An Immediate Functional Progression Program for Adolescent Athletes With Spondylolysis
Lumbar Spondylosis
About this trial
This is an interventional treatment trial for Lumbar Spondylosis focused on measuring Adolescent, Athlete, low back pain
Eligibility Criteria
Inclusion criteria
- Age between 10 and 19 years.
- Active spondylolysis diagnosed by a participating physician using MRI. Signs of active spondylolysis are defined as edema in the posterior elements of the lumbar vertebrae at the pars interarticularis with or without a fracture.
- Organized sport participation at least two times per week at the time of diagnosis or onset of LBP.
Exclusion criteria
- Previous rest from activity > four weeks due to LBP
- Numbness or tingling in any lumbar dermatome.
- Other injury or condition that would alter the plan of care for spondylolysis (i.e., pregnancy, anterior cruci-ate ligament tear in the knee, concussion).
- History of lumbar spine surgery.
Sites / Locations
- Children's Hospital of ColoradoRecruiting
- Nationwide Children's HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Immediate Functional Progression Group
Rest until pain resolves Group
Athletes randomized to this group will start Physical Therapy immediately (with 7 days of diagnosis). Once in PT, Athletes will perform phase I (neutral spine) of the program and progress to phase II (functional motion) as able without an increase in pain and without compensations noted in function. The athlete will be assessed at each session to determine if they meet the criteria to begin the next step of functional progression program. Once the athlete has met the criteria of phase II, they will progress into the final phase of the functional progression program for return to sport activity. As these athletes progress through the third phase, and are able to meet the return to sport criteria, they will be released to return to sport. Athletes will not be released to return to sport prior to their first physician follow-up visit at 4 weeks.
Athletes with an active spondylolysis randomized into the control group will rest from all activity until their pain has resolved. Physicians will assess pain resolution at each visit which occurs every four weeks. Once the pain has resolved, the patient will be referred to physical therapy (PT) two times per week. The time, frequency, and exercise progression will be the same as the IFPP group. Since the pain has resolved in these participants be-fore initiating PT, the criteria to progress through phases will be time-based, not pain and function-based.