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Idiopathic as well as nonspecific low back pain is relevant in health care systems as well asinleisure and high-performance sports. Neuromuscular and/or structural deficits, mostly accompanied by biopsychological factors,are known risk factors for both the onset and chronification of symptoms. Meta-analytic evidence describes positive effects of physical activity. However, type, dose-response relation, minimum of training required and setting-specific implementation has not been fullyclarified. Since 2011, the national research network Medicine in Spine Exercise [MiSpEx] has beenfollowing a project layout called Ran Rcken focussing on the development and validation of intervention programs including neuromuscular and pain adaptation moderated by individual training status, pain behaviour, allostatic load and social settings. Overall about 8000 patients and athletes have been and are being followed experimentally and clinically in 34 studies. It could be shownthat a training program focussing on compensation of external loads elicited by perturbations is effective in prevention and rehabilitation in both athletes and general population. Besides validation of further consecutively developed programs emphasis is put on the evaluation of transfer strategies to medical systems, sports as well as general population. Finally, the evaluation of an efficient dose-response relation is addressed.KEY WORDS: Low Back Pain, MiSpEx, Sports, Perturbations, Therapy, Prevention, Training

In the MiSpEx project, the statistical analysis of main research questions accompanied by the aggregation of diverse data obtained in the individual studies represents a particular challenge. Research goals relating to the effectiveness and efficiency of training interventions in order to reduce the risk and degree of back pain may be addressed by meta-analyticalapproaches. This requires a sufficient similarity of the underlying studies and, in case of applying a meta-analysis of individual data,uniformly structured data sets. Approaches of supervised statistical learning should be applied to research goals concerning the diagnosis of back pain, and the prognosis either of further course of symptoms and of the reaction to preventive and curative interventions. The various underlying data sets should enable a step-by-step approach with several development and validation steps, likewise provided that sufficient comparability exists. The assessment of moderating effects of the influencing factors pain experience, training status, psychophysical distress, and level of care on treatment success is of high importance.KEY WORDS: Aggregation, Analysis Strategy, Prevention, Back Pain

Nicolle Müller1, Daniela Stengel2, Christof Kloos1, Michael Ristow2, Gunter Wolf1, Ulrich A Müller11University Hospital of Jena, Department of Internal Medicine III, Jena, Germany; 2Friedrich-Schiller-University Jena, Institute of Nutrition, Department of Human Nutrition, Jena, GermanyObjective: Long-term outcomes after participation in a structured diabetes treatment and teaching program (DTTP) for patients with diabetes without insulin use, primarily based upon postprandial urine glucose self-monitoring (UGSM).Methods: A total of 126 patients took part in the DTTP in a university outpatient department in 2004–2005. We re-evaluated 119 (94.4%) at baseline and at 6 months, 12 months, and 24 months. Hemoglobin A1c (HbA1c) was DCCT adjusted.Results: HbA1c decreased significantly 6 months after education from 7.33% (±1.59%) to 6.89% (±0.98%; P = 0.001 versus baseline) and was maintained for up to 12 months (7.02% ± 1.07%; P = 0.017 versus baseline) as well as up to 24 months (6.96% ± 1.06%; P = 0.005 versus baseline). Weight decreased from 92.5 kg at baseline to 90.3 kg at 24 months (P = 0.014). A total of 36.5% of patients not on insulin therapy preferred UGSM, whereas 23.5% preferred blood glucose monitoring, at 24 months. Glucose control was similar in both groups at 24 months (HbA1c UGSM 7.03 versus blood glucose monitoring 6.97%; P = 0.807).Conclusion: Participation in the DTTP resulted in long-term behavior modification. HbA1c of patients without insulin met the target 24 months after the DTTP, irrespective of the type of glucose self-monitoring.Keywords: diabetes mellitus type 2, treatment and teaching program, patient education, HbA1c, body weight