Effectiveness of alternative exercise technologies on pain parameters in chronic low back pain patients with special regard to sustainability

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Chronic back pain affects a large part of the population. On the other hand, the beneficial effect of dedicated resistance and stabilization exercise training on chronic back pain has been clearly demonstrated by a wealth of high evidence. Unfortunately, the enthusiasm for conventional exercise is very low in the majority of patients. One reason for this may the kinesiophobia, which can be observed in many chronic back pain patients. In this context, alternative training technologies such as whole-body vibration (WBV) and whole-body Elektromyostimulation (WB-EMS) have great potential for motivating this target group. Both types of training are characterized by a low expenditure of time, small orthopedic load and low subjective perceived exertion. Initial investigations showed an increase in neuromuscular function and blood circulation, a high sensory input and a pain reduction effect for both training technologies. The aim of this project is to evaluate the effectiveness and sustainable implementation along with the feasibility of both training technologies compared with conventional training in order to estimate the potential of WBV and WB-EMS as method for tackling chronic back pain. The study will take place in Erlangen and Cologne with 234 largely untrained 40-70 year old people with chronic low back pain, randomly allocated (stratified for pain severity) into three groups (WBV, WB-EMS, specific back training, each n=78) with a similar number of participants (1-1-1; Strata n = 5). Primary study endpoints are chronic low back pain (questionnaire-based) as well as the sustainability of the exercise intervention conducted by the participants (questionnaire-based). During the first 14 weeks of the study, the proof-of-principle question (i.e. effectiveness of the methods on back pain) will be evaluated. After the end of this consistently supervised training phase, participants will be transferred to appropriate non-university providers of WB-EMS, WBV or back strengthening exercises (health club, WB-EMS-, WBV-centers etc.). Subsequently the sustainable realization of the methods by the participants will be evaluated in a 28-week real-world scenario.