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The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back
  1. Neil Welch1,2,3,
  2. Kieran Moran2,4,
  3. Joseph Antony2,
  4. Chris Richter2,
  5. Brendan Marshall1,4,
  6. Joe Coyle1,
  7. Eanna Falvey1,5,
  8. Andrew Franklyn-Miller1,6
  1. 1Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland
  2. 2INSIGHT Research Centre, Dublin City University, Dublin, Ireland
  3. 3Sports Surgery Clinic, Santry Demesne, Dublin 9, Ireland
  4. 4School of Health and Human Performance, Dublin City University, Dublin, Ireland
  5. 5Department of Medicine, University College Cork, Cork, Ireland
  6. 6Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Neil Welch; neilwelch{at}


Background Low back pain is one of the most prevalent musculoskeletal conditions in the world. Many exercise treatment options exist but few interventions have utilised free-weight resistance training. To investigate the effects of a free-weight-based resistance training intervention on pain and lumbar fat infiltration in those with chronic low back pain.

Methods Thirty participants entered the study, 11 females (age=39.6±12.4 years, height=164 cm±5.3 cm, body mass=70.9±8.2 kg,) and 19 males (age=39.7±9.7 years, height=179±5.9 cm, body mass=86.6±15.9 kg). A 16-week, progressive, free-weight-based resistance training intervention was used. Participants completed three training sessions per week. Participants completed a Visual Analogue Pain Scale, Oswestry Disability Index and Euro-Qol V2 quality of life measure at baseline and every 4 weeks throughout the study. Three-dimensional kinematic and kinetic measures were used for biomechanical analysis of a bodyweight squat movement. Maximum strength was measured using an isometric mid-thigh pull, and lumbar paraspinal endurance was measured using a Biering-Sorensen test. Lumbar paraspinal fat infiltration was measured preintervention and postintervention using MRIs.

Results Postintervention pain, disability and quality of life were all significantly improved. In addition, there was a significant reduction in fat infiltration at the L3L4 and L4L5 levels and increase in lumbar extension time to exhaustion of 18%.

Conclusions A free-weight-based resistance training intervention can be successfully utilised to improve pain, disability and quality of life in those with low back pain.

  • Back injuries
  • Biomechanics
  • MRI
  • Fat percentage

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