Additional Gluteal Control Training for Low Back Pain With Functional Leg Length Inequality

Additional Gluteal Control Training for Low Back Pain With Functional Leg Length Inequality: A Ramdomized Controlled Trail

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT03554746

Enrollment

Registered

2018-06-13

Start date

2017-12-11

Completion date

2018-09-10

Last updated

2019-09-19

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

Conditions

Low Back Pain, Recurrent

Brief summary

Detailed description

Low back pain (LBP) is a prevalent musculoskeletal disorder. A variety of exercise interventions which were designed as randomized control trails (RCTs) have been studied and shown effectiveness in improving pain and disability. These exercises typically focus on the abdominal and back musculature strength. However, many LBP patients did not show any improvement in their symptom after they carry out those exercise programs. Some authors consider that this type of low back pain may be caused by leg length inequality (LLI) in these patients, which resulted from poor gluteal neuromuscular control or muscles' imbalance. In consideration of few studies have been done for investigating the effects of gluteal muscles control training in LBP. Thus, the purpose of this study is to investigate the effect of additional gluteal muscles control training on improving functional LLI in patients with LBP. We hypothesized that gluteal muscle control training would be more effective in self-reported pain, and their functional disability would be improve after 6-week training program than control training group.

Interventions

OTHERGC group

1. core stability training: hold 5s/rep, 20 reps/times 1. supine, pelvic posterior tilt with TrA contraction. 2. supine, pelvic posterior tilt and maintain bil. knee on 90 degrees. 3. All four position with leg raise 2. Stretching ex. : hold 15 s/reps, 5 reps/times 1. Hamstring 2. Quadriceps 3. Additional gluteal muscle control training: hold 10 s/reps, 20 reps/times 1st to 2nd: 1. clam ex. without resistance 2. single leg bridge with maintain bil. ASIS even level 3rd to 4th: maintain 1st to 2nd ex. with resistance 5th:  1. maintain 3rd to 4th ex. 2. single leg standing on rock board to maintain balance 6th:  1. maintain 5th ex. 2. lunge ex. without hip internal rotation

OTHERCG group

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

20 Years to No maximum

Healthy volunteers

Inclusion criteria

* non-specific LBP (from inferior rib margin to the gluteal fold) * more than 3 months * Visual Analog Scale ≧5 (in past one month) * pelvic innominate rotation (anterior rotation in dominant side)

Exclusion criteria

* history of fracture or surgery * congenital anomalies in the spine, pelvis, or lower limbs * recent trauma, tumor, pregnancy or scoliosis * lower extremity paresthesia, unknown weakness * bowel and bladder dysfunction * predominant lower extremity pain with standing * presence of system illness, no reasoning weight loss, predominant night pain * specific sacroiliac joint dysfunction

Design outcomes

Primary

Measure	Time frame	Description
Leg Length Inequality	change from baseline at 6 weeks later	functional leg length inequality
Ilium Anterior Tilt Difference	change from baseline at 6 weeks later	bilateral ilium anterior tilt difference
Pelvic Inclination	change from baseline at 6 weeks later	bilateral pelvic inclination

Secondary

Measure	Time frame	Description
Functional Disability	change from baseline at 6 weeks later	Oswestry disability index (ODI) Maximum: 100 Minimal: 0 higher scores mean a worse outcome
Functional Ability	change from baseline at 6 weeks later	PSFS (0-10) Maximum: 10 Minimal: 0 higher scores mean a better outcome
Pain Intensity	change from baseline at 6 weeks later	Visual Analog Scale (VAS) (0-10) Maximum: 10 Minimal: 0 higher scores mean a worse outcome

Countries

Taiwan

Participant flow

Participants by arm

Arm	Count
GC Group It mainly involve core stability exercise, stretching exercise and gluteal control training. All of above will be arranged 3 times a week for a total 6 weeks. GC group: 1. core stability training: hold 5s/rep, 20 reps/times supine, pelvic posterior tilt with TrA contraction. supine, pelvic posterior tilt and maintain bil. knee on 90 degrees. All four position with leg raise 2. Stretching ex. : hold 15 s/reps, 5 reps/times a. Hamstring b. Quadriceps 3. Additional gluteal muscle control training: hold 10 s/reps, 20 reps/times 1st to 2nd: clam ex. without resistance single leg bridge with maintain bil. ASIS even level 3rd to 4th: maintain 1st to 2nd ex. with resistance 5th: a. maintain 3rd to 4th ex. b. single leg standing on rock board to maintain balance 6th: maintain 5th ex. lunge ex. without hip internal rotation	24
CG Group IIt involve core stability exercise and stretching exercise. All of above will be arranged 3 times a week for a total 6 weeks. CG group: 1. core stability training: hold 5s/rep, 20 reps/times supine, pelvic posterior tilt with TrA contraction. supine, pelvic posterior tilt and maintain bil. knee on 90 degrees. All four position with leg raise 2. Stretching ex. : hold 15 s/reps, 5 reps/times a. Hamstring b. Quadriceps	24
Total	48

Baseline characteristics

Characteristic	GC Group	CG Group	Total
Age, Continuous	47.58 years STANDARD_DEVIATION 9.42	47.38 years STANDARD_DEVIATION 11.31	47.48 years STANDARD_DEVIATION 10.47
Race and Ethnicity Not Collected	—	—	0 Participants
Sex: Female, Male Female	13 Participants	14 Participants	27 Participants
Sex: Female, Male Male	11 Participants	10 Participants	21 Participants

Adverse events

Event type	EG000 affected / at risk	EG001 affected / at risk
deaths Total, all-cause mortality	0 / 24	0 / 24
other Total, other adverse events	0 / 24	0 / 24
serious Total, serious adverse events	0 / 24	0 / 24