EFFECT OF RESISTANCE BAND EXERCISES AS AN ADJUNCT TO CONVENTIONAL PHYSIOTHERAPY ON PAIN, DISABILITY AND QUALITY OF LIFE IN PATIENTS WITH CHRONIC LOW BACK PAIN

Abstract

Background: Even though standard physiotherapy is widely used, chronic low back pain still drives up costs borne by patients and the health system and remains one of the biggest disabilities in the world. While exercise is always strongly recommended as first-line management in clinical guidelines, none of them clearly indicates what kind of exercise will be most beneficial, and the additional value of resistance band training, if combined with regular physiotherapy treatment, is not well known.
Objective: The objective is to compare the effects of resistance band exercises performed in addition to conventional physiotherapy on the intensity of pain, the level of functional disability and quality of life for those who suffer from chronic low back pain versus conventional physiotherapy alone.
Methods: The study was of prospective, random, parallel-assessor blinded, controlled type and was performed in the Physiotherapy Out-Patient Department of a tertiary care Teaching Hospital. Thirty individuals suffering from chronic non specific low back pain (LBP) who had had at least 3 months of persistent pain were randomly allocated in a 1:1 ratio based on a computer-generated list of sequentially opaque, sealed envelopes. A total of 30 adults did have chronic non specific low back pain (LBP) of at least three months duration and were randomly allocated in a 1:1 ratio based on a computer-generated list of sequentially opaque, sealed envelopes. Group A (n = 15) was group that received conventional physiotherapy - Heat therapy, Electrotherapy, Stretching and lumbar stabilisation exercises. Group B (n = 15) received the same conventional programme, along with a supervised, progressive exercise programme utilising elastic resistance bands focusing on the trunk, hip and lower limb musculature three times a week for 4–6 weeks. A blinded rater collected outcomes at baseline and at the end of the intervention, which were the Visual Analogue Scale for pain, the Modified Oswestry Disability Index for disability and the WHOQOL BREF for quality of life. Paired t test and independent t tests were for group comparisons and Cohen's d was the effect size measure for between group t tests.
Results: Significant improvements, between p<0.001, occurred from baseline with both groups on all outcomes. Pain reduction was greater in Group B than Group A (mean change 3.55 versus 1.57 cm, p < 0.001, d = 3.80). Disability improved more in Group B than Group A (mean MODI reduction 16.27% versus 10.13%, p < 0.001, d = 2.19). The improvement in all four WHOQOL BREF domains was found to be significantly larger in Group B, and the highest in the two domains of physical health and social relationships, with d around 2.2. There was moderate but negative correlation between baseline BMI and the amount of pain and disability improvement.
Conclusion: The addition of a structured and progressive resistance band exercise programme to conventional physiotherapy resulted in significantly better outcomes for those patients with chronic low back pain in regard to pain, disability, and quality of life compared to conventional physiotherapy alone. Portable restuvian training is now available where resistance bands can be incorporated into basic rehab interventions for this condition at low cost, portably, and easily at home, thus making it a viable and clinically beneficial option. Further larger multicentre trials with longer follow-up are required to confirm these data, and to test their long-term duration.