Effectiveness of a 10-week low back pain rehabilitation programme with and without bilateral blood flow restriction exercise; monitoring perceptions of pain and hypoalgesia effects.

Background We compared the effectiveness of a 10-week, low back pain (LBP) rehabilitation programme, with and without bilateral blood flow restriction exercise (BFR-RE). Monitoring perceptions of pain (POP), LBP pressure pain thresholds (PPT), hemodynamic variables (HV) and distal hypoalgesia effects within the lumbar region. Methods 28 participants with LBP were block randomised (BFR-RE, n=14; Non BFR-RE, n=14) for this parallel-group, repeated measures study. Periodisation comprised 3 proprioceptive, endurance and strength phases of hip hinge and gluteal programming over 10-weeks, conducted twice weekly. Rating of perceived exertion (RPE) systematically regulated training load and resistance exercise (RE) protocols incorporated conventional hypertrophy and LBP rehabilitation methods, using BFR repetition guidelines. POP, PPT and HV were assessed pre-intervention - post session - post intervention, using the short form McGill pain questionnaire (SF-MPQ), pressure algometer (PA) and blood pressure monitor (BPM). Results 1 withdrawal left 27 completing participants (BFR n=14, Non-BFR n=13), with no adverse baseline characteristics. Significant interactions occurred between BFRE-RE treatment and time (F1 = 6.31, p = 0.03), reducing SF-MPQ values by 80%, 38% greater than Non-BFR (t12 = 02.51, p < 0.03). PPT’s increased over time (F1 = 10.35, p = 0.007), with no group differences (19 ± 0.10%) and main effects of treatment were insignificant for all HV (Systolic (SYS), F1 = 0.08, p = 0.08; Diastolic (DIA), F1 = 0.37, p = 0.55; Heart Rate (HR), F1 = 3.13, p = 0.10; Mean Arterial Pressure (MAP), F1 = 0.17, p = 0.69. Conclusion BFR-RE affords LBP demographics who cannot tolerate load or are troubled by fear avoidance model (FAM) movement modifications, a rehabilitation method that reduces POP and enables corrective LBP exercise to be conducted with practitioners.