Evaluation of neuro-muscular trunk stabilization functions and development of exercise programs for lower back pain prevention

Client ID: Agencija za raziskovalno dejavnost RS
Project type: Basic Research and Application Project
Project duration: 2011 - 2014

Collaborators on project

Low back pain (LBP) is the most common health problem associated with the locomotor system in the developed world, affecting 70-85% of people at least once in a lifetime. LBP reduces the quality of life, being the second most common reason for absence from work and as such it is a major socio-economic problem in most developed countries (in the EU - billions €/year). The purpose of our project is to upgrade objective evaluation and preventive measures for LBP. This will be done through comprehensive investigation of alterations of neuromuscular functions (NMF) in LBP. In addition to standard statistics, we will use the methods of artificial intelligence, so as to construct predictive, expert and descriptive models for LBP. The project will be implemented over the period of three years and will be divided into three thematic sections of 12 months.

The first thematic section will consist of two studies in which we will verify the objectivity, reliability and validity of tests for the evaluation of NMF of the lumbar body region. The subjects will be healthy young adults of both sexes (n = 30). The aim of the first study is to develop comprehensive protocols for reliable evaluation of all key aspects of NMF of the trunk: maximal voluntary force, endurance in sustained force, automatic pre-programmed and reactive stabilizing muscle actions, kinaesthesia and balance. The aim of the second study is to investigate the existence of synergistic muscle activation patterns and develop valid methods of non-invasive monitoring/forecasting of deep muscle activations in the tasks of dynamic stabilization of the lumbopelvic region. On the basis of the results of these studies, we will determine the testing protocols for subsequent stages of the project.

The second thematic section will comprise two studies, the aim of which will be to find the parameters of NMF of the trunk that are presumably altered in subjects (n = 120-150) of the two groups of workplaces with an increased risk of LBP (i.e., sedentary and physically demanding occupations). At the same time, our aim is to identify the parameters of the NMF of the trunk in which people with chronic LBP differ from those of similar occupations without chronic LBP. The objective of this thematic section is to develop models based on the data related to NMF of the trunk and on an objectified ergonomic assessment of the workplace that will enable us to predict the probability of LBP in various occupations. This would allow for an early detection of irregularities and risk factors for LBP as well as for early preventive measures.

In the third thematic section, a study will be carried out on subjects suffering from chronic LBP (n = 80-90). We will investigate the efficiency of two types of exercise programmes aimed at alleviating chronic LBP. Both exercise programmes will take into account the importance of a proper selection of the contents, quality and quantity of exercise as well as the principle of gradual progression in exercise difficulty. The ultimate goal of this thematic section is to create a set of models to aid in the selection, planning and implementation of the most effective exercise methods in chronic LBP.

Work on the project will be divided into five work packages aimed at organization, data acquisition, implementation of the exercise programme, data processing, and dissemination. The studies will be conducted in accordance with ethical principles and legislation on personal data protection.

In consistence with the directions for modern scientific research, the project will aim to transfer new scientific findings, modern measurement and intervention/training technologies and services into practice. The numerous applied results of our project will be developed into widely accessible products that will contribute to a more effective treatment of LBP as a problem of exceptional proportions. Scientific findings will be published at the international level.