Ab1346 Effectiveness of Exercise and Mindfulness on Pain Pressure Threshold in Patients With Non-Specific Chronic Low Back Pain: The Backfit Project

Background: Prolonged stressful situations could increase pain and reduce physical function. Individuals with non-specific chronic low back pain (NSCLBP) experience persistent pain and inhibited neuromuscular control system. A non-pharmacological multimodal treatment, such as exercise and mindfulness, might be effective to reduce pain in this population. Objectives: Compare the effects of a multimodal approach (exercise and exercise+mindfulness) with usual rehabilitation care on pressure pain threshold (PPT) in individuals with NSCLBP. Methods: From 105 participants recruited and randomized, a total of 54 patients with NSCLBP aged 52±9 years attended >65% of the program and included all the measurements: control group (CG, n=20), exercise group (EG, n=14) and exercise+mindfulness group (EMG, n=20). All groups received an 8-week intervention program twice a week for 45 minutes/session. The CG followed usual rehabilitation care (stretching, breathing and motor control exercises in different positions). The EG and EMG received an exercise intervention program focused on muscle strengthening exercises. Additionally, the EMG attended to a mindfulness program once a week for 2.5 hours/session. The PPT was measured with a manual pressure algometer (FPK 20). All groups completed three assessments before (pre) and after (post) the intervention program and after a detraining period (re) of 3 months. Results: Repeated measures analysis of the variance (ANOVA) showed that all groups increased PPT after the intervention (post-pre mean difference (MD)= -1.37; 95% confidence interval (CI)=-2.11,-0.62; p=0.001, MD=-1.14; CI=-2.11,-0.17; p=0.025, and MD=-1.04; CI=-1.81,-0.27; p=0.11 for the CG, the EG, and the EMG, respectively). After the detraining period, all groups showed non-significant PPT values compared to the baseline values (all p>0.05). The analysis of the covariance (ANCOVA) showed that changes from baseline (post-pre) did not differ between groups in PPT (MD=0.13; CI=-1.22, 1.5, MD=0.32; CI=-0.9, 1.5, MD=0.18, CI=-1.16, 1.5 for the CG, EG and EMG). After the detraining period (re-pre) PPT did not differ between groups (MD=0.39; CI=-1.05,1.8 for CG and EG, MD=-0.04; CI=-1.3,1.2 for CG and EMG, MD=-0.44, CI=-1.87,0.99 for EG and EMG). Conclusion: Exercise and mindfulness and usual rehabilitation care were not effective to increase PPT in individuals with NSCLBP. Future studies are warranted to introduce a multimodal approach with higher exercise intensity, mindfulness and pain education to study its' effectiveness on PPT in these individuals. REFERENCES: NIL. Acknowledgements: Participants are deeply acknowledged for their collaboration. This study was supported by the Instituto de Salud Carlos III through the research contract Miguel Servet (CP20/00178) co-funded by European Social Fund. Furthermore, GT was supported by the Instituto de Salud Carlos III through the PFIS contract (FI23/00034) co-funded by European Social Fund+. Disclosure of Interests: None declared.