Investigation of Trunk Neuromuscular Control in Patients With Non-specific Low Back Pain

NCT02972073 | Completed

• 1 other identifier: TRG5880133
• Study Type: interventional
• Target: 16
• Locations: 1 country
• Sites: 1

Brief Summary

The purposes of this study include 1) determine clinical utility of clinical observation of aberrant movement patterns during functional trunk and pelvic movements in asymptomatic individuals and patients with non-specific low back pain, 2) characterize trunk neuromuscular control in asymptomatic individuals and patients with non-specific low back pain, and 3) determine the appropriate physical therapy intervention that addresses trunk neuromuscular control deficits in patients with non-specific low back pain.

Conditions

Low Back Pain

Keywords

Low back pain; Neuromuscular control

Outcome Measures

Primary Outcomes (2)

• Electromyography (EMG) muscle activity

  Muscle activity recorded by surface-electromyography (EMG) during functional movements will be used to determine muscle activation pattern changes at 8 weeks after exercise intervention.

  Change from baseline muscle activity at 8 weeks after exercise intervention.

• Kinematic pattern of movement

  Patterns of functional movement will be captured using electromagnetic tracking system and used to determine changes in kinematic pattern of movement at 8 weeks after exercise the exercise intervention.

  Change from baseline movement pattern at 8 weeks after exercise intervention.

Secondary Outcomes (3)

• Numeric pain rating scale

  Change in pain from baseline at 8 weeks after exercise intervention

• Oswestry disability index

  Change from baseline disability level at 8 weeks after exercise intervention

• Short-form general heath status (SF-36) questionnaire

  Change from baseline general health status at 8 weeks after exercise intervention

Study Arms (2)

Exercise intervention

EXPERIMENTAL

There are 4 different exercise interventions (4 independent intervention studies) based on different concepts in this entire project. Interventions include: 1. core stabilization exercise 2. movement system impairment approach 3. neuromuscular activation using suspension 4. kinematic linkage imbalance

Other: Exercise intervention

Healthy control

NO INTERVENTION

This healthy control group will be informed to maintain usual daily activities and avoid participating in activities that involve trunk muscle exercise

Interventions

Exercise intervention OTHER

Physical therapist will provide exercise for patients with low back pain for 60 minutes per day, 2-3 days per week for the total of 8 weeks.

Exercise intervention

Eligibility Criteria

• Age: 21 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Between the ages of 21 and 65
• Current episode of back pain less than 3 months which they seek medical intervention
• Numeric pain rating scale (NPRS) greater than 5 on an 11-point scale (0 = no pain, 10 = worst pain ever)
• Oswestry disability score (Thai version) greater than 50%
• No medical or professional health care intervention including physical therapy for low back pain in last 6 months
• Between the ages of 21 and 65
• No episode of back pain for 3 months prior to the participation
• No regular exercise routine that is composed of core stabilization exercise.

You may not qualify if:

• Clinical signs of systemic disease
• Definitive neurologic signs including weakness or numbness in the lower extremity
• Previous spinal surgery
• Diagnosed osteoporosis, severe spinal stenosis, and/or inflammatory joint disease
• Pregnancy
• Any lower extremity condition that would potentially alter trunk movement in standing
• Vestibular dysfunction
• Extreme psychosocial involvement
• Body mass index (BMI) greater than 30 kg/m2
• Active treatment of another medical illness that would preclude participation in any aspect of the study

Sponsors & Collaborators

• Mahidol University: lead

Study Sites (1)

Faculty of Physical Therapy, Mahidol University

Salaya, Changwat Nakhon Pathom, 73170, Thailand

Location

Related Publications (3)

• Biely SA, Silfies SP, Smith SS, Hicks GE. Clinical observation of standing trunk movements: what do the aberrant movement patterns tell us? J Orthop Sports Phys Ther. 2014 Apr;44(4):262-72. doi: 10.2519/jospt.2014.4988. Epub 2014 Jan 22.

  PMID: 24450372 BACKGROUND

• Hicks GE, Fritz JM, Delitto A, McGill SM. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehabil. 2005 Sep;86(9):1753-62. doi: 10.1016/j.apmr.2005.03.033.

  PMID: 16181938 BACKGROUND

• Spinelli BA, Wattananon P, Silfies S, Talaty M, Ebaugh D. Using kinematics and a dynamical systems approach to enhance understanding of clinically observed aberrant movement patterns. Man Ther. 2015 Feb;20(1):221-6. doi: 10.1016/j.math.2014.07.012. Epub 2014 Jul 24.

  PMID: 25116648 BACKGROUND

MeSH Terms

Conditions

Low Back Pain

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Peemongkon Wattananon, PhD

  Faculty of Physical Therapy, Mahidol University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: November 17, 2016
• First Posted: November 23, 2016
• Study Start: May 1, 2015
• Primary Completion: December 1, 2017
• Study Completion: December 1, 2017
• Last Updated: March 22, 2018

Record last verified: 2018-03

Data Sharing

• IPD Sharing: Will not share

Locations

TH (1)