Chronic Low Back Pain, Degenerative Spondylolisthesis
Conditions
Keywords
spondylolisthesis, low back pain, stabilization exercise
Brief summary
The purpose of this study is to compare the effectiveness of pain control and functional improvement in patients with degenerative spondylolisthesis treated with lumbar stabilization exercises vs flexor exercises (williams exercises)
Detailed description
This study is a randomized controlled trial in patients with the diagnosis of degenerative spondylolisthesis. To date, it is known that lumbar stabilization exercises are an effective treatment option in controlling pain and improving function in patients with degenerative spondylolisthesis based on previous studies, but it is not known if is this a better treatment that another exercises routine for chronic LBP (Low Back Pain). The purpose is to compare the effectiveness on pain control and functional improvement of lumbar stabilization exercises vs flexor exercises (williams exercises). All clinical evaluations are performed by a single physician who is blinded to the exercises, and include a full medical history, physical examination, and x-ray measurement. After initial evaluation, patients are given a sealed envelope containing the treatment (by simple randomization assigned by the investigator). The envelope is opened by the physical therapist which schedules a monthly session and verify the correct execution of each exercise. Each patient receives a sheet with instructions of the exercises to continue daily at home. Scales to assess pain and function will be recorded at baseline, 4 weeks, 3 months and at 6 months to complete the follow up.
Interventions
The home-exercise program included an initial phase, with use of therapeutic heat via a hot pack for 15 minutes at the lumbosacral region, stretching exercises of the thoracolumbar fascia, hip flexors, hamstrings plus the stabilization exercises to encourage stabilizing motor patterns and determine the neutral position of the spine, with the target in control of transversus and internal oblique abdominis, multifidus, pelvic floor muscles, and diaphragmatic breathing control. Progression stages included hot packs, stretching exercises, and lateral, anterior bridges, leg raises in supine position, and arm and leg lifts in quadruped position (bird-dog)
OTHERFlexor exercises
The home-exercise program included a hot pack for 15 minutes and flexor exercises routine
Sponsors
Instituto Nacional de Rehabilitacion
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Degenerative spondylolisthesis at L4-L5 and chronic LBP with or without radicular pain * Attending the Spinal Rehabilitation Service of the National Institute for Rehabilitation (Mexico City). * Without previous treatment * Agree to participate through informed consent.
Exclusion criteria
* History of lumbar surgery, * Rheumatic diseases: Rheumatoid Arthritis, Lupus Erythematosus Systemic, Fibromyalgia, etc. * Cauda equine symptoms, * Ischemic heart disease * Diabetic polyneuropathy * Illiterate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pain (VAS) | At baseline, 4 weeks, 3 months and 6 months | Visual Analog Scale (VAS), considering no pain to be at 0mm, and 100mm to be unbearable pain. |
| Change in Disability (The Roland Morris Scale) | At baseline, 4 weeks, 3 months and 6 months | The Roland Morris Scale: a self-administered questionnaire consisting of 24 items. The total score can range from 0 (no disability) to 24 (maximum disability) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in use of analgesics | At baseline, 4 weeks, 3 months and 6 months | Total number of days consuming analgesics in the 30 days prior to the evaluation. |
Countries
Mexico
Outcome results
None listed