title: Cognitive functional approach to manage low back pain in male adolescent rowers: a randomised controlled trial.
abstract: BACKGROUND
  Low back pain (LBP) is prevalent among adolescent rowers. This study evaluated the efficacy of a cognitive functional approach to reduce LBP in this population.
  
  
  METHODS
  Thirty-six adolescent male rowers reporting LBP participated. Nineteen were randomly allocated to the intervention group to receive a cognitive functional approach targeting cognitions, movement patterns, conditioning and lifestyle factors relevant to each rower for 8 weeks. The active control group (n=17) received usual care from their coaches (rowing skills and conditioning exercises). The primary outcome of the study was pain intensity as measured by the Numeric Pain Rating Scale during a 15 min ergometer trial preintervention and postintervention. Disability (Patient Specific Functional Scale and Roland Morris Disability Questionnaire) was measured preintervention/postintervention and at 12 weeks follow-up. Isometric muscle endurance of the back extensors and lower limb muscles, usual sitting posture and regional lumbar kinematic data during a 15 min ergometer row were measured preintervention/postintervention.
  
  
  RESULTS
  Compared with the control group, the intervention group reported significantly less pain during ergometer rowing (Numeric Pain Rating Scale -2.4, p=0.008) and reduced disability (Patient Specific Functional Scale (4.1, p=0.01); Roland Morris Disability Questionnaire (-1.7, p=0.003)) following the intervention, and at 12 weeks follow-up. They also demonstrated greater lower limb muscle endurance (20.9 s, p=0.03) and postured their lower lumbar spine in greater extension during static sitting (-9.6°, p=0.007). No significant differences were reported in back muscle endurance and regional lumbar kinematics during ergometer rowing.
  
  
  CONCLUSIONS
  Cognitive functional approach was more effective than usual care in reducing pain and disability in adolescent male rowers.
  
  
  BACKGROUND
  Australian and New Zealand Clinical Trial Registry Number 12609000565246.
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia.
authors.forename: Leo
authors.initials: L
authors.lastname: Ng
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia Body Logic Physiotherapy, Perth, Western Australia, Australia.
authors.forename: J P
authors.initials: JP
authors.lastname: Cañeiro
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia.
authors.forename: Amity
authors.initials: A
authors.lastname: Campbell
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Smith
authors.affiliation: ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors.forename: Angus
authors.initials: A
authors.lastname: Burnett
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Western Australia, Australia Body Logic Physiotherapy, Perth, Western Australia, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: O'Sullivan
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena / Q000502:physiology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000517:prevention & control*; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D009326:Naval Medicine; D010147:Pain Measurement; D013177:Sports / Q000502:physiology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014904:Western Australia; D055815:Young Adult
keywords: Adolescent; Lumbar spine; Physiotherapy; Randomised controlled trial; Rowing