# 12 weeks high intensity interval training versus moderate intensity continuous training in chronic low back pain subjects: a randomised single-blinded feasibility study

PMID: 35491417
Journal: Archives of Physiotherapy
Published: 2022-05-02
Authors: Cerini T, Hilfiker R, Riegler TF, Felsch QTM

## Question

Is 12 weeks of supervised cycling HIIT feasible, acceptable, and safe compared with moderate continuous cycling in adults with chronic nonspecific low back pain?

## Summary

In adults with chronic low back pain, supervised cycling HIIT for 12 weeks had very high adherence and similar enjoyment to moderate continuous cycling. Pain and disability improved within both groups, but the small feasibility trial did not show between-group differences.

## Population

- Adults with nonspecific chronic low back pain
- Sample size: 30
- Age: 29 to 69 years
- Sex: 16 women and 14 men
- Fitness level: Clinical sample; not athlete-selected
- Health status: Chronic low back pain with screened contraindications excluded

## Methodology

- Single-blinded randomized parallel-group feasibility trial
- 12 weeks
- Supervised outpatient clinic cycle-ergometer sessions in Zurich
- Randomized and controlled study design.

## Protocol

- HIIT.
- Modality: Cycle ergometer.
- Work intervals: 60 s above 90% heart-rate reserve.
- Recovery: 60 s at 30-39% heart-rate reserve.
- Sets or repetitions: 10.
- Intensity: >90% HRR work intervals.
- Session duration: 30 min.
- Frequency: 3 sessions/week.
- Program length: 12 weeks.
- Progression: Individual targets set from steep ramp testing.
- MICT.
- Modality: Cycle ergometer.
- Work intervals: 20 min continuous.
- Sets or repetitions: 1 continuous bout.
- Intensity: 40-59% heart-rate reserve.
- Session duration: 30 min.
- Frequency: 3 sessions/week.
- Program length: 12 weeks.
- Progression: Individual target heart-rate and wattage zones.

## Outcomes

### Adherence
Status: no clear change
Adherence was high and similar between HIIT and MICT.

Median ITT adherence 0.94 versus 0.96; difference -0.01, 95% CI -0.11 to 0.06, p=0.76.

### Pain
Status: no clear change
Pain decreased within both groups, with no between-group difference.

Between-group median difference 0.05, 95% CI -1 to 2, p about 0.94.

### Disability
Status: no clear change
Disability decreased within both groups, with no between-group difference.

ODI between-group difference 1.78, 95% CI -6.44 to 9.56, p=0.64.

### Safety
Status: no clear change
No serious adverse events occurred and event counts were similar.

HIIT 8 reports; MICT 9 reports.

## Practical Insights

- A 10 x 1-min cycling HIIT structure was feasible in screened chronic low back pain participants.
- Adherence can be high when sessions are supervised and scheduled.
- Recovery heart-rate targets may be hard to hit during short rests.

## Limitations

- Small feasibility trial
- Not powered for efficacy
- Clinical supervision limits app translation
- Outcome assessor and care provider were not blinded

## Safety And Adherence

- No serious adverse events
- No adverse event required session stoppage or modification
- Dropouts were unrelated to training

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/35491417/) (pubmed)
- [DOI](https://doi.org/10.1186/s40945-022-00136-3) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9059354/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.