Core-strengthening Exercises for Reducing Surgeon Strain

(SCORE Trial)

Overseen By Marian Acevedo-Alvarez

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Loyola University

Disqualifiers: Physical therapy, Joint surgery, Pregnant, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 4 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines whether specific core-strengthening exercises can reduce physical strain for surgeons performing vaginal surgeries. It aims to alleviate work-related pain and injuries associated with the unique physical demands of these procedures. Participants will be divided into two groups: one will follow a special exercise routine (the Surgeon Core-strengthening Program), while the other will continue without added exercises. The trial suits ob/gyn residents, urology residents, urogyn fellows, or urogyn attendings who perform vaginal prolapse surgeries lasting over two hours. As an unphased trial, this study offers a unique opportunity to contribute to research that could enhance surgical practice and reduce physical strain for surgeons.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that the Surgeon Core-strengthening Program is safe for reducing surgeon strain?

Research shows that core-strengthening exercises are generally safe and manageable. In one study, 78 people with weak core muscles completed an 8-week core-strengthening program. This study found significant improvement in their core strength, with no major safety issues reported.

Another review examined the safety of core exercises immediately after abdominal surgery. It assessed the impact on tissue healing and found these exercises safe, suggesting they do not interfere with the healing process.

Overall, research supports that core-strengthening exercises, such as those in the Surgeon Core-strengthening Program, are unlikely to cause harm and may help reduce work-related muscle and joint pain and injuries. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Surgeon Core-strengthening Program because it introduces a simple yet potentially transformative approach to reduce physical strain among surgeons. Unlike traditional methods that might focus on ergonomic tools or surgical techniques, this program emphasizes improving surgeons' physical resilience through targeted core exercises. By incorporating the SCORE workout twice a week, the program aims to enhance core strength, which could lead to better posture and reduced fatigue during long surgeries. This proactive, health-focused strategy offers a fresh angle on enhancing surgeon well-being and efficiency, which is why it's garnering interest.

What evidence suggests that the Surgeon Core-strengthening Program is effective for reducing surgeon strain?

Research has shown that core-strengthening exercises can greatly improve stability and reduce pain. In one study with 78 participants, an 8-week core-strengthening program improved core stability. Another study found these exercises more effective than regular physical therapy for easing long-term lower back pain. Additionally, training in ergonomics, which includes core exercises, has reduced muscle and joint pain in surgeons. Benefits also include better posture and a higher quality of life. In this trial, participants in the Exercise Group will follow the Surgeon Core-strengthening Program, which may help reduce physical strain for surgeons during operations. ^{1 2 4 6 7}

Who Is on the Research Team?

Marian Acevedo-Alvarez, MD

Principal Investigator

Loyola Medical Center

Are You a Good Fit for This Trial?

This trial is for vaginal surgeons experiencing work-related musculoskeletal pain or injuries. Specific eligibility criteria are not provided, but typically participants would need to meet certain health standards and be able to perform the required exercises.

Inclusion Criteria

Participant must be an ob/gyn resident or urology resident or urogyn fellow or urogyn attending

My surgery for vaginal prolapse is expected to last over 2 hours.

Exclusion Criteria

I am not currently in physical therapy.

My vaginal surgery lasted 2 hours or more.

Participant must not be pregnant

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-treatment Exercise

Participants in the exercise group perform the SCORE workout two times each week for 4 weeks prior to their urogynecology rotation

4 weeks

Treatment

Participants in the exercise group continue the SCORE workout two times each week during their urogynecology rotation

4 weeks

Follow-up

Participants are monitored for changes in core strength, physical exertion, and pain during and after surgery

8-12 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Surgeon Core-strengthening Program

Trial Overview The study investigates whether a core-strengthening exercise program can reduce physical strain in surgeons performing vaginal surgeries. Participants will be divided into two groups: one following the exercise regimen (Exercise Group) and one that does not (Control Group).

How Is the Trial Designed?

Group I: Exercise Group Experimental Treatment 2 Interventions

Participants randomized to the exercise group will be asked to perform the SCORE workout two times each week for 4 weeks prior to their urogynecology rotation and for 4 weeks during the rotation.

Group II: Control Group Active Control 2 Interventions

No additional exercises or tasks are requested of control participants. Control group participants will perform or not perform exercise as they otherwise would outside of the study

Who Is Running the Clinical Trial?

Loyola University

Lead Sponsor

Trials

161

Recruited

31,400+

Published Research Related to This Trial

Core strengthening is essential for maintaining stability around the lumbar spine and is widely used in rehabilitation, injury prevention, and performance enhancement, but there is limited research supporting its effectiveness.

