What was your course of action?
Mayer: Scientific baseline experiments have been carried out since mid-2011 to solve individual problems. In the next step, we tested the findings in a multicenter diagnostic accuracy study of 1,000 test subjects and a therapeutic feasibility study of 750 patients since it was unclear whether these could be applied as clinical evidence. We got an affirmative answer. We have subsequently worked with 1,600 test subjects from all over Germany on a central proof-of-concept study since the start of 2015. Each person was monitored for a year. Everyone started an assisted training program, which they subsequently continued as an at-home training program. This major study is now being evaluated.
What have the findings been so far?
Mayer: The perturbation-based training is effective and works. It was also determined that it makes sense to embark on these exercises with assistance for about three weeks in a respective center and then continue the exercises at home. For most patients, the minimum amount of exercise is two 30-minute units a week. However, this requires a pre-exercise screening, since this statement cannot be made for all patients across the board. In addition to a functional status assessment of the lumbar spine and a training readiness assessment, this includes an analysis of the biopsychosocial factors. Likewise, motivation plays a major role, also during training sessions.
Thirteen clinical and non-clinical centers participated in this project. How successful was this collaboration?
Mayer: "Ran Rücken" is funded by the German Federal Institute of Sports Science. The "MiSpEx -National Research Network for Medicine in Spine Exercise" research network includes clinical facilities, universities and research centers. The collaboration between the participants was very successful. What’s more, central organizations, Olympic training centers, rehabilitation clinics and physicians have also joined the project. In a manner of speaking, this has now become a German network.
Now you are finally on the home stretch.
Mayer: Over the past years we have conducted 34 individual studies and 3 additional major multicenter projects. The goal now is to sort, transcribe and publish these large volumes of data. In addition, the transfer concept, which has been completed for the past few weeks, is supported by the respective data and summarized. Previously, we didn’t know what type of exercise is helpful and the minimum amount that’s required, when you overshoot the mark and how much is really good for the body. These are the specific concerns we aim to address and finally assess with this project.