Running is acceptable and efficacious in adults with non-specific chronic low back pain: the ASTEROID randomised controlled trial

Christopher Neason; Claire L Samanna; Scott D Tagliaferri; Daniel L Belavý; Steve J Bowe; Matthew J Clarkson; Emma A Craige; Romina Gollan; Luana C Main; Clint T Miller; Ulrike H Mitchell; Niamh L Mundell; David Scott; Jamie L Tait; Grace E Vincent; Patrick J Owen

doi:10.1136/bjsports-2024-108245

Running is acceptable and efficacious in adults with non-specific chronic low back pain: the ASTEROID randomised controlled trial

Br J Sports Med. 2024 Oct 7:bjsports-2024-108245. doi: 10.1136/bjsports-2024-108245. Online ahead of print.

Authors

Christopher Neason^{1

2}, Claire L Samanna^{1

2}, Scott D Tagliaferri^{3

4}, Daniel L Belavý⁵, Steve J Bowe⁶, Matthew J Clarkson⁷, Emma A Craige⁸, Romina Gollan², Luana C Main², Clint T Miller², Ulrike H Mitchell⁹, Niamh L Mundell², David Scott^{2

10}, Jamie L Tait², Grace E Vincent⁸, Patrick J Owen^{11

2

12}

Affiliations

¹ Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
² Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
³ Orygen, Parkville, Victoria, Australia.
⁴ Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia.
⁵ Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Division of Physiotherapy, Bochum, Germany.
⁶ School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand.
⁷ Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia.
⁸ Appleton Institute, School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia.
⁹ Department of Exercise Sciences, Brigham Young University, Provo, Utah, USA.
¹⁰ School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
¹¹ Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia patrick.owen@easternhealth.org.au.
¹² Eastern Health Emergency Medicine Program, Melbourne, Victoria, Australia.

PMID: 39375007
DOI: 10.1136/bjsports-2024-108245

Abstract

Objectives: Running is one of the most accessible forms of exercise, yet its suitability for adults with chronic low back pain (LBP) is unknown. This study assessed the efficacy and acceptability of running in adults with chronic LBP.

Methods: This two-arm parallel (1:1) individually randomised controlled trial allocated 40 participants (mean (SD) age: 33 (6) years, female: 50%) with non-specific chronic LBP to a 12-week intervention or waitlist control. The intervention was a progressive run-walk interval programme comprising three 30-min sessions per week that were digitally delivered and remotely supported by an exercise physiologist. Efficacy outcomes were self-reported pain intensity (100-point visual analogue scale) and disability (Oswestry Disability Index). Acceptability outcomes were attrition, adherence and adverse events.

Results: At 12-week follow-up, the intervention improved average pain intensity (mean net difference (95% CI): -15.30 (-25.33, -5.27) points, p=0.003), current pain intensity (-19.35 (-32.01, -6.69) points, p=0.003) and disability (-5.20 (-10.12, -0.24) points, P=0.038), compared with control. There was no attrition, and mean (SD) training adherence was 70% (20%; ie, 2.1 of 3 sessions per week). Nine non-serious adverse events deemed likely study-related were reported (lower limb injury/pain: n=7, syncope associated with an underlying condition: n=1, LBP: n=1).

Conclusions: A run-walk programme was considered an acceptable intervention by the participants to improve the pain intensity and disability in individuals aged 18-45 years with non-specific chronic LBP when compared with the control. An individualised and conservative run-walk programme should be considered a suitable form of physical activity for adults with chronic LBP.

Trial registration number: Australian New Zealand Clinical Trials Registry: ACTRN12622001276741. Registered on 29 September 2022.

Keywords: Exercise training; Physical activity; Physiology; Walking.