STUDY DESIGN: Randomized controlled trial. OBJECTIVE: This is the companion study to a previous publication that presented 8-week pain, disability, and trunk muscle motor control results. The objective of this study was to compare the effect of 8-weeks of specific trunk exercises and stationary cycling on outcomes measures of catastrophizing and fear-avoidance beliefs (FAB) in patients with chronic non-specific low back pain (LBP), and provide 6-month outcome data for all self-report measures. SUMMARY OF BACKGROUND DATA: It is thought that any form of moderate-to-vigorous physical activity is sufficient to address catastrophizing and FAB, and concomitant levels of pain and disability. METHODS: Sixty-four patients with LBP were randomly assigned to 8-weeks of specific trunk exercise (SEG), or stationary cycling (CEG). Self-rated pain, disability, catastrophizing and FAB scores were collected before, immediately after (8-weeks), and 6-months after the training program. Clinically meaningful improvements were defined as greater than a 30% reduction from baseline in pain and disability scores. Intention-to-treat principles were used for missing data. Per-protocol analysis was performed on participants who attended at least 2/3 of the exercise sessions. RESULTS: At 8-weeks, disability was significantly lower in the SEG compared to the CEG (d = 0.62, p = 0.018). Pain was reduced from baseline in both groups following training (p < 0.05), but was lower for the SEG (p < 0.05). FAB scores were reduced in the SEG at 8-weeks, and in the CEG at 6-months. No between-group differences in FAB scores were observed. Similar reductions in catastrophizing in each group were observed at each time-point. At 6-months, the overall data pattern suggested no long-term difference between-groups. Per-protocol analysis of clinically meaningful improvements suggest no between-group differences for how many patients are likely to report improvement. CONCLUSION: Inferential statistics suggest greater improvements at 8-weeks, but not 6-months, for the SEG. Inspection of clinically meaningful changes based on a minimum level of adherence suggests no between-group differences. If a LBP patient adheres to either specific trunk exercises or stationary cycling, it is reasonable to believe similar improvements will be achieved.
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