THU0331 Tramadol Effects on Exercise Capacity in Patients with Low Back Pain

2014 
Background Pain is one of the most important factors limiting exercise capacity. Low back pain is a very common problem and a major cause of disability among adults worldwide. The lifetime prevalence of non-specific low back pain is estimated at 60%>70% amoung industrialized countries. Tramadol is a centrally acting analgesic used all over the world to alleviate acute or chronic pain of moderate to severe intensity. In a previous experimental study it has been shown that tramadol improves exercise capacity, neuro-psychological state and oxidants/antioxidants balance in exercise trained rats. Objectives Our study goal was to assess Tramadol effects on exercise capacity in patients with low back pain. Methods A number of 16 patients with middle intensity non-specific low back pain joined the study for a period of 7 days. These patients were divided in two groups: test group (8 patients received 50 mg of tramadol twice a day for 7 days) and control group (8 patients received placebo following the same procedure and equivalent quantity). All patients were tested using cycle ergometer with progressively increasing work-rate exercise test at baseline and after 7 days of treatment. We investigated exercise duration (time), the moment of lactate threshold (LT), peak oxygen uptake (VO 2 max), aerobic contribution to exercise and ventilatory efficiency for each patient at baseline and after 7 days. Results The groups were homogenous regarding age and all evaluated parameters at baseline. Exercise duration and lactate threshold moment significantly improved for patients having received tramadol (p=0,0039). Peak oxygen uptake, VO 2 max was greater for test group but in a non-significant manner. Aerobic contribution to exercise improved for patients in test group (p=0,0195) and was significantly lower in control group (p=0,0039). Ventilatory efficiency also improved for test group at the end of the study (p=0,0078). Conclusions Tramadol administration to patients with low back pain improved exercise capacity and effort tolerance. References www.who.int Tache S, Staicu LM. The organism adaptation to physical exercise. Risoprint Ed. Cluj-Napoca; 2011. David CT, David I, Tache S, Moldovan R. Tramadol influence upon maximal aerobe exercise capacity and upon pain threshold on traine rats. IIIrd Millenium Palestrica. 2007; 28(2):108-112. Barrett KE, Barman SM, Boitano S, Brooks HL. Ganong9s Review of Medical Physiology, ed. 23a. Ed. McGraw Hill, Singapore. 2010; 167-171. Ionescu AM, Tache S, Berteanu M. Biochemichal and physiological basis of muscle pain. IIIrd Millenium Palestrica. 2012; 13(1):48-51. Wassermann K et al. Principles of exercise testing and interpretation, 5th ed. Lippincott WW 12(1): 11-14. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.1439
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