Physical Therapy Intervention in Dental Students

Study Overview
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Brief Summary
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The main purpose of our study is to assess whether guided strength training and stretching intervention with a written home exercise program is more effective than a home exercise program alone for pre-clinical dental students in improving and preventing pain associated with dental laboratory practice. Secondary aims will be to assess relationships between strength and quality of life measures of an individual and pain levels.

Detailed Description
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Musculoskeletal (MSK) pain has been identified as a major concern among dental professionals. This can lead to decreased productivity, efficiency and quality of work along with higher costs for the medical system. The body region that is affected the most is the neck, followed by the back and shoulders. Ergonomic assessments and interventions can identify the areas of concern with workplace set up, however, training the muscles to adapt to abnormal postures may be an effective way of increasing the resilience of the MSK system while decreasing MSK pain as well. Specifically, strength training and stretching has been well researched as a way to prevent and improve pain for neck pain, low back pain and shoulder pain. Physical therapists are well trained in prevention and treatment of injuries, including a wealth of knowledge regarding strength training and stretching for specific regions. The main purpose of our study is to assess whether guided strength Thus, the main purpose of our study is to assess whether guided strength training and stretching intervention with a written home exercise program is more effective than a home exercise program alone for pre-clinical dental students in improving and preventing pain associated with dental laboratory practice. The secondary aim will be to assess the relationships between strength and quality of life measures of an individual and pain levels.

Official Title
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Effectiveness of Physical Therapy Intervention in Pre-Clinical Dental Students

Conditions
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Pain, Strength, Quality of Life

Intervention / Treatment
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* Procedure: Supervised exercise + home exercise program
* Procedure: Home exercise program only


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults ages 18+ Current 2nd year university dental students Exclusion Criteria: Any type of musculoskeletal surgery in the past 6 months

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Supervised exercise + home exercise program<br>The intervention group (supervised exercise) which will receive supervised strengthening and stretching exercises by a licensed physical therapist in a group setting 2 times per month for 30 minutes each session as well as a home exercise program with general stretching and strengthening exercises for various body parts (focusing on neck, thoracic spine, lumbar spine, shoulder and hand/wrist) that will be identical to the home exercise program only group. | Procedure: Supervised exercise + home exercise program<br>* The supervised exercise + home exercise program group will receive a written home exercise program with general stretching and strengthening exercises for the neck, thoracic spine, lumbar spine, shoulder and hand/wrist. They will also be provided with two supervised exercise sessions per month delivered in a group setting in order to ensure proper performance of the home exercise programs.<br>|
| Active Comparator: Home exercise program only<br>The home exercise program only group will be provided with a written home exercise program consisting of general stretching and strengthening exercises for various body parts (focusing on neck, thoracic spine, lumbar spine, shoulder and hand/wrist). The exercise programs will be identical for both the supervised exericse and the home exercise program only groups. | Procedure: Home exercise program only<br>* The home exercise program only group will receive a written home exercise program with general stretching and strengthening exercises for the neck, thoracic spine, lumbar spine, shoulder and hand/wrist, without any supervised guidance on exercise performance.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient-Reported Outcomes Measurement Information System (PROMIS) | PROMIS® is a publicly available system of highly reliable, precise measures of patient-reported health status for physical, mental, and social well-being. This will be measured via electronic survey. | Baseline | 
| Patient-Reported Outcomes Measurement Information System (PROMIS) | PROMIS® is a publicly available system of highly reliable, precise measures of patient-reported health status for physical, mental, and social well-being. This will be measured via electronic survey. | Intervention conclusion (7 months) | 
| Patient-Reported Outcomes Measurement Information System (PROMIS) | PROMIS® is a publicly available system of highly reliable, precise measures of patient-reported health status for physical, mental, and social well-being. This will be measured via electronic survey. | 11 months | 
| Pain Intensity | Visual analog scale (0-10 rating) | Baseline | 
| Pain Intensity | Visual analog scale (0-10 rating) | Intervention conclusion (7 months) | 
| Pain Intensity | Visual analog scale (0-10 rating) | 11 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pec Minor Length Test | Supine measurement in centimeters from table | Baseline, intervention conclusion (7 months), and 4 month follow up prior to beginning clinical rotations. | 
| Pec Minor Length Test | Supine measurement in centimeters from table | Intervention conclusion (7 months) | 
| Pec Minor Length Test | Supine measurement in centimeters from table | 11 months | 
| Middle Trapezius Manual Muscle Test | Patient prone with arms abducted to 90 degrees and externally rotated, resisting horizontal adduction. Measured in lbs or Newtons using a handheld dynamometer. | Baseline | 
| Middle Trapezius Manual Muscle Test | Patient prone with arms abducted to 90 degrees and externally rotated, resisting horizontal adduction. Measured in lbs or Newtons using a handheld dynamometer. | Intervention conclusion (7 months) | 
| Middle Trapezius Manual Muscle Test | Patient prone with arms abducted to 90 degrees and externally rotated, resisting horizontal adduction. Measured in lbs or Newtons using a handheld dynamometer. | 11 months | 
| Lower Trapezius Manual Muscle Test | Patient prone with arms abducted 120 degrees and externally rotated, resisting downward force. Measured in lbs or Newtons using a handheld dynamometer. | Baseline | 
| Lower Trapezius Manual Muscle Test | Patient prone with arms abducted 120 degrees and externally rotated, resisting downward force. Measured in lbs or Newtons using a handheld dynamometer. | Intervention conclusion (7 months) | 
| Lower Trapezius Manual Muscle Test | Patient prone with arms abducted 120 degrees and externally rotated, resisting downward force. Measured in lbs or Newtons using a handheld dynamometer. | 11 months | 
| Cervical Flexor Endurance Test | Patient in supine will be asked to tuck the chin and lift their head maintaining the chin tuck. Measured in seconds for as long as they can maintain appropriate quality of movement. | Baseline | 
| Cervical Flexor Endurance Test | Patient in supine will be asked to tuck the chin and lift their head maintaining the chin tuck. Measured in seconds for as long as they can maintain appropriate quality of movement. | Intervention conclusion (7 months) | 
| Cervical Flexor Endurance Test | Patient in supine will be asked to tuck the chin and lift their head maintaining the chin tuck. Measured in seconds for as long as they can maintain appropriate quality of movement. | 11 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dental students, Supervised exercise, Home exercise program, Strength, Quality of life