Project R-14058

HIT-BACK-HEART: Effects of High Intensity Training on Mechanistic Pain Profiling and Heart Rate Variability in Persons with Chronic Low Back Pain (Research)

Chronic low back pain (CLBP) is a huge burden to patients, society, and healthcare. As 85% of persons with CLBP have complex symptoms without a pathoanatomical origin, several contributing factors have been linked to pain intensity. However, the majority of variance in treatment outcome remains unknown. Mechanistic pain profiling (MPP), an elaborate evaluation of peripheral and central pain processing, and heart rate variability (HRV), a complex measure of variation in time between each heartbeat, recently emerged as critical factors to consider in the development of prognostic strategies and to achieve more personalized care. While the primary treatment option for CLBP is exercise therapy, effect sizes remain modest. High intensity training (HIT) could be an optimal modality to improve exercise therapy effectiveness in CLBP, and it also shows potential to affect MPP and HRV. Therefore, in HIT-BACK-HEART we conduct a RCT in 96 persons with CLBP, recruited from two hospitals. These persons are randomized in two groups that perform a 12-week supervised protocol at high or moderate intensity. Acute (post-protocol) and long term (3-month follow-up) effects are evaluated. HIT-BACK-HEART evaluates: 1) relationships between pain intensity, MPP and HRV, 2) phenotyping potential based on MPP and HRV, 3) if HIT affects MPP and HRV, and 4) if baseline and longitudinal MPP and HRV combined with other contributing factors of CLBP are related to effects of HIT on pain intensity.

01 November 2023 - 31 October 2027