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

慢性背痛影响了很大一部分人口。另一方面，专门的阻力和稳定运动训练对慢性背痛的有益影响已被大量高证据清楚地证明。不幸的是，大多数患者对常规运动的热情非常低。其中一个原因可能是运动恐惧症，这可以在许多慢性背痛患者中观察到。在这种情况下，替代训练技术，如全身振动（WBV）和全身肌肉电刺激（WB-EMS），具有很大的潜力，激励这一目标群体。这两种类型的训练的特点是花费的时间少，骨科负荷小，主观感觉用力低。初步调查显示，神经肌肉功能和血液循环的增加，高感觉输入和减少疼痛的效果，这两种训练技术。本项目的目的是评估有效性和可持续实施沿着的可行性，这两种培训技术相比，传统的培训，以估计潜在的WBV和WB-EMS的方法来解决慢性背痛。该研究将在埃尔兰根和科隆进行，234名40-70岁的慢性腰痛患者基本上未经训练，随机分配（根据疼痛严重程度分层）为三组（WBV、WB-EMS、特定背部训练，每组n=78），参与者人数相似（1-1-1; Strata n = 5）。主要研究终点是慢性下背痛（基于腰椎）以及参与者进行的运动干预的可持续性（基于腰椎）。在研究的前14周内，将评估原理验证问题（即这些方法对背痛的有效性）。在这个持续监督的培训阶段结束后，参与者将被转移到适当的非大学WB-EMS，WBV或背部强化练习提供者（健康俱乐部，WB-EMS-，WBV-中心等）。随后，将在28周的真实世界情景中评估参与者对这些方法的可持续实现。

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.