Physiology And Pathophysiology Of Trunk Control Mechanisms
Funder
National Health and Medical Research Council
Funding Amount
$168,958.00
Summary
The overall aim of this series of experiments is to understand how the spine is controlled and how this changes in disease. Altered control has been identified in people with low back pain, yet we still know very little about the normal mechanisms for protection and support of the spine. Back pain is a common affliction that affects about 5% of Australians each year and is the most common and expensive work-related injury in western society. An understanding of normal control and the mechanism o ....The overall aim of this series of experiments is to understand how the spine is controlled and how this changes in disease. Altered control has been identified in people with low back pain, yet we still know very little about the normal mechanisms for protection and support of the spine. Back pain is a common affliction that affects about 5% of Australians each year and is the most common and expensive work-related injury in western society. An understanding of normal control and the mechanism of dysfunction is critical for identification of risk factors and development of strategies for rehabilitation and prevention. The experiments are divided into two series. The first series addresses normal spinal control. The questions to be asked deal with how the brain copes with the challenge of using trunk muscles for breathing and spinal control at the same time, how the activity of the trunk muscles is affected by input from sensory receptors in the joints, ligaments and muscles of the spine, and whether intra-abdominal pressure can support the trunk. The second series deals with clinical populations. The first aim is to identify whether people with respiratory diseases use trunk muscles for spinal control and breathing at the same time. If they cannot, we predict that they will be more prone to low back pain. We will test this in a large study of incidence of low back pain in people with and without respiratory disease. The second study will investigate the pelvic floor muscles which are important for continence and assist with spinal control. We will investigate whether people with incontinence have poor spinal control and whether this leads to back pain. The final experiment will identify whether people with low back pain interpret sensory information from the spine differently. By answering these questions we hope to intervene in the enormous personal, social and economic consequences of LBP which affects between 60-90% of the population at some stage in their life.Read moreRead less
The Efficacy Of Manipulation For Recent Onset Neck Pain
Funder
National Health and Medical Research Council
Funding Amount
$393,974.00
Summary
Neck pain is extremely common, with a point prevalence of 46% in the general community. Neck pain can cause significant disability, and is the second most common injury causing people to take time off work. Neck pain and its associated disability clearly poses a substantial social and economic burden. Neck manipulation (high velocity thrust of the joints, often associated with a click) is widely used by physiotherapists for the management of recent onset neck pain, but there is no clear evidence ....Neck pain is extremely common, with a point prevalence of 46% in the general community. Neck pain can cause significant disability, and is the second most common injury causing people to take time off work. Neck pain and its associated disability clearly poses a substantial social and economic burden. Neck manipulation (high velocity thrust of the joints, often associated with a click) is widely used by physiotherapists for the management of recent onset neck pain, but there is no clear evidence for its efficacy. In addition, the use of manipulation is associated with serious, although rare, adverse events such as stroke or even death. The risk-benefit analysis, therefore, does not clearly favour manipulation because efficacy has not been established, while the risks are serious, but infrequent. The findings of the proposed study will clearly and precisely determine the efficacy of manipulation compared with the safer treatment technique of mobilisation (gentle oscillatory pressure applied to the joints), information that is currently unavailable. This information is of vital importance to many different disciplines, including health professionals, insurance companies, and to administrators for development of health policy. Our findings will thus provide evidence-based guidelines for the use of manipulation, and will ultimately lead to safer practice of physiotherapy for neck pain.Read moreRead less
Low back pain (LBP) is highly prevalent and enormously expensive to society: total payments made by Workcover for injuries to the low back were in excess of $530 million in NSW in 1996. Chronic LBP (pain lasting more than 3 months) accounts for up to 90% of these costs. Prevention of a large part of this costly problem could be achieved by effective treatment at the earlier sub-acute phase of LBP (6 weeks to 3 months duration). Exercise and advice are two widely-used treatments for sub-acute LBP ....Low back pain (LBP) is highly prevalent and enormously expensive to society: total payments made by Workcover for injuries to the low back were in excess of $530 million in NSW in 1996. Chronic LBP (pain lasting more than 3 months) accounts for up to 90% of these costs. Prevention of a large part of this costly problem could be achieved by effective treatment at the earlier sub-acute phase of LBP (6 weeks to 3 months duration). Exercise and advice are two widely-used treatments for sub-acute LBP, yet remarkably, their efficacy is unknown. For the first time, this study will rigorously evaluate the effectiveness of both a supervised exercise program and advice to return to normal activity for sub-acute LBP. When this study is completed, Australian practitioners will be able to adopt evidence based practice when managing sub-acute LBP. In addition, the study's results will enable practitioners to select the most effective treatment for each individual patient. The results of this study should lead to a large reduction in the incidence of chronic LBP, therefore the results should lead to significant savings in terms of social and economic costs.Read moreRead less
Physiological Mechanisms Of Efficacy Of Cervical Flexor Muscle Retraining
Funder
National Health and Medical Research Council
Funding Amount
$264,750.00
Summary
Neck pain is a significant problem in society and its frequency is beginning to match the proportions of back pain, probably reflecting our increasingly sedentary lifestyles. Several problems have been identified in the muscle system in persons who suffer from neck pain. Therapeutic exercise has been found to have benefit in preventing and relieving pain and improving the neck function. Currently there are several, quite different methods of exercise and there is controversy regarding how therap ....Neck pain is a significant problem in society and its frequency is beginning to match the proportions of back pain, probably reflecting our increasingly sedentary lifestyles. Several problems have been identified in the muscle system in persons who suffer from neck pain. Therapeutic exercise has been found to have benefit in preventing and relieving pain and improving the neck function. Currently there are several, quite different methods of exercise and there is controversy regarding how therapeutic exercise works. It has been argued that parameters such as changes in muscle strength, endurance, joint position sense or muscle coordination may be responsible for the clinical efficacy. It is difficult to disentangle the effective component of exercise strategies and thus prescribe the most effective exercise strategies. This series of experiments will evaluate the physiological factors that change with a specific exercise intervention and to compare different exercise modalities in order to identify the most effective means to induce these changes. Cervical muscle training, using a proven exercise intervention strategy for chronic neck pain and headache, has been chosen as the model to investigate these questions. This exercise strategy has been chosen not only because it has been shown to be effective, but also because it does not conform to contemporary rationales for strength or endurance training. Thus while effective in relieving pain, it is unlikely to produce changes in these parameters. Thus other mechanisms are likely to be responsible for the clinical change. This research stands to make a significant contribution to exercise therapeutics by identifying the effective components of different exercise methods and investigating the pain relieving effects of the specific exercise. This knowledge will lead to the construction of a research based exercise program for neck pain patients, rather than have the current situation of often arbitrary choice of exercise.Read moreRead less