Occlusal byte and Mézières postural therapy improve pain and performance in elite rhythmic gymnasts with low back pain.

چکیده اصلی

BACKGROUND: Low back pain (LBP) is prevalent among rhythmic gymnastics athletes due to repetitive spinal loading and postural asymmetries. The Mézières Method, a postural re-education approach, aims to restore global muscle balance, while occlusal splints (oral bytes) have been proposed to optimize posture and neuromuscular control. This study investigated the combined and independent effects of postural therapy and oral byte use on pain, function, flexibility, and quality of life in elite rhythmic gymnasts with LBP. METHODS: Eighty-nine gymnasts were screened, and 39 met inclusion criteria and completed the intervention: 20 with oral byte and 19 without. All participants underwent the Mézières Method program for six months, consisting of two weekly sessions (30 min each) supervised by a certified physiotherapist. Outcomes included pain intensity (VAS-Pain), functional disability (Roland-Morris Disability Questionnaire-RMDQ), Short Form-12 Health Survey (SF-12), with the Physical Component Summary (PCS) and the Mental Component Summary (MCS), and flexibility (Sit-and-Reach test). Data were analyzed using multivariate ANCOVA and linear mixed-effects models with baseline values as covariates. RESULTS: Both groups demonstrated significant improvements over time in VAS and RMDQ; p < 0.001, with no significant between-group or interaction effects, indicating comparable improvements. PCS and MCS scores improved significantly over time (p < 0.01), indicating enhanced health-related quality of life. Flexibility increased in both groups (p < 0.001), with moderate-to-large effect sizes (η² = 0.12-0.21). No adverse events were reported. CONCLUSIONS: Six months of Mézières-based postural therapy were associated with significant improvements in pain, function, flexibility, and quality of life in rhythmic gymnasts with low back pain. However, in the absence of a non-intervention control group, these improvements may be partially influenced by non-specific or placebo effects. The addition of an occlusal bite device did not produce consistent additional benefits across outcomes. Further controlled studies are needed to determine the specific efficacy of these interventions. TRIAL REGISTRATION: NCT03849053; Registered on 19 February 2019.

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