Clinical trial NCT03831867: Changes in Sagittal Spine Posture and Flexibility on Adolescents
Official title: Effectiveness of Pilates on Sagittal Spine Posture, Flexibility, Back Pain, Quality of Life and Anthropometrics Variables on Adolescents: A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Adolescent Behavior
Keywords: spine
extensibility
children
health
pilates
exercise
physical activity
physical education
Lead sponsor: Universidad Católica San Antonio de Murcia
Sponsor class: OTHER
First posted: 2019-02-06
Enrollment: 286
Sex: ALL
Minimum age (years): 11
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Several research show a high prevalence of spinal misalignments and a lack of stability of the spine in the adolescent population. In addition, back pain in adolescents is correlated with a longer time spent in sedentary activities, less time of physical activity, higher BMI, body fat percentage and / or the waist-hip index.

Therefore, the main aim of this project were assess the effect of a 10-minute Pilates program carried out in the final part of the Physical Education sessions for 4.5 months and 9 months on back pain, quality of life, sagittal spine curvature, hamstring extensibility, BMI, body fat percentage and the waist-hip index.

The present research will be elaborated by a quasi-experimental design, with experimental group (GE) and control group (CG); with pre-test, intermediate and post-test.

The inclusion criteria will be: a) being in Compulsory Secondary Education; b) not present any musculoskeletal, neurological, cardiological, metabolic, rheumatic or previous history of spinal pathologies or with previous treatment; c) be active in the sessions of Physical Education.

It was assessed back pain with Back Pain Survey in adolescents. Quality of life was assessed through the Kidscreen-27 questionnaire. To assess the sagittal spinal curvatura (in several positions) the Spinal Mouse System (Idiag, Fehraltdorf, Switzerland) was used.

The extensibility of hamstring muscle was assessed with seat and reach test, toe touch test and active and passive straight leg raising test.

The sedentary lifestyle as well as the level of physical activity will be evaluated through the Adolescent International Physical Activity Questionnaire (IPAQ).

The body mass index will be obtained by recording weight and height (BMI = Weight (kg) / height (cm) 2).

The waist-hip ratio is the quotient between waist and hip circumferences, which is an indirect marker of intra-abdominal obesity.

The intervention program consisted on performance of exercises of the Pilates Method during the sessions of Physical Education, 32 weeks, two weekly sessions, 10 minutes.

Detailed description: A history of back pain during adulthood is related to a history of back pain during adolescence. Therefore, preventing back pain in adolescents helps to prevent their appearance in adulthood. Sagittal spinal misalignments and stability of the spine are in connection with back pain in adolescents. In addition, they influence on several spinal pathologies and decrease the functional capacity and quality of life of adolescents.

Therefore, the objectives of the following project were: a) assess back pain in schoolchildren and check their relationship with quality of life, sagittal spine curvature, extensibility of the hamstring muscles, sedentary lifestyle, physical activity, BMI , percentage of body fat and the waist-hip index; b) measure the sagittal spinal curvature of the schoolchildren, the quality of life and the prevalence of physical activity among adolescents and check their relationship with the hamstring extensibility, sedentary lifestyle, the BMI , percentage of body fat and the waist-hip index; c) analyze the effect of a 10-minute Pilates program carried out in the final part of the Physical Education sessions for 4.5 months and 9 months on back pain, quality of life, sagittal spinal curvatures, the hamstring flexibility, the BMI, the percentage of body fat and the waist-hip index.

The present investigation will be elaborated by a quasi-experimental design, with experimental group (GE) and control group (CG); with pre-test, intermediate and post-test, with analysis of intra-group and inter-group measurements for each of the dependent variables selected in the study.

The inclusion criteria will be: a) being in Compulsory Secondary Education; b) not present any musculoskeletal, neurological, cardiological, metabolic, rheumatic or previous history of spinal pathologies or with previous treatment; c) be active in the sessions of Physical Education.

It was assessed back pain with Back Pain Survey in adolescents. Quality of life was assessed through the Kidscreen-27 questionnaire. To assess the sagittal spinal curvatura (in several position) the Spinal Mouse System (Idiag, Fehraltdorf, Switzerland) was used.

The extensibility of hamstring muscle was assessed with seat and reach test, toe touch test and active and passive straight leg raising test.

