Low Back Pain

Effects and Mechanisms of Specific Trunk Exercises in Low Back Pain

Physical therapists from the Work Enhancement Rehabilitation Center will be joining clinicians from two Burlington-area physical therapy clinics to collaborate with Dr. Sharon Henry from the Department of Physical Therapy at the University of Vermont. (UVM) Dr. Henry recently received a 1.2 million-dollar grant from NIH/NICHD/ National Center for Medical Rehabilitation and Research to examine muscle function in people with low back pain (LBP). The long-term goal of this work is to gain a better understanding of the complex relationship between poor neuromuscular control and LBP, and the role that LBP plays in altering muscle function. This large clinical trial will address two treatment approaches that are currently available for this patient population. Ninety patients with low back pain (45 with spondylolisthesis and 45 with mechanical low back pain) will be tested on various postural tasks prior to starting a 10-session intervention; patients will be randomized to one of two treatment arms of the study. Following the intervention, subjects will return to the Human Motion Laboratory at UVM to repeat the same set of postural tasks. Subjects will be followed at 6, 12, 18 and 24 months post-treatment to gather information about pain, work status, and quality of life during this time period.

A total of three physical therapists from Fletcher Allen and three physical therapists from the two other Burlington physical therapy clinics will administer the two treatment protocols, both of which are currently used in the treatment of LBP. One treatment approach will focus on flexibility, strength and conditioning exercises while the other intervention will employ a low level isometric training of two trunk muscles, the transversus abdominus and the multifidus. Therapists will use ultrasound imaging to provide feedback and help study participants learn to activate these two trunk muscles correctly. To date we have completed a preliminary study with 12 patients who have received treatment and have undergone tests in the Human Motion Laboratory. This smaller study sets the groundwork for the larger NIH clinical trial that will commence later in 2003. For more information about the study or if you have a patient you would like to refer to the study, you can contact Stephanie Jones, MS at 802-656-1478 ( sljones@zoo.uvm.edu )