In this sample of adults with NSCLBP, the tested periodized resistance training program produced more favorable adjusted post-treatment outcomes than the tested periodized aerobic training program across pain, disability, kinesiophobia, muscular strength, and trunk endurance.
Key Findings
Results
Periodized resistance training (RT) produced lower adjusted post-treatment pain intensity than periodized aerobic training (AT) in adults with nonspecific chronic low back pain.
Adjusted mean difference (AMD) = -2.71, 95% CI -3.17 to -2.25, p < 0.001, ηp² = 0.804.
Pain was measured with the Visual Analogue Scale and was a primary outcome.
Analysis used ANCOVA with post-treatment score as the dependent variable, group as the fixed factor and baseline value as covariate.
38 participants were randomized (19 per group); both groups trained three times weekly for 8 weeks.
Results
RT resulted in lower adjusted post-treatment functional disability than AT.
AMD = -0.20, 95% CI -0.25 to -0.15, p < 0.001, ηp² = 0.641.
Disability was measured with the Arabic-translated Oswestry Disability Index (primary outcome).
The effect size was large.
Results
RT resulted in lower adjusted post-treatment kinesiophobia than AT.
AMD = -5.54, 95% CI -7.89 to -3.19, p < 0.001, ηp² = 0.395.
Kinesiophobia was measured with the Arabic-translated Tampa Scale of Kinesiophobia (primary outcome).
This was the smallest effect size among the reported outcomes, though still large.
Results
RT produced higher adjusted post-treatment muscle strength and trunk endurance than AT on all measures.
Effect sizes were large (ηp² = 0.480-0.693).
Strength was assessed as isometric hip extensor and latissimus dorsi strength via handheld dynamometer.
Endurance was assessed using the Biering-Sorensen Test and a standardized static abdominal endurance protocol.
Results
All randomized participants completed the intervention and post-treatment assessments.
All 38 participants (19 RT, 19 AT) completed the 8-week program and post-treatment testing.
There was no dropout, so analyses included the entire randomized sample.
Methods
Because several outcomes were imbalanced at baseline, the primary analysis adjusted for baseline values using ANCOVA.
Post-treatment score was the dependent variable, treatment group the fixed factor, and the corresponding baseline value the covariate.
Adjusted mean differences, 95% CIs, exact p-values and partial eta squared were reported.
Conclusions
The authors conclude that periodized RT is a supportive rehabilitation option for NSCLBP but that larger trials with longer follow-up are needed.
Findings are limited to this small sample (n = 38) and the specific RT and AT programs tested.
The study addressed an evidence gap on periodized models and psychological outcomes such as kinesiophobia.
Trial registered at ClinicalTrials.gov (NCT06922981).
What This Means
This study compared two types of structured exercise programs for adults with long-lasting low back pain that has no specific identifiable cause. Thirty-eight people were randomly assigned to either a resistance (strength) training program or an aerobic training program. Both groups exercised three times a week for 8 weeks, and the programs were progressively varied over time (periodized).
After 8 weeks, the strength training group had less pain, less back-related disability, and less fear of movement than the aerobic group, after accounting for differences at the start. The strength group also had better hip and upper-back muscle strength and better trunk muscle endurance. The differences were large in statistical terms, and everyone completed the program.
This research suggests that periodized strength training may be a useful rehabilitation option for chronic low back pain. However, the study was small, tested only specific programs, and did not follow people over the long term, so larger and longer trials are needed before firm conclusions can be drawn about how well these benefits last or apply to other groups.
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Mohammed A, Youssef E, Abdelnaeem A. (2026). Periodized Resistance Training Versus Aerobic Training in Managing Nonspecific Chronic Low Back Pain: A Randomized Controlled Trial.. Physiotherapy research international : the journal for researchers and clinicians in physical therapy. https://doi.org/10.1002/pri.70368