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Forschungsprojekte

Back muscle blood perfusion and endurance in patients with chronic non-specific low back pain and the potential role of genetic predisposition

  • Principal Investigator: Prof. Dr. med. Petra Schweinhardt
  • Collaborators: Andrea Vrana, Brigitte Wirth, Paola Valdivieso, Martin Flück

Back muscle blood perfusion and endurance in patients with chronic non-specific low back pain and the potential role of genetic predisposition

The aim of this project is to specifically looking at muscle endurance and muscle metabolism in patients with chronic non-specific low back pain (cnsLBP). During a back muscle endurance test, relative muscle perfusion and oxygenation are measured in both, patients with cnsLBP and healthy controls. In addition, genotype analyses are conducted for the assessment of relevant polymorphisms of genes, whose function influences muscle blood perfusion. The hypothesis is that a subgroup of patients with cnsLBP have reduced back muscle endurance due to an impairment in muscle perfusion and/or oxygenation, which in turn might be related to genetic predisposition.

The effect of changing gravity on spinal stiffness

  • Principal Investigator: Dr. Jaap Swanenburg
  • Sponsor: Prof. Dr. med. Petra Schweinhardt
  • Collaborators: Dr. Anke Langenfeld

The effect of changing gravity on spinal stiffness

The aim of this project is to assess posterior-to-anterior spinal stiffness in earth, hyper-, and microgravity conditions. Additionally, we will measure EMG activity of relevant extensor and flexor back muscles and change of lumbar curvature during changing gravity conditions. This project will be carried out in cooperation with the European Space Agency (esa).

Influence of body position and axial load on spinal stiffness in young healthy adults

  • Principal Investigator: Dr. Jaap Swanenburg
  • Sponsor: Prof. Dr. med. Petra Schweinhardt
  • Collaborators: Melanie Häusler, Léonie Hofstetter, Lea Suzanne Glaus

Influence of body position and axial load on spinal stiffness in young healthy adults Principal 

The aim of this study is to describe spinal motor control with help of spinal stiffness measurements in different body positions and changing axial load. The posterior-to-anterior lumbar and thoracic spinal stiffness of 100 young healthy adults will be measured in three test situations; a) prone, b) standing, c) standing 50% of the body weight.

The supraspinal sensorimotor representation and reorganization of the thoraco-lumbar spine in acute and chronic low back pain

  • Principal Investigator: Dr. Michael L. Meier
  • Sponsor: Prof. Dr. med. Petra Schweinhardt
  • Collaborators: Philipp Stämpfli, Philipp Schütz, Stefan Schmid, Marco Senteler, Daniel Nanz, Marc Bolliger

The supraspinal sensorimotor representation and reorganization of the thoraco-lumbar spine in acute and chronic low back pain

Low back pain (LBP) is extremely common with a life-time prevalence around 75-84% and is globally amongst the health conditions with the highest numbers of years lived with disability. In most instances of LBP, no underlying pathology is detectable, resulting in the unfortunate diagnosis of `non-specific LBP’. An acute episode of LBP spontaneously resolves in one third of the patients within the first three months, however, about 65% of the patients still experience LBP one year after LBP onset. Consequently, recurrent or chronic LBP (LBP persisting for 12 weeks or more) is a common problem, with an enormous individual, economic and societal burden. Therefore, advancing the understanding of factors contributing to the chronification of LBP is a research priority.

Among factors such as genetic, physical and psychosocial features, adaptions of motor control (how we move and protect the body from further pain and injury) likely play a significant role in chronic or recurrent LBP because they are associated with several important factors contributing to LBP chronification, including increased spinal tissue strains due to potential loss of trunk control and enhanced trunk muscle co-contraction, resulting in muscle fatigue. Both factors have been linked with sustained mechanical loading on spinal tissues, conceivably potentiating degeneration of intervertebral discs and other tissues. Motor control is responsible for spine posture, stability and movement and arises from a constant interplay between motor outputs to effectors (e.g. paraspinal muscles) and sensory inputs (e.g. proprioception, the sense of position and movement) from various levels of the nervous system. Factors contributing to motor control adaptations in LBP have been extensively studied on the motor output side but less attention has been payed to changes in sensory input. It is well known that the brain needs to have sensory feedback from the spine to adequatelly control the different players of spine control. It is further known that, in people with recurrent or chronic LBP, sensory feedback from spinal tissues is often disrupted or reduced.

However, it is still an open question where and how the brain processes sensory inputs (in particular proprioceptive inputs) and how these inputs contribute to changes in motor control that occur in LBP. Furthermore, recent research has shown that motor control adaptions in LBP differ between individuals. For example, at the incidence of LBP, some individuals loose their control while others show tighter control (stiffening). This may have important implications for the chronification of LBP.

This long-term project includes measurements of spine kinematics and proprioceptive function in healthy subjects, acute and chronic LBP patients to reveal different patterns of motor adaption strategies and their relationship to proprioceptive functioning. Furthermore, spinal kinematics data will serve as input for driving thoracolumbar spine musculoskeletal models to predict subject specific intervertebral joint loads and muscle forces. The data will serve as a basis to further explore related brain mechanisms with a focus on the processing of paraspinal proprioceptive input (the “spine map” in the brain) and its potential relationship to individual measures of spinal kinematics, joint loads and muscle forces.

We hypothesize, and there is some evidence to suggest that as a result of chronic LBP, the spine map might be altered in some way such as a change in its location in the brain and its connection to other parts of the brain that would affect the normal activity and control of the spine and promote continuing pain. The extend of this reorganization is unknown and it would be very important to see if treatments such as chiropractic spinal manipulation can change or reverse these changes as well as reducing the pain. As clinicians and researchers have observed that back pain patients either respond or do not respond to spinal manipulation, it would be very important to see if responders and non-responders exhibit differential properties regarding the sensory and motor spine control unit in the brain.

In the end, those investigations might enhance our understanding of brain mechanisms involved in trunk motor control and LBP while patients and doctors might benefit for more profound clinical decision-making.

Patient outcome after chiropractic treatment

  • Project leader: Prof. Dr. med. Petra Schweinhardt
  • Collaborators: Dr. Brigitte Wirth, Fabienne Riner, MSc

Patient outcome after chiropractic treatment

The aim of this project is to assess the course of patients under chiropractic treatment at various specified points in time in order to 1) identify subgroups and risk factors for unfavorable outcome and to 2) maintain the high quality standard of the chiropractic policlinic.

Back and neck pain in adolescence – a prospective cohort study

  • Principal Investigator: Dr. Brigitte Wirth
  • Sponsor: Prof. Dr. med. Petra Schweinhardt
  • Collaborators: Fabienne Riner, MSc

Back and neck pain in adolescence – a prospective cohort study

Adolescents with back and neck pain have a fourfold risk for back and neck pain in adult life. Understanding back and neck pain in adolescence relies on a standardized methodology that allows following the adolescents over time. For this reason, the Young Spine Questionnaire (YSQ) was elaborated in Denmark (Lauridsen & Hestbaek, 2013) and a German version is now being validated.