Project R-13116

Technology supported high intensity training in chronic low back pain: the Techno-HIT trial (Research)

Chronic low back pain (CLBP) is the most disabling musculoskeletal disorder worldwide. Exercise therapy can improve CLBP, but effect sizes remain modest. Recently, our research group has shown that high intensity training (HIT) significantly reduces disability in comparison to moderate intensity training (MIT) in moderately disabling CLBP. However, the effectiveness of HIT has not been investigated in persons with severely disabling CLBP, and long-term effects of HIT in CLBP are not known. As persons with CLBP often do not continue exercising after discharge, leading to a decline of treatment effects, a technology supported home program that guides the substantial effort that is necessary for further improvement may enhance (the retention of) training effects. Our primary objective is to evaluate the effectiveness of HIT compared to MIT for the improvement of disability in persons with severely disabling CLBP. Secondary aims are: to 1) evaluate the effect of HIT on central pain processing and psychosocial correlates (self-efficacy and resilience); 2) investigate the added value of a prolonged HIT training at home, 3) investigate the added value of technology support during HIT training at home, and 4) assess whether the proposed training program is beneficial from a health economics point of view (through a costeffectiveness analysis from a societal perspective). In a multicenter randomized controlled trial, 168 patients with severely disabling CLBP will be randomized into 3 groups: 1) HIT at the hospital followed by HIT at home with technology support, 2) HIT at the hospital followed by HIT at home without technology support, or 3) MIT at the hospital followed by MIT at home without technology support. All groups train at the hospital for 12 weeks (2X/week), followed by 12 weeks (2X/week) training at home. Short term (after 12 and 24 weeks of training) and long term (6 and 18 months after cessation of training) effects of HIT are evaluated.

01 October 2022 - 30 September 2026