Time Course Effects of Functional Resistance Training on Fitness and Quality of Life Chronic Low Back Pain Patients
Condition: Chronic Low-back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      Low back pain is categorized according to its duration as acute (<6 weeks), sub-acute (6
      weeks - 12 weeks) and chronic (>12 weeks). Low back pain can be either specific or
      non-specific. Specific low back pain is because of specific spinal pathologies including;
      Malignancy, Infection, Osteoporotic Collapse, Fracture, Ankylosing Spondylitis or other
      inflammatory disorders and Cauda equina compression. About 19 in 20 cases of acute (sudden
      onset) low back pain are classed as 'non-specific' It is called 'non-specific' because it is
      usually not clear what is actually causing the pain or there is no specific problem or
      disease that can be identified as to the cause of the pain.Functional Resistance Training
      (FRT) involves multiplanar and multi joint resistance exercises that simulate movement
      patterns from everyday life and sport Functional training exercises tend to focus more on the
      coordination, technique, posture, and core engagement instead of on training loads.
    

Detailed description: 
      The lower back is also called the 'lumbosacral area' of the back. It is the part of the back
      between the bottom of the ribs and the top of the legs and is made up of the spine bones
      (vertebrae), discs, nerves, muscles and ligaments. Pain in this region is called low back
      pain. (1) Low back pain is categorized according to its duration as acute (<6 weeks),
      sub-acute (6 weeks - 12 weeks) and chronic (>12 weeks). About 19 in 20 cases of acute (sudden
      onset) low back pain are classed as 'non-specific' It is called 'non-specific' because it is
      usually not clear what is actually causing the pain or there is no specific problem or
      disease that can be identified as to the cause of the pain. It is said that cause may be a
      sprain (an over-stretch) of a ligament or muscle, minor problem with the disc between two
      vertebrae, or a minor problem with a small 'facet' joint between two vertebrae. It is not
      possible to identify these causes of the pain by tests. Therefore, it is usually impossible
      to say exactly where the pain is coming from, or exactly what is causing the pain. Sometimes
      a pain may develop immediately after lifting something heavy, or after an awkward twisting
      movement. Sometimes it can develop for no apparent reason. Some people just wake up one day
      with low back pain. Typically the pain is in one area of the lower back, but sometimes it
      spreads to one or both buttocks or thighs. Non-specific low back pain is 'mechanical' in the
      sense that it varies with posture or activity. In a small number of cases the pain persists
      for several months or longer. This is called chronic back pain. There is no test that can
      prove or confirm non-specific low back pain.

      Non-specific low back pain is classed as chronic (persistent) if it lasts longer than six
      weeks. In some people it lasts for months, or even years. Symptoms may be constant.
      Non-specific low back pain affects people of all ages and is a leading contributor to disease
      burden worldwide.

      The ACSM defines functional RT (FRT) as activities involving multiple muscle, joint, and
      planar activities that are closely related to activities of daily living, combining upper and
      lower body movements to use more of the body in each movement. Few studies have examined FRT,
      though initial results suggest that FRT is associated with higher caloric expenditure and
      similar muscular strength, endurance, and gains in flexibility compared with a TRT program.

      Functional training is becoming increasingly popular within the fitness industry and has been
      considered to be a better alternative than traditional resistance training for improving
      various measures of muscular fitness including strength, endurance, coordination and balance.
      The verb form of the word "function" pertains to the performance of an action, work or
      activity. Thus, exercise training programs that are deemed to be "functional" should be
      designed to mimic tasks or activities that occur in a person's daily life to make training
      adaptations more transferable. Engaging in regular RT provides physical, physiological and
      psychological health benefits while providing additional bone health benefits. Although RT
      has greatly increased in popularity, other types of training aside from traditional RT (TRT)
      have yet to be examined. One such type of training, ''functional fitness,'' is defined by the
      ACSM as the use of strength training to improve balance and ease of living, and was in the
      top 10 fitness trends in 2018.

      Functional Resistance Training (FRT) involves multiplanar and multi joint resistance
      exercises that simulate movement patterns from everyday life and sport Functional training
      exercises tend to focus more on the coordination, technique, posture, and core engagement
      instead of on training loads. The goal of FRT is not hypertrophy but to promote a potential
      motor problem in order to train dynamic stabilization. Appropriate functional exercises are
      those in which the lumbo-pelvic region remains aligned within the neutral zone by
      co-contraction of the muscles of the trunk, while other demands executed with the extremities
      are simultaneously and successfully fulfilled. This method of training usually includes: a)
      spinal stabilization exercises; b) balance and proprioceptive exercises; c) flexibility
      exercises; d) resistance training exercises.

      Functional RT may be more feasible and accessible due to the minimal equipment needed and the
      flexibility to be performed in and out of a typical gym setting.
    

Intervention name(s): functional resistance training GROUP A; functional resistance training GROUP B
Intervention type(s): Other; Other
Intervention description(s): Session of 45-60 min. Warm up prior to training Warm up 6-7 min of mild cardiovascular exercise followed by 3-4 min stretching
Cool down post training A cool-down of 1 min of mild cardiovascular exercise followed by 4 min of stretching; Session of 45-60 min Warm up prior to training Warm up 6-7 min of mild cardiovascular exercise followed by 3-4 min stretching
Cool down post training A cool-down of 1 min of mild cardiovascular exercise followed by 4 min of stretching
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Pain; disability; strength; quality of life; functional resistance training