Sports Orthopedics

Abstract

Idiopathic as well as nonspecific low back pain is relevant in health care systems as well asinleisure and high-performance sports. Neuromuscular and/or structural deficits, mostly accompanied by biopsychological factors,are known risk factors for both the onset and chronification of symptoms. Meta-analytic evidence describes positive effects of physical activity. However, type, dose-response relation, minimum of training required and setting-specific implementation has not been fullyclarified. Since 2011, the national research network Medicine in Spine Exercise [MiSpEx] has beenfollowing a project layout called Ran Rcken focussing on the development and validation of intervention programs including neuromuscular and pain adaptation moderated by individual training status, pain behaviour, allostatic load and social settings. Overall about 8000 patients and athletes have been and are being followed experimentally and clinically in 34 studies. It could be shownthat a training program focussing on compensation of external loads elicited by perturbations is effective in prevention and rehabilitation in both athletes and general population. Besides validation of further consecutively developed programs emphasis is put on the evaluation of transfer strategies to medical systems, sports as well as general population. Finally, the evaluation of an efficient dose-response relation is addressed.KEY WORDS: Low Back Pain, MiSpEx, Sports, Perturbations, Therapy, Prevention, Training