Preventive use of physical activity education trial

Back pain is one of the main causes of work disability. The regular practice of an adequate exercise program may reduce the incidence or, at least, the discomfort caused by back pain. The low level of motivation and the wariness towards any physical activity typical of subjects with rachialgia may prevent successful outcome of motor training programs and awareness of body movements. The aim of this study was to assess whether the practice of a specific and standardized training program in subjects with rachialgia leads to significant changes in pain, posture, spine flexibility and mobility, and activity of daily living (ADLs). Forty consecutive subjects with rachialgia were randomly assigned to a treatment group (T) or to a control (C) group. Treatment consisted in “Pilates” training program. All subjects were evaluated by means of specific tests at the beginning and end of the trial. The subjects in the T group followed the assigned activity once a week for 10 weeks, and the evaluation test were performed before and after each session. Sessions consisted in 45 minutes of Pilates activities. Subjects in the C group maintained their normal daily activities without any special training. Program and without the follow-up evaluations. Neck, back and low back pain were evaluated by visual analog scale (VAS), range 0-10; functional disability by Quebec Back Pain Disability Scale (QBPDS). The test performed were: bending test, spine rotation range, Unterberger test, anterior and posterior scapulum hip asymmetry measurement . Statistical analysis was performed by paired T-test (within groups) and ANOVA (between groups). No difference was found between groups in gender distribution, age, height and Body Mass Index. In the following lines some of the most representative results are shown as mean values +- SEM VAS for Neck Pain changed from 3,80 ± 0.97 to 4.25 ± 0,96 (NS) in C, and from 6.18 ± 0.81 to 2.15 ± 0.52 (P< 0,001) in T. VAS for back pain changed from 1.33 ± 0.53 to 1.65 ± 0.50 (ns) in C, and from 2.63 ± 0.73 to 0.85 ± 0.36 (P< 0.001) in T. VAS for low back pain changed from 4.55 ± 0.77 to 5.33 ± 0.84 (ns) in C, and from 5.25 ± 0.67 to 2.08 ± 0.39 (P< 0,01) in T. BENDING Test changed from -8.82 ± 2.28 to – 10.14 ± 2.46 ( P< 0,05) in C, and from -8.22 ± 2.11 to 3.11 ± 1.68 (P< 0.01) in T. QBPDS changed from 22.25 ± 2. to 27.50 ± 2.65 (P< 0,01) in C, and from 19.95 ± 3.14 to 15.70 ± 2.75 (P< 0,01) in T. We conclude that the standardized training may have positive effects on pain, functional disability and quality of life in back pain related to muscle in balance, stiffness and posture defects. Standardized trials of physical activity education may play a role in a preventive dimension. Other training methods are being evaluated to be compared with the present data.