Chronic Low Back Pain (CLBP)
Conditions
Keywords
movement quality, balance, trunk muscle training
Brief summary
The goal of this project is to assess if Chronic Low Back Pain (CLBP) participant's movement quality and balance variables can change after training that decreases their pain and disability. It will also compare the difference between structural exercise (SE) and isolated trunk exercise (ITE). The main questions it aims to answer are: 1. What are the effect of the training on the participant's movement quality and balance. 2. What are the difference between different types of trunk muscle training on people with CLBP. Researchers will compare SE, ITE and control. Control group will receive back school education that was shown not to be effective in reducing pain and disability. Participants will: 1. Do home and in-lab based SE or ITE training, or maintain active daily living over 2 months. 2. Complete the pain and disability questionnaire and do several physical functioning tests while having their trunk and lower limb movement and muscle activation measured.
Detailed description
Both ITE and SE training are equalized in terms of training intensity based on rate of perceived exertion, training duration per session, training frequency, and intervention period. Training intensity measurement does not use other methods of quantification as ITE training does not increase heart rate or blood lactate significantly regardless of the intensity.
Interventions
BEHAVIORALStructural Exercise
Multi-joint limb movement with force vector through the spine. The spine is held at neutral position
BEHAVIORALIsolated Trunk Exercise
Holding the spine in neutral position with no limb movement, with static loading through the spine
BEHAVIORALBack school
Patient education that has been proven to not be effective and has been used as control in past low back pain intervention studies
Sponsors
The Hong Kong Polytechnic University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* body mass index (BMI) 18-25 kg/m2 * experiencing intermittent pain lasting at least 3 months * had Oswestry Disability Index (ODI) score ranging between 17% and 45%.
Exclusion criteria
* exercise contraindication based on physical activity readiness questionnaire * indication or diagnosis of other chronic diseases (such as cancer, cardiovascular disease, diabetes, bone fracture, or infection) * artificial lower limb joints, history of spinal surgery, walking aid use * personal mobility restrictions (due to connective tissue diseases, rheumatoid arthritis, or central nervous system disorders) * pregnancy or within 1 year post partum
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 5RSTS time | Same day as first day of intervention and within one week after intervention | Time required to complete five-repetitions sit-to-stand with smaller time indicating better performance. |
| Perceived pain | Same day as first day of intervention and within one week after intervention | score from numerical pain rating scale from zero (0) to ten (10), with 0 indicating no pain. |
| Perceived disability | Same day as first day of intervention and within one week after intervention | Score based on oswestry disability index scoring from zero (0) to one hundred (100) percent, with zero indicating no disability. |
| Lower lumbar active range of motion | Same day as first day of intervention and within one week after intervention | active range of motion of the lower lumbar area during five-repetitions sit-to-stand test. |
| Segmental movement coordination | Same day as first day of intervention and within one week after intervention | Lumbar-to-pelvis and pelvis-to-femur movement coordination as quantified by mean absolute relative phase angle during five-repetitions sit-to-stand. Smaller number indicates greater coordination between the two segments. |
| Segmental movement stability | Same day as first day of intervention and within one week after intervention | lumbar-to-pelvis and pelvis-to-femur movement stability as quantified by deviation phase during five-repetitions sit-to-stand. Greater number indicates lesser segmental movement stability. |
| Postural stability | Same day as first day of intervention and within one week after intervention | Center-of-pressure normalized mean velocity during Y-balance test. Smaller number indicate greater stability |
| Postural Control | Same day as first day of intervention and within one week after intervention | normalized leg reach during y-balance test, with larger number indicating greater postural control. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Muscle synergy | Same day as first day of intervention and within one week after intervention | Muscle synergy as measured by the surface electromyography (SEMG) output of the latissimus dorsi, longissimus pars thoracis, longissimus pars lumborum, external oblique, rectus abdominis, gluteus maximus and biceps femoris muscle both on left and right side during all functional tests. SEMG signals would then be processed using non-negative matrix factorization to find the underlying muscle synergies |
| LAP performance | Same day as first day of intervention and within one week after intervention | time required to complete the lift and place test with lesser time indicating greater performance |
Countries
Hong Kong
Contacts
Primary ContactDhananjaya Sutanto, Ph.D.
Outcome results
None listed