The Breathe-(H)IT trial: Multimodal high intensity training to improve diaphragm functioning in persons with chronic low back pain. (R-12218)

International guidelines recommend exercise therapy as the first-choice treatment for chronic non-specific low back pain (CNSLBP). A crucial factor within this context is exercise intensity. Indeed, multimodal high intensity training (HIT) leads to higher improvements in disability and cardiorespiratory fitness compared to moderate intensity training (MIT) in persons with CNSLBP. However, the underlying mechanisms for the additional value of a HIT approach remain largely unknown. Interestingly, low back pain is associated with impairments in diaphragm function, as the diaphragm is not only a principal inspiratory muscle, but also plays an essential role in postural control. The latter is a key factor in the development and maintenance of CNSLBP. Therefore, this project aims to investigate 1) the effects of HIT compared to MIT on diaphragm muscle strength, -endurance, -fatigue and - activation, 2) to which extent these changes in diaphragm functioning are related to changes in cardiorespiratory fitness, postural control, pain and disability after HIT versus MIT, 3) to which extent depressive mood and anxiety moderate the effects of HIT on diaphragm functioning. A double-blind randomized controlled trial, involving 64 persons with CNSLBP, will be performed with a long-term follow up. As such, we aim to unravel the working mechanisms of HIT in CNSLBP in order to provide a basis for the optimization of the care path of this costly and common condition.

Keywords:Chronic non-specific low back pain, Diaphragm functioning, Muscle strength (human) Exercise therapy, Musculoskeletal research (human)

Disciplines:Musculo-skeletal systems, Exercise physiology, Physiotherapy, Rehabilitation