Prevention and Treatment of Low Back Pain in Young Female TeamGym Gymnasts
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      Specific stabilization training targeting the deep trunk muscles has shown good effect in the
      rehabilitation of Low Back Pain (LBP) in young female TeamGym (TG) gymnasts. However, if this
      training can prevent LBP in this young population remains to be investigated. The aim of the
      present study was to investigate if a specific lumbar stabilization program can reduce and
      prevent LBP in young female TG gymnasts.
    

Detailed description: 
      Objectives: To study if a progressive specific lumbar stabilization program can reduce and
      prevent low back pain (LBP) in young female TeamGym (TG) gymnasts aged 10-16 years.

      Design A cluster randomized controlled intervention study

      Participants: All available competitive youth female TG teams including gymnasts aged 10-16
      years, in the area of Stockholm, were invited to participate in the present study. A team
      consists of approximately 16 gymnasts. Fourteen out of 17 teams and a total of 258 gymnasts
      accepted to participate. Gymnasts and parents were informed about the study and written
      consent was collected. A cluster randomization process was undertaken as follows: the
      gymnasts in each team answered questions at inclusion and the teams were matched with respect
      to age, level of competition, amount of training sessions per week and reports of LBP. LBP in
      this study was defined as; "pain between the 12th rib and the gluteal fold". Thereafter a
      cluster randomization took place. This means that all gymnasts in one team were either in the
      control or in the intervention group. There were no differences with respect to demographic
      and training data and reports of LBP between the two groups at randomization. Ninety gymnasts
      did not report LBP at inclusion or during baseline and were included in a subgroup analysis
      on the preventive effect of the exercise program.

      Methods Every week the gymnasts were visited by a registered physical therapist (RPT). The
      RPT answered questions from the gymnasts concerning injuries and collected a weekly-based
      questionnaire. The gymnasts in the intervention group were instructed to perform an
      eight-week progressive specific lumbar stabilization program, implemented in the warm-up at
      every training session. The gymnasts answered a weekly based questionnaire regarding training
      and LBP during the intervention period, and thereafter a questionnaire at 3-, 6- and 12
      months follow-up. The gymnasts and the coaches were also instructed to continue with the
      lumbar stabilization program after the intervention period.
    

Intervention name(s): A progressive specific lumbar stabilization program
Intervention type(s): Other
Intervention description(s): The aim of these programs is to optimize the stabilization and control of segmental motion of the lumbar spine. It is based on the draw-in action, hereafter called the abdominal hollowing, presented by Richardson and Jull (1995). The training program consists of three levels. Level 1 introduces the abdominal hollowing exercise in the prone and four-point kneeling position. Level 2 is a progression of these exercises and the gymnasts are also instructed to perform the abdominal hollowing standing on a balance board with slightly flexed knees while slowly moving the arms. Level 3 takes the training into sports specificity and the abdominal hollowing are to be held during three different basic trampette jumps with emphasis on good trunk and body control during jumping and landing.
Other intervention name(s): Draw-in-action, abdominal hollowing, core
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: stabilization training; abdominal hollowing; gymnastics