Breathe-(H)IT Trial: High-intensity training to improve diaphragm functioning in persons with chronic nonspecific low back pain: protocol for a randomized controlled trial.

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Bibliographic Details
Title:	Breathe-(H)IT Trial: High-intensity training to improve diaphragm functioning in persons with chronic nonspecific low back pain: protocol for a randomized controlled trial.
Authors:	Klaps, S., Verbrugghe, J., Goossens, N., Köke, A., Verbunt, J., Langer, D., Janssens, L., Timmermans, A.
Source:	Pain Practice. 2022 Supplement, Vol. 22, p36-37. 2p.
Subjects:	Diaphragm physiology, Lumbar pain, Chronic pain, Resistance training, Exercise physiology, Conferences & conventions, Exercise intensity
Geographic Terms:	Netherlands
Abstract:	Introduction: Persons with chronic nonspecific low back pain (CNSLBP) benefit more from high-intensity training (HIT) compared to (usual care) moderate-intensity training (MIT) to improve physical1 and psychosocial2 outcomes. However, the underlying mechanisms for these effects are unknown. A possible underlying mechanism is an improvement in diaphragm functioning. The diaphragm plays an important role in postural control3, and an impaired postural control due to diaphragm dysfunction has been shown to contribute to the development of CNSLBP. Methods: Sixty-four persons with CNSLBP will be randomly assigned to a 12-week HIT-or MIT-program. Both programs will consist of cardiorespiratory, limb strength and core muscle training. The only difference between both groups, will be the intensity of the exercise therapy. Primary outcomes will include diaphragm activation during postural control (EMG), and diaphragm strength (maximal inspiratory pressure), endurance and fatigue. Secondary outcomes will include pain processing (quantitative sensory testing), exercise capacity, and lumbar proprioceptive use during postural control. Questionnaires about pain intensity, disability, anxiety, and depression will also be inventoried. Outcomes will be assessed at baseline, during and immediately post-intervention, and at 3-and 12-months follow-up. Effects and relations will be investigated using, respectively, linear mixed models and multiple linear regression. Results: We hypothesize that diaphragm functioning will improve more after HIT compared to MIT in persons with CNSLBP. Discussion: The Breathe-(H)IT Trial will be the first study investigating the effects of HIT on diaphragm functioning in persons with CNSLBP Process evaluation: Ethical approval is currently being requested from the Medical Ethical Committee of UHasselt. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection

Description
Abstract:	Introduction: Persons with chronic nonspecific low back pain (CNSLBP) benefit more from high-intensity training (HIT) compared to (usual care) moderate-intensity training (MIT) to improve physical1 and psychosocial2 outcomes. However, the underlying mechanisms for these effects are unknown. A possible underlying mechanism is an improvement in diaphragm functioning. The diaphragm plays an important role in postural control3, and an impaired postural control due to diaphragm dysfunction has been shown to contribute to the development of CNSLBP. Methods: Sixty-four persons with CNSLBP will be randomly assigned to a 12-week HIT-or MIT-program. Both programs will consist of cardiorespiratory, limb strength and core muscle training. The only difference between both groups, will be the intensity of the exercise therapy. Primary outcomes will include diaphragm activation during postural control (EMG), and diaphragm strength (maximal inspiratory pressure), endurance and fatigue. Secondary outcomes will include pain processing (quantitative sensory testing), exercise capacity, and lumbar proprioceptive use during postural control. Questionnaires about pain intensity, disability, anxiety, and depression will also be inventoried. Outcomes will be assessed at baseline, during and immediately post-intervention, and at 3-and 12-months follow-up. Effects and relations will be investigated using, respectively, linear mixed models and multiple linear regression. Results: We hypothesize that diaphragm functioning will improve more after HIT compared to MIT in persons with CNSLBP. Discussion: The Breathe-(H)IT Trial will be the first study investigating the effects of HIT on diaphragm functioning in persons with CNSLBP Process evaluation: Ethical approval is currently being requested from the Medical Ethical Committee of UHasselt. [ABSTRACT FROM AUTHOR]
ISSN:	15307085
DOI:	10.1111/papr.13128