Table 1 Details of the Graded Activity Protocol
Pre Exercise Component | Description | Dosage/ Progression/Frequency |
|---|---|---|
1. 1. Home and work place visit | Researcher’s assessment of each patient’s physical work demands in terms of requirements for standing, standing and twisting, walking, sitting, sitting and twisting, lying, lying and twisting, kneeling, squatting, forward bending, backward bending, working with the arms above the shoulders, working with the hands above the shoulders, and working with the hands and arms without support. | Carried out at weeks 0, 4 and 8 of the study. |
2. 2. Back School | Patient taught the main content of the Nigerian Back School [23]. Contents included details of basic anatomy, functions of the muscles, functions of the back, and LBP disability treatments. Emphasis was placed on the body’s natural capacity for healing. Observed individual working postures and working techniques, both in the work place and at home were discussed in terms of biomechanical load. The advantages of PA and the damaging effects of poor posture and immobilization on muscles, tendons, joints, and discs were emphasized. | Carried out for 10 min during each treatment session at weeks 1 through to week 12 of the study. |
Exercise Component | ||
 1. Warm up | Comprised stretches and strolling at self-determined pace around the research venue. | 5 min |
 2. Aerobic training | Participants pedalled a bicycle ergometer (American fitness, Model YK-B28N) at an intensity of 50–80% of Heart Rate Reserve (HRR) | Pre-set baseline, week 5–8, and week 9–12 exercise goals set at: 50, 70 and 80% of HRR, respectively. |
 3. Abdominal sit up exercises | This was performed with the patient in supine lying; knees flexed, feet unsupported, hands stretched toward the knees. The trunk was then curled until the back has no support. | Pre-set baseline, week 5–8, and week 9–12 exercise goals set at: 1 set of 7–10 repetitions, 2 sets of 7–10 reps, and 3 sets of 7–10 reps, respectively. |
 4. Dynamic back extension exercise | With the patient lying prone, arms along the trunk, the trunk was raised until there was no contact between the chest and the support surface. | Pre-set baseline, week 5–8, and week 9–12 exercise goals set at: 1 set of 7–10 repetitions, 2 sets of 7–10 reps, and 3 sets of 7–10 reps, respectively. |
 5. Bent over row-dumb bells exercises | With two dumb bells held one in each hand, the patient bending forward through the hips, trunk upright knees slightly flexed and the dumb bells held hanging down by the side, patient was asked to flex the elbows while forearms were still held firmly to the trunk and thereafter extended the elbows. | One Repetition Maximum (1-RM) was determined by the Bryzcki’s formula (Bryzcki, 1993). Pre-set baseline, week 5–8, and week 9–12 exercise goals set at: 1 set of 7–10 repetitions, 2 sets of 7–10 reps, and 3 sets of 7–10 reps, respectively. |
 6. The squatting exercise | With the normal lordotic posture and an erect spine still maintained, patient was asked to flex the knees to a point where the tops of the thighs were parallel to the floor. | Pre-set baseline, week 5–8, and week 9–12 exercise goals set at: 1 set of 7–10 repetitions, 2 sets of 7–10 reps, and 3 sets of 7–10 reps, respectively. |
 7. Cool-down phase | Low intensity exercise and stretches | Five minutes. |