Can Exercise Targeting Mid-Thoracic Spine Segmental Movement Reduce Back Pain and Improve Sensory Perception in Cross-Country Skiers?

OBJECTIVE:To assess the role of exercise targeting proper trunk stabilization and segmental spinal movement in back pain and sensory perception among cross-country skiers. DESIGN:Randomized, controlled trial with blinded outcome assessors. SETTING:University Hospital, Department of Rehabilitation and Sports Medicine. PARTICIPANTS:Twenty elite cross-country skiers aged 17 to 27 years. INTERVENTIONS:Ten cross-country skiers integrated 3 types of exercise targeting segmental motion in mid-thoracic spine into their routine training practice for 2 months. The 10 controls performed routine athletic training. MAIN OUTCOME MEASURES:The Young Spine Questionnaire to measure intensity and frequency of back pain was completed at the start and end of study. Tactile sensory perception using 10-g Semmes-Weinstein monofilament, thermic perception using TIP THERM device, graphesthesia assessed by a touch monitor pencil, 2-point discrimination assessed by a digital caliper, and vibration perception assessed by a 128-Hz tuning fork measured in mid-thoracic spine 5 times. RESULTS:No significant group differences in pain and sensory perception were identified at baseline. Over the 2-month study interval, repeated-measures analysis of variance revealed that the experimental group improved significantly relative to the control group on pain intensity (P = 0.005 for cervical, P = 0.004 for thoracic, and P = 0.014 for lumbar) and frequency of pain in the thoracic area only (P = 0.011). Improvements were also observed in the experimental relative to control group on graphesthesia (P < 0.001), vibration perception (P = 0.002), and 2-point discrimination (P < 0.001). CONCLUSIONS:Exercise targeting the mid-thoracic spine may decrease back pain and improve sensory perception in cross-country skiers. LEVEL OF EVIDENCE:Original research, level I.