Low Back Pain
Conditions
Keywords
Low back pain, lumbar multifidus, Proprioception, Elastography, Magnetic resonance imaging
Brief summary
Low back pain (LBP) is a severe epidemic in the world. Despite its high prevalence, 90% of the cases have no identifiable cause. Approximately 44% of them experience recurrent LBP within one year and 10% of them develop chronic LBP that lasts for three months or more. Mechanically, the lumbar spine is unstable and requires spinal muscle to maintain spinal stability and to prevent injuries. Lumbar multifidus (LM) muscle is thought to be the major spinal stabilizer responsible for spinal stability and spinal proprioception. Prior studies have revealed that increased fat infiltration, atrophy or activation deficits of LM in patients with LBP as compared to asymptomatic individuals. Unfortunately, inconsistent findings have also been reported. Although prior research attempted to determine if abnormal LM characteristics can inform clinical decision-making, their results are limited because they only investigated a single LM characteristic at a time, which might not reflect the actual LM condition. Further, many studies adopted cross-sectional design that could not reveal the casual relations between abnormal LM characteristics and LBP. As such, the current study aims to identify specific LM characteristics that can predict new episode of LBP in asymptomatic individuals, and recurrent/chronic LBP in individuals with LBP at baseline.
Detailed description
Low back pain (LBP) is a severe epidemic in the world. Despite its high prevalence, 90% of the cases have no identifiable cause. While most people with LBP recover shortly after onset, approximately 44% of them experience recurrent LBP within one year and 10% of them develop chronic LBP that lasts for three months or more. Mechanically, the lumbar spine is unstable and requires spinal muscle to maintain spinal stability and to prevent injuries. Lumbar multifidus (LM) muscle is thought to be the major spinal stabilizer responsible for spinal stability and spinal proprioception. Different cross-sectional studies have revealed that increased fat infiltration, atrophy or activation deficits of LM in patients with LBP as compared to asymptomatic individuals. Research has shown that abnormal morphology or activation of LM is associated with LBP intensity/location, or LBP-related disability. Unfortunately, inconsistent findings have also been reported. Although prior research attempted to determine if abnormal LM characteristics can inform clinical decision-making, their results are limited because they only investigated a single LM characteristic at a time, which might not reflect the actual LM condition. Further, many studies adopted cross-sectional design that could not reveal the casual relations between abnormal LM characteristics and LBP. Given the above, the current study aims to identify specific LM characteristics that can predict new episode of LBP in asymptomatic individuals, and recurrent/chronic LBP in individuals with LBP at baseline.
Interventions
None listed
Sponsors
University of Oulu
The University of Hong Kong
Rush University
Concordia University, Montreal
Zurich University of Applied Sciences
The Hong Kong Polytechnic University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* aged 18 to 65 years * Symptomatic participants should have LBP that requires medical consultation(s) in the last three months * LBP intensity of at least 5 on the 11-point numeric pain rating scale at baseline (for symptomatic participants) * Asymptomatic participants should be pain free at baseline, and should not have LBP in the last year nor LBP lasting more than a week in the last 3 years
Exclusion criteria
* a history of neurological disease or vestibular impairment * systemic inflammatory disease * prior spinal surgery * acute/chronic neuropathy or radiculopathy * spinal infections/fractures/tumors, metabolic disorders, * medical 'red flags'
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 11-point numeric pain rating scale (NPRS) for low back pain | 2 years | The current pain intensity of each participant will be quantified by an 11-point NPRS, where 0 means no pain and 10 means the worst imaginable pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proprioception of lumbar multifidus | 2 years | An established protocol to measure proprioception of lumbar multifidus |
| Morphometry of lumbar multifidus | 2 years | B-mode ultrasound imaging will be used to quantify morphometry of multifidus |
| Stiffness of lumbar multifidus | 2 years | Elastography will be used to measure lumbar multifidus stiffness |
| Fatty infiltration of lumbar multifidus | 2 years | Magnetic resonance imaging will be used to quantify the fatty infiltration of multifidus |
Countries
Hong Kong
Contacts
Primary ContactArnold Wong, PhD
Outcome results
None listed