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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.
Trial registration:
Identification number DRKS00010129. German Clinical Trial registered on 3 March 2016.
Background:
Exercising at intensities where fat oxidation rates are high has been shown to induce metabolic benefits in recreational and health-oriented sportsmen. The exercise intensity (Fat peak ) eliciting peak fat oxidation rates is therefore of particular interest when aiming to prescribe exercise for the purpose of fat oxidation and related metabolic effects. Although running and walking are feasible and popular among the target population, no reliable protocols are available to assess Fat peak as well as its actual velocity (V PFO ) during treadmill ergometry. Our purpose was therefore, to assess the reliability and day-to-day variability of V PFO and Fat peak during treadmill ergometry running.
Methods:
Sixteen recreational athletes (f = 7, m = 9; 25 ± 3 y; 1.76 ± 0.09 m; 68.3 ± 13.7 kg; 23.1 ± 2.9 kg/m 2 ) performed 2 different running protocols on 3 different days with standardized nutrition the day before testing. At day 1, peak oxygen uptake (VO 2peak ) and the velocities at the aerobic threshold (V LT ) and respiratory exchange ratio (RER) of 1.00 (V RER ) were assessed. At days 2 and 3, subjects ran an identical submaximal incremental test (Fat-peak test) composed of a 10 min warm-up (70 % V LT ) followed by 5 stages of 6 min with equal increments (stage 1 = V LT , stage 5 = V RER ). Breath-by-breath gas exchange data was measured continuously and used to determine fat oxidation rates. A third order polynomial function was used to identify V PFO and subsequently Fat peak . The reproducibility and variability of variables was verified with an int raclass correlation coef ficient (ICC), Pearson ’ s correlation coefficient, coefficient of variation (CV) an d the mean differences (bias) ± 95 % limits of agreement (LoA).
Results:
ICC, Pearson ’ s correlation and CV for V PFO and Fat peak were 0.98, 0.97, 5.0 %; and 0.90, 0.81, 7.0 %, respectively. Bias ± 95 % LoA was − 0.3 ± 0.9 km/h for V PFO and − 2±8%ofVO 2peak for Fat peak.
Conclusion:
In summary, relative and absolute reliability indicators for V PFO and Fat peak were found to be excellent. The observed LoA may now serve as a basis for future training prescriptions, although fat oxidation rates at prolonged exercise bouts at this intensity still need to be investigated.
Background
Recently, the incidence rate of back pain (BP) in adolescents has been reported at 21%. However, the development of BP in adolescent athletes is unclear. Hence, the purpose of this study was to examine the incidence of BP in young elite athletes in relation to gender and type of sport practiced.
Methods
Subjective BP was assessed in 321 elite adolescent athletes (m/f 57%/43%; 13.2 ± 1.4 years; 163.4 ± 11.4 cm; 52.6 ± 12.6 kg; 5.0 ± 2.6 training yrs; 7.6 ± 5.3 training h/week). Initially, all athletes were free of pain. The main outcome criterion was the incidence of back pain [%] analyzed in terms of pain development from the first measurement day (M1) to the second measurement day (M2) after 2.0 ± 1.0 year. Participants were classified into athletes who developed back pain (BPD) and athletes who did not develop back pain (nBPD). BP (acute or within the last 7 days) was assessed with a 5-step face scale (face 1–2 = no pain; face 3–5 = pain). BPD included all athletes who reported faces 1 and 2 at M1 and faces 3 to 5 at M2. nBPD were all athletes who reported face 1 or 2 at both M1 and M2. Data was analyzed descriptively. Additionally, a Chi2 test was used to analyze gender- and sport-specific differences (p = 0.05).
Results
Thirty-two athletes were categorized as BPD (10%). The gender difference was 5% (m/f: 12%/7%) but did not show statistical significance (p = 0.15). The incidence of BP ranged between 6 and 15% for the different sport categories. Game sports (15%) showed the highest, and explosive strength sports (6%) the lowest incidence. Anthropometrics or training characteristics did not significantly influence BPD (p = 0.14 gender to p = 0.90 sports; r2 = 0.0825).
Conclusions
BP incidence was lower in adolescent athletes compared to young non-athletes and even to the general adult population. Consequently, it can be concluded that high-performance sports do not lead to an additional increase in back pain incidence during early adolescence. Nevertheless, back pain prevention programs should be implemented into daily training routines for sport categories identified as showing high incidence rates.