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

20 Participants Needed

Trial Summary

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 data supports the effectiveness of the treatment Surgeon Core-strengthening Program?

Core strengthening exercises have been shown to help reduce pain and improve stability in people with low back pain, suggesting they might also help reduce strain for surgeons by improving core stability and muscle control. ^{1 2 3 4 5}

Is core-strengthening exercise generally safe for humans?

Core-strengthening exercises, including those using instability devices, are generally considered safe and are widely used in rehabilitation and conditioning programs. They can help improve balance and reduce low back pain, although they should not be the primary method for building muscle strength or power in athletes. ^{1 3 4 5 6}

How does the treatment of core-strengthening exercises differ from other treatments for reducing surgeon strain?

Core-strengthening exercises are unique because they focus on improving the stability and control of the muscles around the spine, which can help reduce strain and improve functional stability. Unlike traditional treatments that may focus on static stability, core exercises incorporate dynamic stability and neuromuscular control, potentially offering better prevention and rehabilitation for musculoskeletal strain. ^{2 3 4 5 7}

What is the purpose of this trial?

Work-related musculoskeletal pain and injury is a growing concern in surgery. Vaginal surgery has unique ergonomic risks, but no studies have addressed the potential for an exercise regimen to reduce physical strain by vaginal surgeons

Research Team

Marian Acevedo-Alvarez, MD

Principal Investigator

Loyola Medical Center

Eligibility Criteria

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.

I have not had any joint surgery or injury in the past 3 months.

Timeline

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

Treatment Details

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).

Participant Groups

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+

Findings from Research

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]

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 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 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]

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]

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]

References

1. England 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. [2015]

2. United States pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Trial of Core Strengthening Exercises in Helicopter Crewmembers with Low Back Pain. [2015]

3. Puerto Rico pubmed.ncbi.nlm.nih.gov

Core strengthening exercises for low back pain. [2009]

4. United States pubmed.ncbi.nlm.nih.gov

Core strengthening. [2022]

5. Canada 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. [2022]

6. Canada pubmed.ncbi.nlm.nih.gov

The use of instability to train the core musculature. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Core stability exercise principles. [2022]