The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back

Neil Welch, Kieran Moran, Joseph Antony, Chris Richter, Brendan Marshall, Joe Coyle, Eanna Falvey, Andrew Franklyn-Miller, Neil Welch, Kieran Moran, Joseph Antony, Chris Richter, Brendan Marshall, Joe Coyle, Eanna Falvey, Andrew Franklyn-Miller

Abstract

Background: Low back pain is one of the most prevalent musculoskeletal conditions in the world. Many exercise treatment options exist but few interventions have utilised free-weight resistance training. To investigate the effects of a free-weight-based resistance training intervention on pain and lumbar fat infiltration in those with chronic low back pain.

Methods: Thirty participants entered the study, 11 females (age=39.6±12.4 years, height=164 cm±5.3 cm, body mass=70.9±8.2 kg,) and 19 males (age=39.7±9.7 years, height=179±5.9 cm, body mass=86.6±15.9 kg). A 16-week, progressive, free-weight-based resistance training intervention was used. Participants completed three training sessions per week. Participants completed a Visual Analogue Pain Scale, Oswestry Disability Index and Euro-Qol V2 quality of life measure at baseline and every 4 weeks throughout the study. Three-dimensional kinematic and kinetic measures were used for biomechanical analysis of a bodyweight squat movement. Maximum strength was measured using an isometric mid-thigh pull, and lumbar paraspinal endurance was measured using a Biering-Sorensen test. Lumbar paraspinal fat infiltration was measured preintervention and postintervention using MRIs.

Results: Postintervention pain, disability and quality of life were all significantly improved. In addition, there was a significant reduction in fat infiltration at the L3L4 and L4L5 levels and increase in lumbar extension time to exhaustion of 18%.

Conclusions: A free-weight-based resistance training intervention can be successfully utilised to improve pain, disability and quality of life in those with low back pain.

Keywords: Back injuries; Biomechanics; Fat percentage; MRI.

Figures

Figure 1
Figure 1
Waveform of the vertical centre of mass velocity (mm/s) throughout the squat movement. Dark grey indicates areas of significant difference and lighter grey indicates significance before correction.
Figure 2
Figure 2
Waveform of the pelvis angles (degrees) throughout the squat movement. Dark grey indicates areas of significant difference and lighter grey indicates significance before correction.
Figure 3
Figure 3
Waveform of the hip angles (degrees) throughout the squat movement. Dark grey indicates areas of significant difference and lighter grey indicates significance before correction.
Figure 4
Figure 4
Waveform of the knee moment (Nmm) throughout the squat movement. Dark grey indicates areas of significant difference and lighter grey indicates significance before correction.
Figure 5
Figure 5
Waveform of the hip moment (Nmm) throughout the squat movement. Dark grey indicates areas of significant difference and lighter grey indicates significance before correction.

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