This review aims to clarify the concept of core strengthening and its applications, highlighting the need for more rigorous studies to validate its benefits in various contexts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Core strengthening. Akuthota, V., Nadler, SF.[2022]

Core strengthening exercises, which focus on dynamic spinal stability and neuromuscular control, may effectively reduce pain, functional disability, and the recurrence of acute low back pain episodes, according to the best available evidence.

The article reviews the anatomy of the core and the physiological models of spinal stability, emphasizing the need for more research to fully understand the benefits of core strengthening in low back rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Core strengthening exercises for low back pain. Baerga-Varela, L., Abréu Ramos, AM.[2009]

Core strengthening exercises significantly reduced in-flight pain severity for U.S. Air Force helicopter aircrew members with low back pain, with a mean decrease of 1.8 points on the Numerical Pain Rating Scale (NPRS) compared to a slight increase in the control group.

Participants who performed the core exercises also experienced a notable reduction in disability, as indicated by a 4.8 point decrease in the Modified Oswestry Low Back Pain Disability Index (MODI), demonstrating the exercises' efficacy over a 12-week period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Trial of Core Strengthening Exercises in Helicopter Crewmembers with Low Back Pain. Brandt, Y., Currier, L., Plante, TW., et al.[2015]

Core stability is crucial for maintaining proper balance and function in the spine and pelvis, involving a coordinated effort from various trunk muscles, which is essential for athletic performance and injury prevention.

Core strengthening exercises, also known as lumbar stabilization, are effective not only for enhancing athletic performance but also as a therapeutic approach for treating low back pain conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Core stability exercise principles. Akuthota, V., Ferreiro, A., Moore, T., et al.[2022]

A study involving 78 participants with poor core stability found that an 8-week supervised core-strengthening program significantly improved core stability measures compared to both a home-based program and a control group.

While the home-based program showed some improvements in static core stability, it was less effective in enhancing dynamic core stability compared to the supervised approach, highlighting the importance of supervision in maximizing treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The efficacy of a supervised and a home-based core strengthening programme in adults with poor core stability: a three-arm randomised controlled trial. Chuter, VH., de Jonge, XA., Thompson, BM., et al.[2015]

Training the core using instability devices can enhance muscle activation compared to stable conditions, but similar activation levels can also be achieved with traditional free-weight exercises like squats and deadlifts.

While instability training may not be ideal for athletic conditioning due to decreased force and power, it can be beneficial in rehabilitation programs and for nonathletic individuals seeking musculoskeletal health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Canadian Society for Exercise Physiology position stand: The use of instability to train the core in athletic and nonathletic conditioning. Behm, DG., Drinkwater, EJ., Willardson, JM., et al.[2022]

Instability resistance training can effectively reduce low back pain and improve sensory efficiency in soft tissues, making it beneficial for rehabilitation and recreational training.

However, it is not recommended as the primary method for building muscle size, strength, or power in trained athletes, who should focus on ground-based free-weight exercises with some instability for core training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The use of instability to train the core musculature. Behm, DG., Drinkwater, EJ., Willardson, JM., et al.[2022]

Citations

1. withpower.com withpower.com/trial/phase-musculoskeletal-pain-7-2024-e3b90

Core-strengthening Exercises for Reducing Surgeon Strain A study involving 78 participants with poor core stability found that an 8-week supervised core-strengthening program significantly improved core stability ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5648929/

Effectiveness of core stabilization exercises and routine ... Core stabilization exercise is more effective than routine physical therapy exercise in terms of greater reduction in pain in chronic nonspecific low back pain.

3. research.aota.org research.aota.org/ajot/article/78/5/7805205090/25934/Preventing-Surgeon-Work-Related-Musculoskeletal

Preventing Surgeon Work-Related Musculoskeletal Disorders ... Outcomes and Measures: CORE program outcomes were assessed using qualitative and quantitative data to indicate changes in posture, physical ...

4. semthorcardiovascsurg.com semthorcardiovascsurg.com/article/S1043-0679(21)00430-5/fulltext

Surgeon Strength: Ergonomics and Strength Training ... Lastly, implementation of ergonomics training at some programs have been effective at reducing the rates of musculoskeletal pain among surgeons.

5. mdpi.com mdpi.com/1660-4601/19/6/3324

The Effectiveness of Group-Based Core Stability Exercise ... 4. Discussion. According to our results, we found that the 8-weekly-session core stability exercise was beneficial for the disability level and quality of life ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10726400/

Safety of core muscle training immediately after abdominal ... The aim of this review was to assess the safety of abdominal (core) muscle physiotherapy in terms of fascial healing, starting immediately after surgery.

7. sciencedirect.com sciencedirect.com/science/article/pii/S1043067921004305

Ergonomics and Strength Training in Cardiothoracic Surgery SURGEON STRENGTH. There is compelling evidence that regular resistance training is protective against development of MSK disease, and improves quality of life ...