Intervention
chronic pain, pain, NLBP
CHRONIC PAIN
The intervention consisted of a novel and original programme based on the BSP, which follows the recommendations of the biopsychosocial model of chronic pain [Summary of the intervention and procedure(a) Theoretical sessions: The first session aimed to explain basic concepts of anatomy and biomechanics of the spine with the help of anatomical models and videos, and to inform about erroneous catastrophic beliefs about the causes and origin of NLBP. The second session aimed to easily explain the main psychosocial factors that can influence the perception of pain, such as emotions or previous experiences of pain, by means of pictures and examples.(b) Practical sessions: The practical sessions followed a structured format, consisting of four parts: doubts, warm-up, main part, and cool-down. The first part, lasting approximately three minutes, allowed participants to ask questions and review the fundamental principles of each exercise. In sessions where no doubts were raised, the physiotherapist utilized this time to inquire about the topics covered in the theoretical classes, aiming to reinforce knowledge integration between theory and practice.The warm-up phase lasted seven minutes and involved joint mobility exercises. The main part of the session spanned 30 min and included a variety of exercises such as squats, isometric abdominal exercises, alternative arm/leg extensions, lateral trunk/leg raises, arm/leg raises, shoulder bridges, abdominal exercises with controlled exhalation, oblique abdominal exercises with controlled exhalation, rolling onto the back, abdominal exercises raising opposite arm/leg with controlled exhalation, rolling from one sacroiliac joint to the other, abdominal exercises with controlled exhalation and leg raise to 45º, alternate leg lifts with spine elongation, alternate arm/leg lifts with spine elongation, and simultaneous arm/leg lifts with spine elongation. Throughout this phase, exercises aimed to activate the trunk stabilizing muscles were interspersed with active breaks consisting of gentle stretching and joint mobility exercises.For the first five practical classes, exercises were performed without any equipment. In the subsequent three sessions, a light resistance band was introduced as an implement. Sessions 12, 13, and 14 incorporated the use of a half-kilogram toning ball, while the last three classes utilized a one-kilogram dumbbell for resistance.The cool-down phase lasted five minutes and focused on flexibility, breathing exercises, and relaxation techniques. Practical sessions were conducted in groups, with a maximum of 10 participants.