Low Back Pain
Conditions
Keywords
Low Back Pain
Brief summary
Exercise therapy is effective in improving pain experience and disability in patients with non-specific low back pain (NSLBP) and movement/postural control impairments. However, patients often find traditional exercises monotonous and discontinue their execution. Augmented feedback tools (AF) might improve patient adherence and therapy outcomes, but evidence is currently lacking on their effects on movement/postural control. In a pilot randomised controlled trial (RCT) on a population of patients with NSLBP and movement control impairment, treatment with physiotherapy and home exercise supported by AF is compared to traditional physiotherapy and home exercise treatment without AF (control group). The primary outcomes are defined as lumbar movement control and postural control, measured using an inertial measurement system.
Interventions
DEVICEAugmented Feedback
An inertial measurement unit (IMU) system is the basis of the augmented feedback (AF) system, where the IMU-system communicates with a laptop using a bluetooth dongle. The corresponding software includes therapeutic games. Movements of the lower back and pelvis by the patient are used to control an avatars movement or the graphical interface in computer exercises. The AF-system provides real-time feedback regarding the patient's performance and helps to rectify incorrect execution of the exercises. The intervention took place at a physiotherapy clinic and in an home environment. In the physiotherapy clinic the patients exercised under the supervision of the physiotherapists. They continued the exercises at home as home exercises.
OTHERControl Group
Conventional impairment-specific physiotherapy exercises for low back pain patients.The control intervention took place at a physiotherapy clinic and in an home environment. In the physiotherapy clinic the patients exercised under the supervision of the physiotherapists. They continued the exercises at home as home exercises.
Sponsors
Danube University Krems
MedBase Brunngasse Winterthur
Zurich University of Applied Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Masking description
The investigators who collected the outcome data, as well as the statistician were blinded to group allocation.
Intervention model description
Randomized controlled pilot trial
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* non specific low back pain for at least four weeks * at least moderate disability (as indicated by an Oswestry disability index (ODI) \> 8% (Mannion et al., 2006)) * low levels of biopsychosocial risk factors (STarT Back Screening tool \> 4 points) (Hill et al., 2011) * at least two positive movement control impairment tests (Luomajoki et al., 2008, Sahrmann, 2002)
Exclusion criteria
* specific low back pain * pain in other areas of the body (e.g. neck, head, thoracic spine or arms) * vertigo or equilibrium disturbances * systemic diseases (e.g. tumours and diabetes) * injuries * surgeries of the legs within the last six months * medication affecting postural control * pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline ratio of the range of motion (ROM) of the stabilized lumbar spine (ROMLS) over the moving body segment, the hip (ROMHip) | From Baseline to the completion of nine physiotherapy sessions, which are completed after a maximum of five weeks (Swiss standard prescription) | Movement control was quantified using the ratio of the range of motion (ROM) of the stabilized lumbar spine (ROMLS) over the moving body segment, the hip (ROMHip) during the movement control test (lumbar spine (LS) over the hip) |
| Changes from Baseline of the mean absolute deviation of lumbar agular displacement | From Baseline to the completion of nine physiotherapy sessions, which are completed after a maximum of five weeks (Swiss standard prescription) | Postural control was quantified using the mean absolute deviation of lumbar angular displacement (MAD) |
Countries
Switzerland
Outcome results
None listed