Perturbation-based exercise for prevention of low-back pain in adolescent athletes

The purpose of this study was to assess the effectiveness of a perturbation-based exercise intervention on the prevention of chronic non-specific low-back pain in adolescent athletes over 1 year. In a 2-year prospective research design, thirty-seven adolescent athletes (13-18 years) were recruited. In the first year (control), the athletes performed their usual training program, while in the second year (intervention), a perturbation-based trunk exercise intervention was implemented (two times per week for 25 minutes). Low-back pain incidence, trunk muscle strength, lumbo-pelvic alignment, and kinematics were measured four times per year. The 3 months prevalence of low-back pain reduced by 49% in the intervention compared to the control year. Further, low-back pain intensity decreased (P = .019, d = 0.524) and muscle strength of the trunk extensors (P = .040, d = 0.585) and trunk flexors (P = .002, d = 0.515) increased in the intervention year. Finally, a reduction (P < .001, d = 1.401) of strength imbalances between the flexor and extensor muscles was observed. Lumbo-pelvic alignment and kinematics during forward bending did not alter (P > .05) due to the intervention. The findings evidence beneficial effects of a perturbation-based exercise intervention on the prevention of low-back pain. This underlines the need for the implementation of specific interventions of trunk muscles in the training process.