Cognitive Functional Therapy for the Management of Low Back Pain in an Adolescent Male Rower: A Case Report.
J Orthop Sports Phys Ther. 2013 Jun 11;
Authors: Cañeiro JP, Ng L, Burnett A, Campbell A, O’Sullivan PB
STUDY DESIGN: Case report. BACKGROUND: Contemporary low back pain (LBP) models propose that the experience and responses to pain result from a complex interaction of bio-psycho-social factors, supporting the need for a management approach that addresses the biological, psychological and social components that may be related to the pain disorder. This case report demonstrates the application and outcomes associated with a cognitive functional intervention, which considers neurophysiological, physical, psychosocial, cognitive and lifestyle dimensions, for the management of a rower with non-specific chronic low back pain (NSCLBP). CASE DESCRIPTION: A male club-level rower with NSCLBP was classified as having a motor control impairment with a lower lumbar compressive loading pattern in flexion. Evaluation of this patient included ergometer rowing analysis (clinical and laboratory) pre and post an 8-week intervention, and 12 weeks outcome measure follow up. The intervention consisted of a cognitive functional approach which targeted optimisation of movement behaviour, providing the rower with alternative movement strategies to minimise sustained flexion loading. OUTCOMES: Reduction in temporal summation of pain while ergometer rowing, reduced disability – changes in scores from pre to post (12 weeks) intervention (Roland Morris Disability Questionaire 12/24 to 1/24; Patient Specific Functional Scale 4/30 to 26/30), and associated improvement in lower limb and back muscle endurance and changes in hip and spino-pelvic kinematics during ergometer rowing. In particular, there was greater use of his available range of movement in the lumbar spine post intervention. DISCUSSION: The cognitive functional intervention for this patient resulted in reduced pain and functional disability related to ergometer rowing, which was associated with a change in lumbar kinematics and improved lower limb and back muscle endurance. The results suggest that providing the rower with greater use of his available range may enhance load distribution during the drive phase of rowing. LEVEL OF EVIDENCE: Therapy, Level 4.J Orthop Sports Phys Ther, Epub 11 June 2013. doi:10.2519/jospt.2013.4699.
PMID: 23760295 [PubMed – as supplied by publisher]