Does aerobic training enhance effects of spa therapy in back pain patients? A randomized, controlled clinical trial

Objectives: The aim of the present study was to evaluate the effects of 3 weeks of individualized aerobic exercise training combined with conventional spa therapy on patients' assessment of chronic pain and quality of life. Patients and Methods: 44 patients of either sex and advanced age (50-70 years) with chronic pain underwent an inpatient spa therapy in Bad Tatzmannsdorf, Austria. Participants were randomized into 2 groups, a control group receiving spa therapy alone, and a training group carrying out an additional aerobic training. Every participant performed an exhaustive bicycle exercise test at the beginning of the study. Subsequently, participants of the training group performed individualized training programs, controlled and documented by ambulatory heart rate monitors. At the beginning and the end of the study the following outcome measures were assessed by use of questionnaires: positive and negative mood, general depression, health satisfaction, general pain, exhaustion, abdominal complaints, and cardiac pain. The results of the questionnaires were analyzed by use of a MANOVA to evaluate differences between the two groups. Results: We observed positive effects in all participants and on all parameters investigated after 3 weeks of spa therapy. However, no significant differences could be demonstrated between the two groups (all p > 0.05). Conclusion: Individualized aerobic training does not seem to enhance beneficial effects of a 3-week spa therapy on chronic pain and quality of life.