Low back pain (LBP) is one of the significant musculoskeletal conditions that accounts for pain, disability and seeks substantial medical and occupational costs annually. (Oriyes - Perez, 2008). Prevalence of LBP is about 60 - 80% in world population. (WHO, 2003). It also substantially influences the working capacity, inability to obtain or maintain employment and lost productivity. (Anthony H.Wheeler).
The prevalence of musculoskeletal disorders is a serious problem among the local police officers, due to the result of awkward posture, jolt/vibrations and stress. And the most common disorders are cervico-brachial pain, low back pain and sciatica. Specific to Tamilnadu Police Forces, LBP was the second most common reason to seek healthcare and leave facilities. A Police review suggests that LBP was the most common condition bringing about a medical board a change of duty.
Low-back pain (LBP) is a due as a result of exposing to awkward posture of the spine (Policemen involved in office-based duties). Reduction of pain and disability associated with LBP is a significant research priority for the Policemen.
Reduction of pain and disability associated with LBP has been classified into 2 phases - primary and secondary prevention. Primary prevention states the interventions and strategies that are implemented before the onset of low back injury. Primary prevention focus on reducing the LBP related disability by reducing the total number of people who eventually experience an episode of LBP. Secondary prevention states the interventions and strategies that are implemented for the patient with acute episode of low back injury, before chronic symptoms occur. Secondary prevention reduces LBP related disability by reducing the number of people who eventually experience chronic disability from LBP. This randomized clinical trial incorporates a combination of primary and secondary prevention strategies for limiting the onset and severity of LBP for Policemen.
The commonly used primary prevention strategies such as back schools, lumbar supports and ergonomic interventions, but the current scientific literature review does not support these commonly used methods. Despite this lack of evidence, efforts continue to investigate primary prevention interventions & recent review article suggests that future research related to primary prevention should focus on exercise programs (CSEP & TEP), as they may offer the greatest potential for reducing disability from LBP. Core stabilization exercise programs (CSEP) may be a good choice for primary prevention studies because biomechanical, anatomical, and clinical studies provide evidence that core stabilization is an effective intervention.
"Core stability" describes the ability to control the position and movement of the central portion of the body. Core stability training targets the muscles deep within the abdomen which connect to the spine, pelvis and shoulders, which assist in the maintenance of good posture and provide the foundation for all arm and leg movements. Good core stability can help maximise running performance and prevent injury. Well-conditioned core muscles help to reduce the risk of injury resulting from bad posture.
Secondary prevention strategies primarily focus on PSEP to reduce disability from LBP because effective primary prevention strategies are currently lacking. Secondary prevention strategies are based on two consistent themes. The first theme is that psychological factors play a significant role in the development of chronic disability from LBP. The second theme is that early interventions that address these psychological factors result in decreased disability from LBP.
Psychological models are commonly used to explain the chronic disability that develops from LBP and one specific model is the Fear-Avoidance Model (FAM). This model proposed that fear-avoidance beliefs and pain catastrophizing are the primary psychosocial factors involved in the development and maintenance of chronic symptoms. Fear-avoidance beliefs are comprised of an individual's pain experiences, present stress level, pain behaviour, and certain personality traits. Fear-avoidance beliefs detail an individual's fear of pain and re-injury specific to LBP and the belief as to whether physical activity should be maintained while experiencing LBP. Pain catastrophizing is a negative, multidimensional construct comprised of rumination, helplessness, and pessimism cognitions.
Fear-avoidance beliefs and pain catastrophizing were strongly associated with pain intensity and disability in patients with chronic LBP. Longitudinal studies have demonstrated that fear-avoidance beliefs and pain catastrophizing are also precursors to the development of chronic disability. As a result, it has been hypothesized that early reduction of fear-avoidance beliefs and pain catastrophizing is an important way to reduce development of chronic LBP. Randomized clinical trials suggest that psychological and physical LBP severity can be decreased when PSEP's are implemented in individuals experiencing LBP.
1.1 NEED FOR THE STUDY:
Police officers play a pivotal role in our societies. Police officers involvement ranges from general, daily, proactive patrol activities to specific criminal activities such as narcotic investigations. Because there is such a wide range of activities involved in police work, they may be exposed to different health and safety risks in their occupation. Low back pain seems to be a common ailment influencing the lives of police officers. Activities such as exposure to wearing body armour, vehicle vibration & prolonged work in a vehicle in relation to low back trouble create strenuous forces on the back which are required during a training sessions predispose to low back pain. If the back and trunk has not been trained to function optimally, this can lead to weakness and reduced movement capabilities. Over time, this can lead to impaired performance, injury and pain. No research has been done to examine the effect of prevention protocol for LBP in Policemen.
Trunk strength is critical because all movements either originate in or coupled through the trunk and well developed core stability allows for improved force output, increased neuromuscular efficiency and a decrease in the incidence of overuse injuries. By strengthening the core stability system one enhances the ability to better utilize the musculature of the upper and lower body to perform certain tasks. This results in more efficient, accurate and powerful movements. This research aims to provide a form of management of acute low back pain that is cost effective and easily accessible for Policemen
1.2 OBJECTIVIES:
To evaluate the onset and severity of low back pain in Police Trials
To assess the efficacy of core stability exercise program in preventing the onset and severity of low back pain in policemen trials
To assess the efficacy of traditional exercise program in preventing the onset and severity of low back pain in policemen trials
1.3 STATEMENT OF THE PROBLEM
A study to assess the effectiveness of core stabilization exercise program (CSEP) and traditional exercise program (TEP) in preventing the primary onset and severity of low back pain following basic training program in police trails
1.4 HYPOTHESIS:
1.4.1. NULL HYPOTHESIS (H0)
There will be no significant difference between CSEP and TEP on basic training program in preventing the primary onset and severity of LBP among police trails.
1.4.2. ALTERNATIVE HYPOTHESIS (H1)
There will be a significant difference between CSEP and TEP on basic training program in preventing the primary onset and severity of LBP among police trails
1.5 KEY WORDS
1.4 OPERATIONAL DEFINITIONS:
Low Back Pain:
Pain in the lower back area that can relate to problems with the lumbar spine, the discs between the vertebrae, the ligaments around the spine and discs, the spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, or the skin covering the lumbar area
Police Trials
Police Officers maintain law and order in communities by patrolling neighbourhoods, investigating crime, building relationships with community members and arresting or citing lawbreakers.
Randomized Controlled Trial:
A randomized controlled trial (RCT) is a type of scientific experiment most commonly used in testing the efficacy or effectiveness of healthcare
1.5 PROJECT OUTCOME
Based on literature review, the investigator expected that there may be significant effect of Core Stabilization Exercise Program in Preventing the Primary Onset and Severity of Low Back pain in Police Trails.
