title: Resistance exercise, disability, and pain catastrophizing in obese adults with back pain.
abstract: OBJECTIVE
  The purpose of this study was to compare the effects of two different resistance exercise protocols on self-reported disability, fear avoidance beliefs, pain catastrophizing, and back pain symptoms in obese, older adults with low back pain (LBP).
  
  
  METHODS
  Obese adults (n = 49, 60-85 yr) with chronic LBP were randomized into a total body resistance exercise intervention (TOTRX), lumbar extensor exercise intervention (LEXT), or a control group (CON). Main outcomes included perceived disability (Oswestry Disability Index, Roland Morris Disability Questionnaire). Psychosocial measures included the Fear Avoidance Beliefs survey, Tampa Scale of Kinesiophobia, and Pain Catastrophizing Scale. LBP severity was measured during three functional tasks: walking, stair climbing, and chair rise using an 11-point numerical pain rating scale.
  
  
  RESULTS
  The TOTRX group had greater reductions in self-reported disability scores due to back pain (Oswestry Disability Index, Roland Morris Disability Questionnaire) compared with those in the LEXT (P < 0.05). The Pain Catastrophizing Scale scores decreased in the TOTRX group compared with that in the CON group by month 4 (64.3% vs 4.8%, P < 0.05). Pain severity during chair rise activity and walking was decreased in both the LEXT and TOTRX groups relative to the CON group.
  
  
  CONCLUSIONS
  Greater reductions in perceived disability due to LBP can be achieved with TOTRX compared with those achieved with LEXT. Pain catastrophizing and pain severity decreased most with TOTRX. The positive change in psychological outlook may assist obese, older adults with chronic back pain in reconsidering the harmfulness of the pain and facilitate regular participation in other exercise programs.
authors.affiliation: 1Department of Orthopaedics and Rehabilitation, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, FL; 2Department of Physical Therapy and Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL; and 3Departments of Anesthesiology, Psychiatry, Orthopaedics, and Neurology, University of Florida, Gainesville, FL.
authors.forename: Heather K
authors.initials: HK
authors.lastname: Vincent
authors.forename: Steven Z
authors.initials: SZ
authors.lastname: George
authors.forename: Amanda N
authors.initials: AN
authors.lastname: Seay
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Vincent
authors.forename: Robert W
authors.initials: RW
authors.lastname: Hurley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058443:Catastrophization / Q000209:etiology; D059350:Chronic Pain / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D059026:Diagnostic Self Evaluation; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000009:adverse effects; D005239:Fear; D005260:Female; D005684:Gait; D006801:Humans; D017116:Low Back Pain / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000523:psychology*; D010147:Pain Measurement; D055070:Resistance Training / Q000379:methods*; D057566:Self Report; D016138:Walking