Two new doctoral graduates at the Institute of Physiotherapy
On 12 November 2018, the Institute of Physiotherapy celebrated the graduation of two new doctors of physiotherapy. Jeannette Saner and Christoph Bauer spent four to five years investigating research questions on the topic of nonspecific low back pain.
It is assumed that reduced mobility and movement control impairment of the lumbar spine could be more than just a direct consequence of low back pain and, in the case of certain patients, should be examined and treated. In their PhD projects, Saner and Bauer examined, on the one hand, movement control impairments and the effect of active physiotherapy, and on the other hand, a portable and easy-to-use measurement system to record lumbar movement. Their results have appeared in various publications.
Jeannette Saner completed her PhD at the University of Maastricht Faculty of Health in the Netherlands. In her work, Saner examined a subgroup of people with lumbar back pain. Patients with movement control impairment (the subgroup) were recruited through a movement control test battery. In a quantitative, randomised, controlled study, Saner investigated the effect and efficacy of two exercise programmes: one specifically designed for movement control impairment and one nonspecific general strength training programme. Both were carried out in conjunction with a home exercise programme. In addition, a qualitative questionnaire was conducted to evaluate participants’ adherence to their programme. The short-term research results showed significant reductions in the activity and functional impairments in both exercise groups. This was also confirmed in the long-term measurements, with further significant improvements in the results. This indicates that for patients with movement control impairment both specific exercise programmes and general strength training can be recommended. It is also important to emphasise the subgroup’s good adherence to the training programmes. This can be explained by the increased confidence patients experienced as a result of the precise, individual instructions for the exercises they received from the therapists, the connection they felt between the exercises and decrease in pain and the fewer restrictions they perceived in everyday life due to the increase in their self-efficiency.
Christoph Bauer conducted his PhD project in collaboration with scientists at the Faculty of Medicine and Life Sciences, University of Tampere, the UKK Institute, Tampere, Finland, and the medical technology company Hocoma AG. First, a new portable system to measure lumbar movement control was developed by Hocoma AG. The reliability and validity of the measurement system was examined and confirmed in a comparison with a reference standard in the movement lab. Then the research group investigated several questions of clinical relevance. They discovered that, with increasing back pain, movement control of the lower spine changed when repetitive movements were performed. Apart from the pain factor, the fatigue experienced by the people affected is significant, since they apply different compensation strategies from pain-free people in order to be able to carry out repetitive movements. To conclude, it can be said that employees with physically demanding jobs, such as nursing professionals, can benefit from back training. The back training followed by the nursing professionals in the trial allowed them to develop more variable compensation strategies when performing repetitive movements. This is particularly helpful for people who are at a high risk of developing back pain.
Doctoral programme «Care & Rehabilitation Sciences»
Up until recently, physiotherapists have completed their PhDs in neighbouring EU countries, but in future, this will also be possible in Switzerland. From the autumn semester 2018, the doctoral programme «Care and Rehabilitation Sciences», which has been developed by the University of Zurich Medical Faculty and the ZHAW School of Health Professions, enables health profession graduates from universities of applied sciences to pursue their doctoral studies in Switzerland. Further information on the doctoral programme
Publications related to Jeannette Saner’s PhD thesis
- Saner J, Kool J, Sieben JM, Luomajoki H. Movement control exercises versus general exercise to reduce disability in patients with low back pain and movement control impairment. A randomized controlled trial. Bmc Musculoskel Dis. 2011;12:207.
- Saner J, Kool J, Sieben JM, Luomajoki H, Bastiaenen CH, de Bie RA. A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: A randomised controlled trial with one-year follow-up. Man Ther. 2015;20:672-9.
- Saner J, Sieben JM, Kool J, Luomajoki H, Bastiaenen CH, de Bie RA. A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: Short-term results of a randomised controlled trial. J Bodyw Mov Ther. 2016;20:189-202
- Saner J, Bergman EM, de Bie RA, Sieben JM. Low back pain patients' perspectives on long-term adherence to home-based exercise programmes in physiotherapy. Musculoskeletal science & practice. 2018;38:77-82.
- Kromer Thilo O. SJ, Sieben Judith M., Bastiaenen Caroline H.G. (2018). The Patient-specific Functional Scale - its construct validity and validity to change in patients with shoulder and low back pain. Submitted.
- Saner-Bissig J. Specific or non-specific exercises for patients with low back pain and movement control impairment. What works? Dissertation. Maastricht, The Netherlands: Maastricht University; 2018. ISBN: 978 94 9301 980 5.
Publications related to Christoph Bauer’s PhD thesis
- Bauer CM, Rast FM, Ernst MJ, Kool J, Oetiker S, Rissanen SM, Suni JH, Kankaanpää MJ. Concurrent validity and reliability of a novel wireless inertial measurement system to assess trunk movement. Journal of Electromyography and Kinesiology. 2015;25(5):782-90. https://doi.org/10.21256/zhaw-2713
- Bauer CM*, Heimgartner M*, Rast FM, Ernst MJ, Oetiker S, Kool J. Reliability of lumbar movement dysfunction tests for chronic low back pain patients. Manual Therapy. 2016;24:81-4. 10.1016/j.math.2016.02.013
- Bauer CM, Rast FM, Ernst MJ, Oetiker S, Meichtry A, Kool J, Suni JH, Kankaanpää MJ. Pain intensity attenuates movement control of the lumbar spine in low back pain. Journal of Electromyography and Kinesiology. 2015;25(6):919-27. https://doi.org/10.21256/zhaw-2707
- Bauer CM, Rast FM, Ernst MJ, Meichtry A, Kool J, Rissanen SM, Suni JH, Kankaanpää MJ. The effect of muscle fatigue and low back pain on lumbar movement variability and complexity. Journal of Electromyography and Kinesiology.2017;33:94-102
https://doi.org/10.1016/j.jelekin.2017.02.003 - Bauer CM, Kankaanpää MJ, Rast FM, Meichtry A, Rissanen SM, Suni JH. Efficacy of six months neuromuscular exercise on lumbar movement variability – A randomized controlled trial. In Preparation.
- Buch: Bauer, Christoph, 2018. Reliability and validity of lumbopelvic kinematics related to nonspecific low back pain [Dissertation]. Tampere: University of Tampere, Faculty of Medicine and Life Sciences. Acta Universitatis Tamperensis; 2379. ISBN 978-952-03-0745-5.