Background: Individuals with chronic primary low back pain (CPLBP) exhibit high levels of sedentary behavior and spend small time in physical activity, which might lead to excessive weight gain [1]. A combination of supervised exercise and mindfulness might be effective to improve body composition in these individuals.

Objectives: To compare the effects of a supervised exercise and a multimodal approach (supervised exercise+mindfulness) compared to a usual rehabilitation care group on body composition in individuals with CPLBP.

Methods: From 105 participants recruited and randomized, a total of 53 individuals with CPLBP aged 52±9 years attended >65% of the program and completed all the assessments: control group (CG, n =20), exercise group (EG, n =13) and exercise+mindfulness group (EMG, n =20). All groups received an 8-week intervention program twice a week for 45 minutes/session. The CG followed usual rehabilitation care (stretching, breathing and motor control exercises in different positions). The EG and EMG received a supervised exercise intervention program focused on muscle strengthening exercises. Additionally, the EMG attended a mindfulness program once a week for 2.5 hours/session. Body weight (kg), fat (%) and muscle (%) were measured with an 8-point tactile-electrode bioimpedance (InBody R20). Height was measured with a height rod. Body mass index (BMI) was calculated as weight/height². Neck and waist circumferences were measured with a measuring tape (Holtain 110P). All groups completed three assessments before (pre) and after (post) the intervention program and after a detraining period (re) of 3 months.

Results: Repeated measures analysis of variance (ANOVA) showed that the CG exhibited an increase in waist circumference following the intervention (post-pre mean difference (MD)=2.20; 95% confidence interval (CI)=0.70,3.7; p =0.06). In the EG, a reduction in neck circumference was observed (-0.36; -0.69, -0.03; p =0.037). For the EMG, both neck circumference and BMI decreased following the intervention (-0.47; -0.90, -0.03; p =0.038 and -0.41; -0.72, -0.10; p =0.012, respectively). After the detraining period, the CG showed a reduction in neck circumference (-0.70; -1.32, -0.08; p =0.030) and an increase in waist circumference (3.6; 2.34, 4.84; p <0.001). No significant differences were detected within groups for the remaining outcomes (all, p >0.05). Analysis of covariance (ANCOVA) showed a greater decrease in waist circumference changes from baseline (post-pre) in the EMG compared to the CG (between-group MD=-3.72; 95% CI=-6.26, -1.18; p =0.002). BMI changes from baseline (post-pre) differed between the EMG and EG, with the EMG showing a greater reduction (-0.54; -0.25,-1.1; p =0.037). After the detraining period, waist circumference changes from baseline (re-pre) were lower in the EMG compared to the CG (-3.29; -6.07, -0.52; p =0.015). Additionally, BMI changes from baseline (re-pre) differed between the EMG and EG, with the EMG showing a greater reduction (-0.89; -1.71, -0.07; p =0.028). No significant differences were found between groups for other variables (all, p >0.05).

Conclusion: The intervention resulted in significant reductions in waist circumference and BMI in the EMG compared to the CG and EG, respectively, both immediately post-intervention and after the detraining period. These findings suggest that combining exercise with mindfulness can enhance anthropometric outcomes, particularly BMI and waist circumference, with sustained effects post-detraining. However, no significant differences were observed for other outcomes, indicating the need for further investigation.

REFERENCES: [1] Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: An overview of Cochrane Reviews. Cochrane Database of Systematic Reviews 2017;2017. https://doi.org/10.1002/14651858.CD011279.pub3 .

Acknowledgements: Authors greatly appreciate participant involvement and ongoing dedication in the studies processes. This study was supported by the Instituto de Salud Carlos III through the research contract Miguel Servet (CP20/00178) co-funded by European Social Fund. Furthermore, GT was supported by the Instituto de Salud Carlos III through the PFIS contract (FI23/00034) co funded by European Social Fund+.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.