The sedentary lifestyle as well as the level of physical activity will be evaluated through the Adolescent International Physical Activity Questionnaire (IPAQ).

The body mass index will be obtained by recording weight and height (BMI = Weight (kg) / height (cm) 2).

The waist-hip ratio is the quotient between waist and hip circumferences, which is an indirect marker of intra-abdominal obesity.

The intervention program consisted in the realization of exercises of the Pilates Method during the sessions of Physical Education. The duration of the program will be 32 weeks, with a frequency of two weekly sessions and a duration per intervention of 10 minutes. During this time the experimental group developed the intervention program with the Pilates Method and the control group carried out their usual sessions of Physical Education . All students to be taken into account in the research must have attended and conducted the practice at least 80% of sessions. The program consisted of four Pilates exercises, planned with a basic-intermediate level, gradually incorporating the Principles of the Pilates Method and increasing the intensity of the exercises. Among these four exercises, two focus on the work of the resistance of the flexor muscles of the trunk, one in the work of the resistance of the trunk extensor musculature and another in the work of hamstring extensibility.The exercises will be performed in cool down of the sessions of Physical Education.

Eligibility criteria: Inclusion Criteria:

* be enrolled in Compulsory Secondary Education
* be active in the sessions of Physical Education.

Exclusion Criteria:

* presenting any musculoskeletal, neurological, cardiological, metabolic or rheumatic alteration
* missing more than one session of the programme (91.66% attendance)

Primary outcomes:
measure: Change Sagittal spinal curvature
timeFrame: Change from Baseline Sagittal spinal curvature at 4,5 month and at 9 month
measure: Change Hamstring extensibility - active straight leg raising test.
timeFrame: Change from Baseline hamstring extensibility at 4,5 month and at 9 month
measure: Change Hamstring extensibility - passive straight leg raising test.
timeFrame: Change from Baseline Hamstring extensibility at 4,5 month and at 9 month
Secondary outcomes:
measure: Change Back pain, physical activity and sedentary behaviour (questionnaire)
timeFrame: Change from Baseline Sagittal spinal curvature at 4,5 month and at 9 month
measure: Change Quality of life: Kindscreem 27 questionnaire
timeFrame: Change from Baseline Back pain, physical activity and sedentary behaviour at 4,5 month and at 9 month
measure: Change Body mass index
timeFrame: Change from Baseline Body mass index at 4,5 month and at 9 month
measure: Change Waist-hip ratio
timeFrame: Change from Baseline Waist-hip ratio at 4,5 month and at 9 month
measure: Change Hamstring extensibility Seat and Reach test
timeFrame: Change from Baseline Hamstring extensibility at 4,5 month and at 9 month
measure: Change Hamstring extensibility Toe touch test
timeFrame: Change from Baseline Hamstring extensibility at 4,5 month and at 9 month
measure: Change Level of physical activity - Adolescent International Physical Activity Questionnaire (IPAQ).
timeFrame: Change from Baseline Level of physical activity at 4,5 month and at 9 month
Other outcomes:
Locations:
Study officials:
affiliation: UCAM
name: Noelia G Gálvez, PhD.
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Miranda IF, Souza C, Schneider AT, Chagas LC, Loss JF. Comparison of low back mobility and stability exercises from Pilates in non-specific low back pain: A study protocol of a randomized controlled trial. Complement Ther Clin Pract. 2018 May;31:360-368. doi: 10.1016/j.ctcp.2017.12.005. Epub 2017 Dec 8.
citation: Gonzalez-Galvez N, Marcos-Pardo PJ, Carrasco-Poyatos M. Functional improvements after a pilates program in adolescents with a history of back pain: A randomised controlled trial. Complement Ther Clin Pract. 2019 May;35:1-7. doi: 10.1016/j.ctcp.2019.01.006. Epub 2019 Jan 10.
citation: Gonzalez-Galvez N, Marcos-Pardo PJ, Albaladejo-Saura M, Lopez-Vivancos A, Vaquero-Cristobal R. Effects of a Pilates programme in spinal curvatures and hamstring extensibility in adolescents with thoracic hyperkyphosis: a randomised controlled trial. Postgrad Med J. 2022 Mar 31:postgradmedj-2021-140901. doi: 10.1136/postgradmedj-2021-140901. Online ahead of print.