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Can exercise targeting mid-thoracic spine segmental movement reduce back pain and improve sensory perception in cross-country skiers?
Kobesova A, Andel R, Cizkova K, Kolar P, Kriz J
Clinical Journal of Sport Medicine 2021 Mar;31(2):e86-e94
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To assess the role of exercise targeting proper trunk stabilization and segmental spinal movement in back pain and sensory perception among cross-country skiers. DESIGN: Randomized, controlled trial with blinded outcome assessors. SETTING: University Hospital, Department of Rehabilitation and Sports Medicine. PARTICIPANTS: Twenty elite cross-country skiers aged 17 to 27 years. INTERVENTIONS: Ten cross-country skiers integrated 3 types of exercise targeting segmental motion in mid-thoracic spine into their routine training practice for 2 months. The 10 controls performed routine athletic training. MAIN OUTCOME MEASURES: The Young Spine Questionnaire to measure intensity and frequency of back pain was completed at the start and end of study. Tactile sensory perception using 10-g Semmes-Weinstein monofilament, thermic perception using TIP THERM device, graphesthesia assessed by a touch monitor pencil, 2-point discrimination assessed by a digital caliper, and vibration perception assessed by a 128-Hz tuning fork measured in mid-thoracic spine 5 times. RESULTS: No significant group differences in pain and sensory perception were identified at baseline. Over the 2-month study interval, repeated-measures analysis of variance revealed that the experimental group improved significantly relative to the control group on pain intensity (p = 0.005 for cervical, p = 0.004 for thoracic, and p = 0.014 for lumbar) and frequency of pain in the thoracic area only (p = 0.011). Improvements were also observed in the experimental relative to control group on graphesthesia (p < 0.001), vibration perception (p = 0.002), and 2-point discrimination (p < 0.001). CONCLUSIONS: Exercise targeting the mid-thoracic spine may decrease back pain and improve sensory perception in cross-country skiers. LEVEL OF EVIDENCE: Original research, level I.
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