title: The effects of therapeutic climbing in patients with chronic low back pain: a randomized controlled study.
abstract: METHODS
  A randomized controlled study investigated the effects of therapeutic climbing in patients with chronic low back pain. Before and after 4 weeks of training, physical and mental well-being were measured by two questionnaires (36-Item Short Form Health Survey [SF-36]; Hannover Functional Ability Questionnaire for measuring back pain-related disability [FFbH-R]).
  
  
  OBJECTIVE
  Therapeutic climbing has been suggested to increase muscular strength and perceived physical and mental well-being. This study focused on the psychological effects of therapeutic climbing and compared it with standard exercise therapy.
  
  
  BACKGROUND
  Therapeutic climbing has become increasingly popular in rehabilitation and its effects on muscular strengthening have been shown. Therapeutic climbing has also been suggested to yield psychological effects such as changes in attentional focus from pain to physical capabilities. To date, no controlled clinical trial has investigated these psychological effects and it is unclear whether therapeutic climbing is comparable or superior to other forms of exercise.
  
  
  METHODS
  Twenty-eight patients with chronic low back pain conducted either a therapeutic climbing or a standard exercise regime. Each program took 4 weeks, including four guided training sessions per week. Before and after the program, patients answered two questionnaires assessing their physical and mental well-being.
  
  
  RESULTS
  For the Hannover Functional Ability Questionnaire for measuring back pain-related disability, there was no difference before versus after or between the treatments. For the SF-36, both treatments showed significant improvements in 3/8 subscales of the SF-36. In 2/8 subscales, only the participants of the therapeutic climbing improved and in 1/8 subscales the converse was true. Comparing both groups, significantly larger improvements were found after therapeutic climbing in two subscales of the SF-36: physical functioning and general health perception.
  
  
  CONCLUSIONS
  The benefits of therapeutic climbing were comparable with those of a standard exercise regime. In two subscales of the SF-36, the benefits of therapeutic climbing exceeded those of standard exercise therapy, primarily in perceived health and physical functioning of the patients. This finding demonstrates that therapeutic climbing is equivalent and partly superior to standard exercise therapy for patients with chronic low back pain.
authors.affiliation: Department of Sport Psychology, Technical University Munich, Munich, Germany. ke@kai-engbert-sportpsychologie.de
authors.forename: Kai
authors.initials: K
authors.lastname: Engbert
authors.forename: Michaela
authors.initials: M
authors.lastname: Weber
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods / Q000639:trends; D005260:Female; D006306:Health Surveys; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000534:rehabilitation* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009051:Mountaineering; D010147:Pain Measurement / Q000379:methods; D011795:Surveys and Questionnaires / Q000592:standards; D016896:Treatment Outcome