A comparison of high intensity aerobic exercise and passive modalities for the treatment of workers with chronic low back pain: a randomized, controlled trial

Eur J Phys Rehabil Med. 2011 Sep;47(3):359-66. Epub 2011 May 23.


Background: In recent years, disability due to chronic low back pain (LBP) has steadily increased in all industrialized countries. In the treatment of chronic LBP, the objectives are to reduce pain, to improve function and minimize avoiding behavior. Exercise therapy is a management strategy that is widely used as a treatment for LBP.

Aim: The aim of this study was to investigate the effects of high- intensity aerobic exercise on pain, disability, anxiety or depression in people with chronic LBP.

Design: This was a randomized controlled trial

Setting: Institute of Occupational Medicine, Department of Physical Medicine and Rehabilitation - Outpatient Ward

Population: Kosovo power plant workers.

Methods: Participants with chronic low back pain, excluding those with "red flag" criteria were assigned randomly to one of the two treatment groups: an aerobic exercise group (N.=50), and an passive modalities group (N.=51). Data on low back pain intensity (visual analogue scale), disability (Oswestry Low Back Pain Disability Questionnaire), fingertip-to-floor distance, and psychosocial factors (Hospital Anxiety and Depression Scale) were collected at baseline and after 12-weeks follow-up points.

Results: At 12-week follow-up, significant improvements in pain intensity and disability had occurred in the exercise group. We have verified significant improvements in comparison with basic values in pain intensity (6 ± 2.6 vs. 2 ± 1.7, diff. of mean=3.9, P < 0.001), disability (31 ± 17.4 vs. 15.8 ± 12.7, diff. of mean=15.2, P<0.001), anxiety and depression (21.1 ± 8.2 vs. 14 ± 6.7, diff. of mean=7.1, P < 0.001), and fingertip- to-floor distance (27.8 ± -9.1 vs. 14.2 ± -5.7, P<0.001). Whereas, differences in average pain, disability, anxiety and depression and fingertip-to-floor distance are not significant in the control group.

Conclusion: High intensity aerobic exercise reduces pain, disability and psychological strain in patients with chronic low back pain.

Clinical rehabilitation impact: This research is important for the fact that High Intensity Aerobic Exercise Programs are not so exploited in the current available literature for the treatment of LBP. Therefore, this is another modest contribution which can reinforce the need for more frequent use of High Intensity Aerobic Exercise Programs in the treatment of LBP.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Anxiety / etiology
  • Chi-Square Distribution
  • Chronic Disease
  • Depression / etiology
  • Disability Evaluation
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Low Back Pain / complications
  • Low Back Pain / rehabilitation*
  • Male
  • Middle Aged
  • Occupational Diseases / etiology
  • Occupational Diseases / rehabilitation*
  • Pain Measurement
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Treatment Outcome