Effects of 2 Training Protocols on Aspects of Pain in Older Women With Chronic Low Back Pain: A Randomized Clinical Trial.

Abstract

Objective: The purpose of this study was to compare the effects of 16 weeks of functional versus dual-task training on aspects of pain in older women with chronic nonspecific low back pain.

Methods: This randomized clinical trial included 38 participants aged 60 to 79 years divided into 2 groups: functional training (FT) and dual-task training (DT). We assessed pressure pain threshold (PPT), temporal summation of pain, conditioned pain modulation (CPM), trunk instability, isometric strength, and endurance of trunk muscles before and 16 weeks after training. Generalized mixed models were used to compare the groups over time, adopting P ≤ .05. Additionally, the effect size (Cohen's d) was calculated.

Results: Functional training and DT promoted statistically significant increases in PPT (d = 1.82 and 1.10, respectively) and CPM (d = 1.60 and 1.13, respectively). Only FT promoted a statistically significant increase in PPT (d = 1.23). Functional training was superior to DT in PPT and CPM (P < .05). Functional training and DT increased the maximum isometric strength of trunk extensors (d = 2.14 and 2.12, respectively; P < .05), without statistically significant differences between groups. Only DT showed a statistically significant improvement in the endurance of extensors and lateral flexors of the trunk (d = 0.77; d = 0.69).

Conclusion: Both FT and DT were effective in promoting increased pain pressure threshold, improvement of CPM, and trunk function in older women with chronic nonspecific low back pain, however, without effects on temporal summation of pain and trunk stability. These indicators show that the proposed training may promote pain attenuation and increased trunk function.