Although it is impossible to blind the participants and exercise coaches in this trial, the exercise coaches will be not involved in the assessment of outcome.
Whereas exercises in the trial by Holme et al. were supervised by physical therapists, 18 we used an unsupervised training programme.
A number of considerations went into designing the supervised exercise intervention in this trial.
5 The exercise regimen in this trial included careful instruction to focus on contracting trunk muscles in an attempt to maintain a stable core during all functional exercises, but we did not include a direct measure of core strength.
Both exercise programs in this trial are supervised, based on individualized goal-based patient treatment that allows the program to target the presenting musculoskeletal impairments that contribute to the patient's symptoms and functional limitations.
Exercise by itself did not significantly improve symptoms (the modest effect of exercise on pain in this trial was similar to its effect in other trials [ 81]).
Another consideration was selecting the type of exercises to be used in this trial.
While losing a little over one pound of fat per week is a decent result, the men taking part in this trial exercised for more than one hour, every single day, for three months.
Adherence to prescribed exercise was one main interest in this trial.
To mimic performance enhancement in sports, and possibly to boost the effect of the intervention, both exercise modalities will be used in this trial.
