Relative Stiffness of Lumbar Spine and Hamstrings Muscle Stretching

NCT03787979 | Completed

• 1 other identifier: 2018/200.1010
• Study Type: interventional
• Target: 32
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to investigate the effect of lumbopelvic stabilization on hamstrings muscle stretching in individuals with history of low back pain suspected to have a clinical lumbar instability.

Conditions

Back Pain; Instability Lumbar Spine; Muscle Tightness

Keywords

History of low back pain; Clinical lumbar instability; Stretching exercise

Outcome Measures

Primary Outcomes (4)

• Lumbar, pelvic, and lumbopelvic motions at baseline.

  Clinical motion analysis system will be used to measure these segmental motions. This system is composed of triple axis accelerometers (MPU6050, China), data acquisition board (Arduino Uno R3, Italy), and a LabVIEW software version 2012 (National Instrument, USA). The system will be used to measure pre- and post-intervention of angle of lumbar, pelvic, and lumbopelvic motions through a custom LabVIEW program at 100 Hz.

  These data will be collected at baseline and immediately after intervention.

• Lumbar, pelvic, and lumbopelvic motions after intervention.

  Clinical motion analysis system will be used to measure these segmental motions. This system is composed of triple axis accelerometers (MPU6050, China), data acquisition board (Arduino Uno R3, Italy), and a LabVIEW software version 2012 (National Instrument, USA). The system will be used to measure pre- and post-intervention of angle of lumbar, pelvic, and lumbopelvic motions through a custom LabVIEW program at 100 Hz.

  These data will be collected at immediately after intervention.

• Hamstrings muscle length at baseline.

  Clinical motion analysis system will be used to measure the angle of knee extension that represents hamstrings muscle length at pre- and post-intervention.

  These data will be collected at baseline.

• Hamstrings muscle length after intervention.

  Clinical motion analysis system will be used to measure the angle of knee extension that represents hamstrings muscle length at pre- and post-intervention.

  These data will be collected at immediately after intervention.

Secondary Outcomes (2)

• Muscle length based on modified Thomas and Trendelenburg test.

  These data will be collected at baseline only.

• Abdominal and back muscle strength .

  These data will be collected at baseline only.

Study Arms (2)

Lumbopelvic stiffening technique

EXPERIMENTAL

Hamstring muscle stretching with lumbopelvic stiffening technique.

Other: Lumbopelvic stiffening technique; Other: Lumbopelvic relaxing technique

Lumbopelvic relaxing technique

ACTIVE COMPARATOR

Hamstrings muscle stretching with lumbopelvic relaxing technique.

Other: Lumbopelvic stiffening technique; Other: Lumbopelvic relaxing technique

Interventions

Lumbopelvic stiffening technique OTHER

Participants will stretch their hamstrings muscle in standing position with lumbopelvic stiffening technique. Fifteen percent of the body weight will be used to standardize stretching force. During stretching protocol, the participants will be instructed to face the hydraulic table with their hips square, maintain trunk straight up and look straight ahead. Researcher commands "during adjusting the bed up, please tense your back rigid". After that, hydraulic bed will be lifted up until force reaches 15 percent of the body weight. Participant will perform 30 seconds/repetition for 4 repetitions with 15 seconds rest between repetitions.

Lumbopelvic relaxing technique; Lumbopelvic stiffening technique

Lumbopelvic relaxing technique OTHER

Participants will be instructed to face the hydraulic table with their hips square, maintain trunk straight up and look straight ahead. The researcher commands "During adjusting the bed up, please relax your back". The hydraulic bed will be lifted up until force reaches 15 percent of the body weight. Participant will perform 30 seconds/repetition for 4 repetitions with 15 seconds rest between repetitions.

Lumbopelvic relaxing technique; Lumbopelvic stiffening technique

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Between the ages of 20 and 40
• A recurrent pattern of LBP at least two episodes that interfered with activities of daily living and/or required treatment
• Presenting aberrant movement pattern during active forward bend test
• Passive straight leg raising test (SLR) greater than 91 degrees
• Having hamstrings muscle tightness of both legs (passive knee extension in supine with 90° hip flexion position greater than 20 degrees)

You may not qualify if:

• Having a history of abdominal, back surgery and/or fracture.
• Having any red flags, such as infection, tumor, fracture, radicular syndrome, or inflammatory.
• Pregnancy or having menstruation.
• Having spinal deformities, such as scoliosis.
• Having neurological, musculoskeletal or cardiopulmonary diseases.
• Previously receiving physical therapy intervention involving in motor control training.
• Taking muscle relaxant medication.
• Having hip joint stiffness or pain
• Having positive Trendelenburg's sign.
• Currently having routine vigorous exercise.

Sponsors & Collaborators

• Mahidol University: lead

Study Sites (1)

Faculty of Physical Therapy, Mahidol University

Salaya, Changwat Nakhon Pathom, 73170, Thailand

Location

Related Publications (4)

• 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

• Sahrmann S, Azevedo DC, Dillen LV. Diagnosis and treatment of movement system impairment syndromes. Braz J Phys Ther. 2017 Nov-Dec;21(6):391-399. doi: 10.1016/j.bjpt.2017.08.001. Epub 2017 Sep 27.

  PMID: 29097026 BACKGROUND

• Jandre Reis FJ, Macedo AR. Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending. Asian Spine J. 2015 Aug;9(4):535-40. doi: 10.4184/asj.2015.9.4.535. Epub 2015 Jul 28.

  PMID: 26240711 BACKGROUND

• Wattananon P, Prasertkul W, Sakulsriprasert P, Laskin JJ. Effect of increased relative stiffness of the lumbar spine on hamstring muscle stretching in individuals with a history of low back pain suspected to have a clinical lumbar instability: A randomized crossover design. Clin Biomech (Bristol). 2020 May;75:104996. doi: 10.1016/j.clinbiomech.2020.104996. Epub 2020 Apr 20.

  PMID: 32339943 DERIVED

MeSH Terms

Conditions

Back Pain

Condition Hierarchy (Ancestors)

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: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: The assessor and investigator will be blinded to the random order. This process will be handled by the research manager.
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Model Details: Participants will be randomly assigned to either stretching exercise with lumbopelvic stiffening technique or lumbopelvic relaxing technique. They will be provided a 2-day wash-out period. Then, participants will cross-over to another technique.

Study Record Dates

• First Submitted: December 19, 2018
• First Posted: December 27, 2018
• Study Start: December 24, 2018
• Primary Completion: April 30, 2019
• Study Completion: May 30, 2019
• Last Updated: June 3, 2019

Record last verified: 2019-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: The supporting information will be sent upon official request.
• Access Criteria: Having an official written request.

Locations

TH (1)