PhD position: Specific versus general exercises for recurrent low back pain: unravelling the puzzle of peripheral muscle and central brain changes’, Ghent University (deadline January 30)
Exercise therapy has been shown to be effective in decreasing pain and improving function for patients with recurrent low back pain. Research on the mechanisms that trigger and/or underlie the effects of exercise therapy on low back pain problems is of critical importance for prevention of recurring or persistence of this costly and common condition. One factor that seems to be crucial within this context is the dysfunction of the back muscles. Recent pioneering results have shown that individuals with recurring episodes of low back pain have specific dysfunctions of these muscles (peripheral changes) and also dysfunctions at the cortical level (central changes). This work provides the foundation to take a fresh look at the interplay between peripheral and central aspects, and its potential involvement in exercise therapy. The current project will draw on this opportunity to address the following research questions: What are the immediate (after a single session) and the long-term effects (after 18 repeated sessions and at 3 months follow up) of exercise training on back muscle structure and function and on the structure and functional connectivity of the brain? This research project also aims to examine whether the effects are dependent on how the training was performed. Therefore a specific versus a general exercise program will be compared. Guided exercise training will be complemented by exercises performed at home and will be provided by an experienced musculoskeletal physiotherapist. The PhD researcher involved in this research project will be blinded from the two treatment interventions and will be responsible for the pre and post treatment assessments and the processing/analysis of the data. Outcome measures include assessments of pain, disability and proprioception using questionnaires and clinical tests. MRI will be used to evaluate the structure and function of the back muscles (i.e. mfMRI (T1, T2, T2-shift) and Dixon sequences) and the brain (i.e. rs-FMRI, HARDI 3 Shell DTI, and T1 MPRAGE sequences). Using surface EMG back muscle function (timing and amplitude measures) will be evaluated.