Newcastle Low Back Pain Intervention Study

European Space Agency, The University of Queensland, International Space University, Aalborg University

The aim of this study is to investigate if six-weeks of exercise intervention, 3 times per week on the Functional Re-adaptive Exercise Device (FRED) reduces non-specific mechanical low back pain in adults ages 18-60.

The aim of this study is to investigate whether an six-week FRED exercise intervention reduces low back pain (LBP) and improves a range of related outcomes. The objectives of this study are to examine whether FRED exercise reduces mechanical LBP ( low back pain); whether FRED exercise improves functional and static balance in people with LBP; whether FRED exercise has an effect on cross-sectional area (CSA) of relevant lumbo-pelvic muscles; whether FRED exercise has an effect on TrA (Transversus Abdominis), LM ( Lumbar Multifidus), lumbar Erector Spinae, External and Internal Oblique muscle activity and function in individuals with LBP; whether FRED exercise has an effect on TrA and internal oblique muscle thickness; the rate of muscle physiology change in response to FRED exercise in people with LBP; whether FRED exercise affects the analgesic intake, need for intervention and physical activity level of individuals with LBP; whether FRED exercise affects wellbeing and every-day function in people with LBP; the rate of change of level of pain, wellbeing and of function (incl. balance) in response to FRED exercise in people with LBP.

Lumbo-pelvic muscles, Rehabilitation, Exercise, Low back pain, Functional Re-adaptive Exercise Device

Exercise intervention 3 times per week for up to 30min. Difficulty and time will be progressed as indicated by clinical presentation, assessed by the Physiotherapist team.

iEMG of Lumbar Multifudus (LM), Transversus Abdominus (TrA), External Obliques and Internal obliques during exercise and balance tasks

USI of cross sectional area and thickness of Lumbar Multifudus (LM),and thickness of Transversus Abdominus (TrA)

At baseline (intervention -6 weeks) within 1 week prior to intervention, within 1 week post intervention, 1 x week during intervention, and at intervention +12 weeks (10 data collections)

Measuring postural sway changes in center of pressure during the balance and rapid arm movement tasks, repeated measure throughout study

At baseline (intervention -6 weeks) within 1 week prior to intervention, within 1 week post intervention, at intervention +6 week, +12 weeks and +16 weeks follow up (5 data collections)

At baseline (intervention -6 weeks) within 1 week prior to intervention, within 1 week post intervention, at intervention +6 week, +12 weeks and +16 weeks follow up (5 data collections)

At baseline (intervention -6 weeks) within 1 week prior to intervention, within 1 week post intervention, at intervention +6 week, +12 weeks and +16 weeks follow up (5 data collections)

At baseline (intervention -6 weeks) within 1 week prior to intervention, within 1 week post intervention, 3 x week during intervention, at intervention +6 weeks and +12 weeks follow up (22 data collections)

Inclusion Criteria: Mechanical LBP for 8 weeks or longer Score of < 15 on FABQ Age 18-60 Commitment to taking part in the study for its full duration Exclusion Criteria: Presence of "red flags" - indicative of non-mechanical LBP Score of > 15 on FABQ or other indicators of a likely poor response to a solely physical approach to treatment incl. seeking compensation for LBP Exercise contraindicated as per Physical Activity Readiness Questionnaire Inability to exercise safely on the FRED Pregnancy Surgery within the previous nine months Difficulty to exercise safely in standing for 30 mins 3x/week Cardio/respiratory disease Neurological disorders BMI > 28 where adipose tissue infringes on ultrasound imaging and intramuscular electrode placement

Caplan, N, Gibbon, KC, Hibbs, A & Debuse, D 2014, 'Phasic-to-tonic shift in tunk muscle activity during low-impact weight bearing exercise', Acta Astronautica, vol 104, pp. 388-395.

Debuse D, Birch O, St Clair Gibson A, Caplan N. Low impact weight-bearing exercise in an upright posture increases the activation of two key local muscles of the lumbo-pelvic region. Physiother Theory Pract. 2013 Jan;29(1):51-60. doi: 10.3109/09593985.2012.698718. Epub 2012 Jul 12.

Gibbon KC, Debuse D, Caplan N. Low impact weight-bearing exercise in an upright posture achieves greater lumbopelvic stability than overground walking. J Bodyw Mov Ther. 2013 Oct;17(4):462-8. doi: 10.1016/j.jbmt.2013.02.004. Epub 2013 Apr 22.

Evetts SN, Caplan N, Debuse D, Lambrecht G, Damann V, Petersen N, Hides J. Post space mission lumbo-pelvic neuromuscular reconditioning: a European perspective. Aviat Space Environ Med. 2014 Jul;85(7):764-5. doi: 10.3357/asem.3943.2014.