Protocol of identical exercise programs with and without specific breathing techniques for the treatment of chronic low back pain: randomized feasibility trial with two-month follow-up.

Background: Chronic low back pain (CLBP) is a leading cause of disability globally. Exercise therapies are one of the commonly prescribed treatment options for CLBP. The specific exercise therapies for CLBP most commonly target movement dysfunction, but seldom brain-based pain modulation. Exercise therapies with specific breathing techniques (SBTs) have been shown to influence and enhance brain-based structural and functional pain modulation. Aims and objectives To assess the feasibility of the SBTs protocol, eligibility criteria, randomization, and dropout rates. To quantify the changes in patient outcome measures and choose the most relevant measure for larger-scale study. To quantify self-adherence levels to home exercise and monitor and record possible pain medication and other treatment modality usage, and adverse events during exercise. Design A parallel randomised analyst-blinded feasibility trial with two-month follow-up. Outcome measures Feasibility related to aims and objectives. Multiple pain- and health-related patient-reported outcome measures of pain intensity, disability, central sensitization, anxiety, kinesiophobia, catastrophising, self-efficacy, sleep quality, quality of life, and health and well-being status. Exercise adherence, pain medication and other treatment modality usage, and possible adverse events related to exercises will be monitored and recorded. Methods Thirty participants will be randomized to movement control exercise with SBTs (experimental group) or movement control exercise without SBTs (control group) with an allocation ratio of 1:1. Discussion SBTs are a simple, free, and safe addition to exercise that may influence clinical outcomes. The clinical difference in effectiveness between practically identical exercise programs in uniform study settings with or without SBTs has not been studied before.