Refine
Has Fulltext
- no (13) (remove)
Language
- English (13)
Is part of the Bibliography
- yes (13)
Keywords
- Exercise (13) (remove)
Background: Arising from the relevance of sensorimotor training in the therapy of nonspecific low back pain patients and from the value of individualized therapy, the present trial aims to test the feasibility and efficacy of individualized sensorimotor training interventions in patients suffering from nonspecific low back pain. Methods and study design: A multicentre, single-blind two-armed randomized controlled trial to evaluate the effects of a 12-week (3 weeks supervised centre-based and 9 weeks home-based) individualized sensorimotor exercise program is performed. The control group stays inactive during this period. Outcomes are pain, and pain-associated function as well as motor function in adults with nonspecific low back pain. Each participant is scheduled to five measurement dates: baseline (M1), following centre-based training (M2), following home-based training (M3) and at two follow-up time points 6 months (M4) and 12 months (M5) after M1. All investigations and the assessment of the primary and secondary outcomes are performed in a standardized order: questionnaires - clinical examination biomechanics (motor function). Subsequent statistical procedures are executed after the examination of underlying assumptions for parametric or rather non-parametric testing. Discussion: The results and practical relevance of the study will be of clinical and practical relevance not only for researchers and policy makers but also for the general population suffering from nonspecific low back pain.
Objectives: To compare the impact of short term training with resistance plus plyometric training (RT+P) or electromyostimulation plus plyometric training (EMS+P) on explosive force production in elite volleyball players. Design: Sixteen elite volleyball players of the first German division participated in a training study. Methods: The participants were randomly assigned to either the RT+P training group (n = 8) or the EMS+P training group (n= 8). Both groups participated in a 5-week lower extremity exercise program. Pre and post tests included squat jumps (Si), countermovement jumps (CMJ), and drop jumps (DJ) on a force plate. The three-step reach height (RH) was assessed using a custom-made vertec apparatus. Fifteen m straight and lateral sprint (S15s and S15l) were assessed using photoelectric cells with interims at 5 m and 10 m. Results: RT+P training resulted in significant improvements in Si (+2.3%) and RH (+0.4%) performance. The EMS+P training group showed significant increases in performance of CMJ (+3.8%), DJ (+6.4%), RH (+1.6%), S15l (-3.8%) and after 5 m and 10 m of the S15s (-2.6%; -0.5%). The comparison of training-induced changes between the two intervention groups revealed significant differences for the Si (p = 0.023) in favor of RT+P and for the S15s after 5 m (p = 0.006) in favor of EMS+P. Conclusions: The results indicate that RT+P training is effective in promoting jump performances and EMS+P training increases jump, speed and agility performances of elite volleyball players. (c) 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges.
Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S).
Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined.
Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly.
Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments.