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

Kobesova, Alena MD, PhD*; Andel, Ross PhD†,‡; Cizkova, Karolina MPT*; Kolar, Pavel PaedDr, PhD*; Kriz, Jiri MD, PhD*

doi: 10.1097/JSM.0000000000000699
Original Research: PDF Only

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.

*Department of Rehabilitation and Sports Medicine, 2nd Faculty of Medicine, Charles University, University Hospital Motol, Prague, Czech Republic;

School of Aging Studies, University of South Florida, Tampa, Florida; and

International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.

Corresponding Author: Alena Kobesova, MD, PhD, Department of Rehabilitation and Sports Medicine, Second Medical Faculty, Charles University, University Hospital Motol, V Uvalu 84, Prague 5, 150 00, Czech Republic (

Supported by the foundation Movement Without Help, Prague, Czech Republic, and by Institutional Program Progres Q41.

The authors report no conflicts of interest.

Received February 01, 2018

Accepted October 13, 2018

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