural deformities, fractures, conditions restricting physical activity, cardiovascular or respiratory conditions that could compromise exercise safety, autonomic dysfunction, and use of medications that could affect heart-rate responses. Participants were randomly allocated to either the HIIT group or the control exercise group using a computer-generated random sequence with permuted blocks of 4 and 6. Randomization was stratified according to baseline pain severity (VAS ≤5 versus \>5). Allocation concealment was maintained using sequentially numbered, sealed, opaque envelopes prepared by a researcher who was not involved in participant recruitment or outcome assessment. Due to the nature of the exercise interventions, participant blinding was not feasible. The HIIT group participated in supervised cycling sessions three times per week for 4 weeks. Each session lasted approximately 30-40 minutes and included a warm-up, repeated high-intensity cycling intervals, recovery periods, and a cool-down. High-intensity intervals were performed at approximately 80% of maximum heart rate, with heart rate continuously monitored during training. Sessions were supervised by a licensed physiotherapist. The control group participated in supervised low- to moderate-intensity exercise consisting of stretching and treadmill walking performed at approximately 40-60% of maximum heart rate. Exercise intensity was monitored using heart-rate monitoring. Outcomes were assessed at baseline and after completion of the 4-week intervention. Pain intensity was assessed using the Visual Analog Scale (VAS). Functional disability was assessed using the Oswestry Disability Index (ODI). Body composition, including fat mass percentage and muscle mass, was assessed using bioelectrical impedance analysis. Cardiorespiratory fitness was assessed by measuring maximal oxygen uptake (VO₂ max) using cardiopulmonary exercise testing. Quality of life was assessed using the Quality-of-Life Scale (QOLS). Adverse events were monitored throughout the supervised exercise sessions. Participants were instructed to report symptoms including dizziness, excessive fatigue, exacerbation of musculoskeletal pain, or cardiovascular discomfort. Statistical analyses were conducted using SPSS. Data distribution was assessed before statistical analysis. Appropriate statistical tests were used to evaluate within-group changes and between-group differences. Effect sizes were calculated to quantify the magnitude of observed differences, and statistical significance was assessed using a two-sided p-value threshold of \<0.05.
Interventions
OTHERHIIT
participated in supervised cycling sessions lasting 30-40 minutes, three times per week, performed at intensities ranging from 80% to 90% of maximum heart rate (HRmax).
performed supervised moderate- to low-intensity exercises, including stretching and treadmill walking at 40-60% HRmax, for 30-40 minutes, with heart rate monitoring to regulate exercise intensity.
Sponsors
MTI University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
randomized controlled trial with two parallel groups
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
\*\*Inclusion Criteria:\*\* * Female participants aged 20 to 38 years. * Mild to moderate nonspecific low back pain persisting for more than 3 months. * Low back pain without an identifiable specific pathological cause. * Body mass index (BMI) between 18.5 and 34.9 kg/m². * Able to participate safely in the prescribed cycling exercise intervention. \*\*
Exclusion criteria
\*\* * Pregnancy or lactation. * Recent surgery. * Any chronic medical condition that restricts physical activity or exercise participation. * Secondary causes of low back pain. * Osteoporosis. * Osteoarthritis. * Sciatica. * Generalized neuromuscular disorders. * Structural spinal deformities. * Vertebral or other relevant fractures. * Reliance on assistive walking devices. * Cardiovascular disease that could compromise safe participation in cycling exercise. * Respiratory disease that could compromise safe participation in cycling exercise. * Autonomic dysfunction, including diabetes mellitus. * Current use of medications known to affect heart rate variability, including beta-blockers or calcium channel blockers.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oswestry Disability Index (ODI) | Baseline (pre-intervention) and immediately post-intervention at 4 weeks | Functional disability was assessed using the Oswestry Disability Index (ODI), a validated self-reported questionnaire for assessing disability related to low back pain. Total scores range from 0 to 100, with higher scores indicating greater disability. |
| Visual Analog Scale (VAS) | Baseline (pre-intervention) and immediately post-intervention at 4 weeks | Pain intensity was assessed using the Visual Analog Scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pain intensity. |
| Body Composition Parameters | Baseline (pre-intervention) and immediately post-intervention at 4 weeks | Body composition was assessed using bioelectrical impedance analysis with the InBody 700 system. The assessed parameters included percentage body fat and skeletal muscle mass. |
| Maximal Oxygen Uptake (VO₂ max) | Baseline (pre-intervention) and immediately post-intervention at 4 weeks | Cardiorespiratory fitness was assessed by measuring maximal oxygen uptake (VO₂ max) using the COSMED Quark CPET system during a graded exercise test. VO₂ max was expressed in mL/kg/min, with higher values indicating better cardiorespiratory fitness. |
| Quality of Life Scale (QOLS) | Baseline (pre-intervention) and immediately post-intervention at 4 weeks | Quality of life was assessed using the Quality of Life Scale (QOLS), a multidimensional instrument assessing physical, social, and psychological aspects of quality of life. Total scores range from 16 to 112, with higher scores indicating better quality of life. |
Countries
Egypt
Outcome results
None listed