The Neural Basis of Lumbosacral Proprioceptive Impairment in Recurrent Low Back Pain

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT01540617

Enrollment

Registered

2012-02-29

Start date

2012-04-30

Completion date

2014-04-30

Last updated

2014-04-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Low Back Pain

Keywords

Low back pain, Proprioception, Postural control, Spine, Variability, MRI, Vibration, Brain

Brief summary

Low back pain (LBP) is a well known health problem in Western society that is significantly responsible for socio-economic problems like absenteeism and disability. The lifetime prevalence of LBP is 60-80% and approximately 85% of this LBP has a non-specific character whereby the underlying causes and risk factors cannot be demonstrated. While many people recover within a month, most individuals will have recurrence within a year with more severe symptoms. This might be due to insufficient knowledge of the underlying mechanisms. Impaired proprioception, the ability to discern body/limb positions and movements, may cause and maintain LBP shown by an altered postural control strategy. Specifically, patients with LBP rely more on proprioceptive signals from the ankles due to less reliable proprioceptive input of proximal segments. Moreover, they show a decreased variability in postural control and less postural robustness, while variability is a prerequisite for optimal functioning of biological systems. However, further clarification of the neural correlates is necessary. Deficits in proprioception, as found in a subgroup of patient with LBP, are associated with a decreased ability of the brain to process proprioceptive inputs. The aim of this project is to clarify the central changes in individuals with recurrent non-specific low back pain and healthy controls. To evaluate these central changes MRI techniques (3DTFE, DTI and RS-fMRI) will be used. In addition, the association between central changes and postural control tasks will be evaluated.

Interventions

None listed

Study design

Observational model

CASE_CONTROL

Time perspective

CROSS_SECTIONAL

Eligibility

Sex/Gender

ALL

Age

20 Years to 50 Years

Healthy volunteers

Yes

Inclusion criteria

persons with low back pain: * Age: 20-50 year * At least 6 months of low back pain with/without referred pain in buttock/thigh * At least 3 episodes of disabling low back pain * At least a score of 14% on the Oswestry Disability Index * Willingness to sign the informed consent * Met the MRI related requirements Inclusion Criteria healthy persons: * Age: 20-50 year * No history of low back pain * A score of 0% on the Oswestry Disability Index * Willingness to sign the informed consent * Met the MRI related requirements

Exclusion criteria

* History of major trauma and/or major orthopedic surgery of the spine, the pelvis or the lower quadrant * One of the following conditions: Parkinson, MS, Stroke with sequels.... * Radicular symptoms * Not Dutch-speaking * Strong opioids * Neck pain * Ankle problems * Smoking

Design outcomes

Primary

Measure	Time frame
Structural changes in white matter pathways (3DTFE and DTI) (in individuals with recurrent non-specific low back pain compared to healthy controls)	One time point
Changes in resting state activity between individuals with recurrent non-specific low back pain and healthy controls)	One time point
Proprioceptive postural control (center of pressure displacement in response to muscle vibration)	One time point

Countries

Belgium

Outcome results