Drexel University
College of Nursing & Health Professions
1505 Race Street Ms 501 Philadelphia, PA 19102
Physical Therapy and Rehabilitation Sciences Department
MECHANICAL LOW BACK PAIN
REHABILITATION SCIENCES SPINE RESEARCH LAB
PROJECTS
Recurrent Low Back Pain: Linking Mechanism to Outcomes
Investigators
Sheri P. Silfies, PT, PhD (PI) – Physical Therapy & Rehabilitation Sciences, Drexel University
Susan Smith, PT, PhD – Physical Therapy & Rehabilitation Sciences, Drexel University
Simon Giszter, PhD – Neurobiology & Anatomy, College of Medicine, Drexel University
Rupal Metha, PT, DPT, PhD- Adjunct Faculty, Physical Therapy & Rehabilitation Sciences,
Drexel University
1 Drexel University
College of Nursing & Health Professions
1505 Race Street Ms 501 Philadelphia, PA 19102
Summary / Overview
The objectives of the grant are to gain a better understanding of how trunk movement and stability
are coordinated. A component of this process will be to determine reliability and responsiveness of
novel measures of trunk control, and begin to clarify the relationship between poor control, low back
pain (LBP) and physical thearpy outcomes. Studies have been designed to test the general
hypothesis that, in patients with LBP and clinical findings of lumbar instability, altered neuromuscular
control strategies are associated with poor movement patterns and clincial symptoms. The proposed
studies go on to test the hypothesis that poor movement strategies can be improved through
exericses emphasing trunk stabilization. Experiments are being conducted to (1) characterize
alterations in neuromuscular control in patients LBP, (2) determine the measurement properties of our
methods, (3) identify which aspects of trunk neuromuscular control can be improved with therapeutic
intervention and (4) begin to investigate mechanism underlying improvement in pain and disability
with a neuromuscular rehabilitation program. Collectively, the experimental outcomes from this grant
will have a substantive impact on treatments for patients with LBP, improve our ability to identify
patients who might respond this trunk muscle training approach and provide strategies for reducing
the recurrence of low back symptoms.
Funding
NIH, NICHD K01HD53632 (6/2007-5/2011)
Participating Sites
Drexel University Physical Therapy Services
Physiotherapy Associates, West Chester, PA
Articles
Biely, SA, Smith, SS, Silfies, SP. Clinical Instability of the Lumbar Spine: Diagnosis and Intervention,
Orthopedic Practice, 2006; 18(3), 11-18.
Silfies, SP, Bhattacharya A, Biely, S, Smith, S, Giszter, SF. Trunk Control during Standing Reach: A
Dynamical System Analysis of Movement Strategies in Patients with Mechanical Low Back Pain. Gait
Posture, 2008; 29:370-376 (doi.org/10.1016/j.gaitpost.2008.10.053)
2 Drexel University
College of Nursing & Health Professions
1505 Race Street Ms 501 Philadelphia, PA 19102
Silfies, SP, Mehta, R, Smith, S, Karduna, A. Differences in Feedforward Trunk Muscle Activity in
Subgroups of Patients with Mechanical Low Back Pain, Arch Phys Med Rehabil, 2009;
90:1159-1169.
Mehta, R, Cannella, M, Smith, S, Silfies, SP. Altered Trunk Motor Planning in Patients with NonSpecific Low Back Pain, J Motor Behavior. 2010; 42(2):135-144. PubMed PMID:20207604
Presentations
Bhattacharya A, Biely, S; Silfies, SP. Qualitative Analysis of Lumbopelvic Movement Patterns in
Individuals with Mechanical Low Back Pain: A Kinematic Study, J Ortho Sports Phys Ther, 2009;
39(1): A 84-85
Mehta, R, Smith, S, Silfies, SP. Trunk Muscle Timing and Amplitude Differences in Patients with
Mechanical Low Back Pain during a Self-initiated Perturbation, J Ortho Sports Phys Ther, 2009;
39(1): A 96
El-Kerdi, A, Mehta, R, Bhattacharya, A, Silfies, SP. Reliability of Trunk Postural Control Parameters in
Unstable Sitting, J Ortho Sports Phys Ther, 2009;39(1): A 95
Silfies, SP, Hart, C, Cannella, M, Giszter, SF. Task-Independent and Task Specific Trunk Muscle
Synergies Are Recruited In Bending and Reaching. International Society for Posture and Gait
Research, Bologna, Italy, June 21-25, 2009.
Cannella, M, Bhattacharya, A, Giszter, SF, Silfies, SP. Trunk Control Testing using Stationary
Target Paradigm. International Society for Posture and Gait Research, Bologna, Italy, June 21-25,
2009.
Sung W, Silfies, SP, Abraham M, Plastaras, C. (2012) Trunk Neuromuscular Control is
Impaired in Patients with Mechanical Low Back Pain and Improves Following a Lumbar
Stabilization Program, PM & R, Volume 4, Issue 10, Supplement Pages S187-S188, October
2012. doi:10.1016/j.pmrj.2012.09.628
Contact Us
If you are interested in learning more about current low back pain studies being conducted through
the Rehabilitation Sciences Spine Research Lab at Drexel University, please contact Dr. Sheri Silfies
at 215.762.3589 or silfies@drexel.edu.
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