Running is associated with intervertebral disc adaptations: a pre-planned secondary analysis of the ASTEROID randomised controlled trial.
To identify patient and intervention factors that moderate the effects of running on intervertebral disc health (IVD) in adults with non‑specific chronic low back pain.
Pre‑planned secondary analysis of a 12-week parallel-group (1:1) randomised controlled trial of 40 adults with non-specific CLBP (mean [SD] age: 33 [6] years, female: 50%). Participants were allocated to a digitally-delivered progressive run-walk interval exercise training program (3 days/week, 30 min/session) or waitlist control. Magnetic resonance imaging at baseline, six, and 12 weeks quantified primary outcome IVD composition as whole-disc T2 (ms) from T11/T12 to L5/S1. Moderators included baseline degeneration (Pfirrmann grade; aggregated Pfirrmann score), sex, body mass index, and intervention factors (cumulative running volume, mean speed, and dominant surface). Linear mixed models were fitted at the IVD level to estimate group-by-time effects within each moderator-defined subgroup (α = 0.05).
The highest aggregated Pfirrmann scores reflecting greater multi-level degeneration (estimated marginal mean net difference [95%CI]: 3.42 [0.22, 6.62] ms, P = 0.036), cumulative running volumes between 28.6 and 46.1 kms (4.80 [2.51, 7.10] ms, P < 0.001), mean running speeds between 10.5 and 11.7 km/h (2.46 [0.14, 4.79] ms, P = 0.038), and running on grass (2.93 [0.10, 5.76] ms, P = 0.043) positively moderated between-group IVD T2 changes.
In this pre-planned secondary analysis of a randomised control trial of a run-walk program, our data suggest running speed, volume and surface, as well as more multi-level IVD degeneration, may be associated with more favourable 12-week IVD T2 changes. Findings are hypothesis-generating and may inform future trials designed to optimise IVD health.
Pre‑planned secondary analysis of a 12-week parallel-group (1:1) randomised controlled trial of 40 adults with non-specific CLBP (mean [SD] age: 33 [6] years, female: 50%). Participants were allocated to a digitally-delivered progressive run-walk interval exercise training program (3 days/week, 30 min/session) or waitlist control. Magnetic resonance imaging at baseline, six, and 12 weeks quantified primary outcome IVD composition as whole-disc T2 (ms) from T11/T12 to L5/S1. Moderators included baseline degeneration (Pfirrmann grade; aggregated Pfirrmann score), sex, body mass index, and intervention factors (cumulative running volume, mean speed, and dominant surface). Linear mixed models were fitted at the IVD level to estimate group-by-time effects within each moderator-defined subgroup (α = 0.05).
The highest aggregated Pfirrmann scores reflecting greater multi-level degeneration (estimated marginal mean net difference [95%CI]: 3.42 [0.22, 6.62] ms, P = 0.036), cumulative running volumes between 28.6 and 46.1 kms (4.80 [2.51, 7.10] ms, P < 0.001), mean running speeds between 10.5 and 11.7 km/h (2.46 [0.14, 4.79] ms, P = 0.038), and running on grass (2.93 [0.10, 5.76] ms, P = 0.043) positively moderated between-group IVD T2 changes.
In this pre-planned secondary analysis of a randomised control trial of a run-walk program, our data suggest running speed, volume and surface, as well as more multi-level IVD degeneration, may be associated with more favourable 12-week IVD T2 changes. Findings are hypothesis-generating and may inform future trials designed to optimise IVD health.
Authors
Samanna Samanna, Neason Neason, Tagliaferri Tagliaferri, Belavý Belavý, Mitchell Mitchell, Nez Nez, Buntine Buntine, Miller Miller, Scott Scott, Mundell Mundell, Clarkson Clarkson, Owen Owen
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