Effects of Exercise Intervention in Patients With Spondylolisthesis Related LBP (EXER-SPO-TNC)

Effects of Exercise Intervention in Patients With Low Back Pain Due to Spondylolytic Spondylolisthesis

The first purpose of this study is to define parameters of the trunk neuromuscular functions that are pathologically altered in patients with low back pain due to spondylolytic spondylolisthesis. The second and also the main purpose of the study is to examine the effects of exercise intervention on patients with low back pain due to spondylolytic spondylolisthesis. Our overall hypothesis is that specific exercise intervention will improve neuromuscular functions of the trunk in patients with low back pain due to spondylolytic spondylolisthesis.

Low back pain is known to affect a considerable portion (> 75%) of the society, causing enormous financial burden for the healthcare systems. Exercise interventions incorporated into low back pain patients rehabilitation protocols are known as successful treatment strategies, but ore often focused on strength training and not on functional stabilization. Spondylolytic spondylolisthesis is one of the most known types of spine instabilities. To date, no studies examined the effects of exercise intervention on patients with low back pain due to spondylolytic spondylolisthesis. Research will be carried out as a cross-sectional study, where patients with spondylolytic spondylolisthesis will be randomly arranged in one controlled and two experimental groups. For the forth group healthy asymptomatic participants will be recruited. Exercise intervention will last 12 weeks with a frequency of three times a week and duration of 60 minutes per training unit. Exercise intervention will include congregated set of trunk stabilisation exercises, starting with simple isometric tasks. Dynamic and more complex movements will be added progressively to achieve whole body tasks involving fast and sudden movements. Neuromuscular functions of the trunk will be measured before and after the intervention.

Set of tests that objectively evaluate the neuromuscular functions of the trunk. Ability to reposition the trunk position during forward bent Maximal voluntary contraction during trunk flexion, extension and lateral flexion Muscle endurance during isometric trunk extension. Trunk's muscles activation during sudden loading and fast arm movement Single leg stance Leg symmetry during squat Hip and spine flexibility

Oswestry Low Back Pain Questionnaire commolny used by clinicians and researchers to quantify disability for low back pain.

Inclusion Criteria: Low back pain presence for at least three months. Age between 20 and 60 years. Isthmic Spondylolisthesis (1st and 2nd level according to Meyerding) at L5/S1 and L4/L5. Body mass index below 30. without neurological pathological conditions. Exclusion Criteria: Intermittent claudication pain. History of operational treatment of the lumbar spine. Traumatic, oncological, infectional pathology of the spine Degenerative stenosis of the lumbar spinal canal.