Effects Of Aerobic Exercise Training On Some Physiological And Biochemical Parameters In Subjects With Chronic Low Back Pain

ABSTRACT

Low back pain (LBP) is the leading cause of occupational- related sickness, injuries, absences, and disability. Inflammation may be one of the mechanisms causing lumbo-sciatic pain. Exercise has been found to reduce pain and increase function which promotes a return to work in subjects with low back pain. Little is known about the potential mechanisms responsible for the effect of exercise on low back pain. The aim of this study was to determine the effects of eight weeks of interval aerobic exercise training programmes on cardiovascular fitness/ parameters such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), maximum volume of oxygen consumed (VO2 max.). Furthermore, pain level as measured by visual analogue scale scores (VAS) and Aberdeen low back pain questionnaire (ABD) scores, level of disability as measured by (Roland Morris Questionnaire [RMDQ]), interleukin-6 (IL-6), white blood cell count (WBC), prostaglandin-E (PGD-E), body mass index (BMI), and c-reactive protein (CRP). A randomized independent control (pretest-posttest) groups design was used to determine the influence of training programmes on the variables of interest. Population for the study was male and female subjects with chronic low back pain attending the General Outpatient clinic of National Orthopedic Hospital, Enugu, Nigeria and University of Nigeria Teaching Hospital Ituku Ozalla Enugu State. The study subjects were volunteers, sedentary, non-diabetic subjects with chronic low back pain. Eighty (80) male and female subjects met the inclusion criteria; they were age matched and randomly assigned to exercise (40) and control (40) groups. Sixty subjects, exercise (33) and control (27) groups completed the eight weeks programme. The exercise group exercised on a bicycle ergometer three times a week at moderate intensities of between 50% and 70% of their age predicted maximum heart rate (HR max) for a period of between 48 to 72 minutes. The control group did not engage in any organized exercise programme. Before the actual tests, a pilot survey in which ten (10) male and female subjects with chronic low-back pain participated was conducted using test-retest method. High positive correlation coefficient, (r = 0.06-0.89) was achieved in the pilot study. Descriptive statistics was used to describe the physical characteristics of subjects. Independent t-test and Pearson’s product moment correlation coefficient test was used to find relationship among variables of interest. The results showed significant groups difference in VO2max (p < 0.05) resting SBP (p < 0.05), resting DBP (p < 0.05), resting HR (p < 0.05), BMI (p < 0.005), CRP (p < 0.005), VAS (p < 0.05), ABD (p < 0.05), RMDQ (p < 0.05), PGD-E (p < 0.05), IL-6 (p < 0.05) and WBC (p 0.05), ABD (p > 0.05), RMDQ (p > 0.05), WBC (p > 0.05), IL-6 (p > 0.05), CRP (p > 0.05) . Significance difference was also observed among post exercise males and females HR (p < 0.05), DBP (p < 0.05), BMI (p < 0.05), RMDQ (p < 0.05), VO2max (p < 0.05) while no significant difference was observed in other variables such as SBP (p > 0.05), VAS (p > 0.05), ABD (p > 0.05), WBC (p > 0.05), IL-6 (p > 0.05), PGDE (p > 0.05), CRP (p > 0.05). Since exercise training programme had beneficial effects on VO2max, resting SBP, resting DBP, resting HR, BMI, CRP, VAS, ABD, PGD-E, IL-6, WBC and level of disability of subjects with chronic low back pain, such training programme should form part of the treatment programmes in the management of chronic low back pain.