Lumbar stabilisation exercises versus back endurance-resistance exercise training in athletes with chronic low back pain: protocol of a randomised controlled trial.

BACKGROUND: Chronic low back pain (CLBP) is an important disorder in athletes that may negatively affect their performance in competitions. The literature usually recommends physiotherapy based on exercises for back pain management in athletes. Recent evidence suggests that interventions based on lumbar muscle stabilisation exercises (LMSE) and back endurance-resistance exercises (BERE) may improve back pain and function performance. However, it is still unclear which type of exercise is more effective for the treatment of CLBP in athletes. OBJECTIVE: To compare the efficacy of LMSE versus BERE in athletes with CLBP. DESIGN: The study is a 2-arm, prospectively registered, randomised controlled trial. SETTING: The physical therapy clinical and biomechanics laboratory of the UNOPAR University. PARTICIPANTS: 32 male athletes with CLBP, age between 18 and 40 years old, recruited from the local community. INTERVENTION: An 8-week intervention programme will be carried out with LMSE s versus BERE. MEASUREMENTS: Trunk neuromuscular patterns during balance tasks (unipodal and over a ball) using electromyography and force platform parameters, pain, disability, fear and avoidance will be assessed by a blinded assessor at baseline and at follow-up after 8 weeks of intervention period. LIMITATIONS: The absence of blinding intervention and the exclusion of female athletes, seated sports and swimmers will affect the internal and external validity of the study. CONCLUSIONS: The results of this study will elucidate which of these two interventions promote better results in trunk neuromuscular pattern, back pain and function in male athletes with CLBP.

Letter to the Editor: RE: Costa et al. (''Nutritional Risk is Associated with Chronic Musculoskeletal Pain in Community-Dwelling Older Persons: The PAINEL Study'').

We read Costa and colleagues' report1 in 2016 in the Journal of Nutrition in Gerontology and Geriatrics with great interest. In this article, the authors reported a statistically significant association between chronic musculoskeletal pain and nutritional risk after controlling for age, gender, body mass index (BMI), depression (GDS, geriatric depression scale), and diabetes in a Brazilian community-dwelling older adult's population (the PAINEL study, see Table 2 in Costa et al. 1 . However, in their study, Costa and colleagues used the DETERMINE 2 Questionnaire, a questionnaire in which 3 out of the 10 questions are directly or indirectly related to pain (i.e., presence of an illness, tooth or mouth problems, and physical disability). The purpose of this letter is to discuss the potential drawbacks of including pain-related questions in nutrition risk screening tool when these tools are used to investigate the relationship between pain and nutritional risk.