Effects of GPR on Non-Specific Chronic Low Back Pain

NCT06928597 | Recruiting

• 1 other identifier: FU_Bahia
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

Introduction: Low back pain affects approximately 18.5% of the Brazilian population in adulthood, significantly impacting the quality of life and generating substantial costs for the health system. The Global Postural Reeducation Method (GPR) is a promising therapeutic alternative due to its multidimensional approach, capable of improving postural control and reducing pain. Objectives: to evaluate the Efficacy of the RPG method compared to simulated RPG (SHAM) in treating patients with chronic nonspecific low back pain. Methods: Randomized sham-controlled clinical trial. Forty-two adult individuals with chronic nonspecific low back pain will be recruited and distributed into two groups: the Experimental Group (EG), which will receive GPR sessions, and the Control Group (CG), which will receive RPG-SHAM sessions. Both groups will be treated for 30 minutes once a week for 8 weeks. Descriptive analysis will be performed, continuous variables will be summarized to the mean, and standard deviation and categorical variables will be summarized as absolute and relative frequencies. To assess the effects of the intervention over team, analysis of variance (ANOVA) with repeated measures will be used, with a significance level of 5% (p \< 0.05). Expected Results: This study is expected to provide robust evidence on the effectiveness of RPG in treating patients with low back pain, contributing to a better understanding of this complex health condition. The results will potentially positively impact the clinical practice of Orthopedic Physiotherapy, offering an exercise-based and accessible approach for treating patients with low back pain.

Conditions

Low Back Pain

Keywords

Low back pain; Global Posture Reeducation; Chronic Pain

Outcome Measures

Primary Outcomes (1)

• Pain Gradiation

  Pain will be assessed three times: at rest, after a short walk, and during stem flexion using the Scale Visual Analog (EVE). This scale consists of a graduated horizontal line from 0 to 10, where 0 (zero) represents absence of pain and 10 (ten) represents maximum unbearable pain. Higher scores mean greater pain intensity.

  pre and post eight weeks of intervention.

Secondary Outcomes (8)

• Range of motion (ROM) of the spine (Adams test)

  pre and post eight weeks of intervention.

• Range of motion (ROM) of the spine (Inclinometer)

  pre and post eight weeks of intervention.

• Postural Organization (photogrammetry)

  pre and post eight weeks of intervention.

• Activity and participation assessment - World Health Organization Disability Assessment Schedule (WHODAS 2.0)

  pre and post eight weeks of intervention.

• Lower limb strength (sit-to-stand test - SST)

  pre and post eight weeks of intervention.

Other Outcomes (1)

• The perceived overall effect - Likert Scale

  post eight weeks of intervention.

Study Arms (2)

Experimental Group (EG) - GPR

EXPERIMENTAL

The experimental group (EG) will receive GPR sessions. Participants will receive treatment through GPR postures in each session, regardless of the group. A minimum of one and a maximum of two postures will be chosen, what will be evolved progressively put node minimum 15 (fifteen) minutes, case two postures are chosen and, at most, 30 (thirty) minutes, in the case of only one posture. Both groups will be treated for 30 (thirty) minutes, once a week, for eight weeks, totaling eight sessions. One physiotherapist with complete training in the RPG method will carry out the EG services. For the EG, the guidelines for breathing during GPR will be rhythmic breathing, prioritizing the associated expiration and contraction of the abdominal muscles and of the floor pelvis during exhalation.

Procedure: Global Postural Reeducation; Procedure: Global Postural Reeducation Sham

Control Group (CG) - GPR-SHAM

SHAM COMPARATOR

The Control Group (CG) will receive GPR-SHAM sessions. In each session, participants will receive treatment through GPR postures regardless of the group. A minimum of one and a maximum of two postures will be chosen, what will be evolved progressively put node minimum 15 (fifteen) minutes, case two postures are chosen and, at most, 30 (thirty) minutes, in the case of only one posture. Both groups will be treated for 30 (thirty) minutes, once a week, for eight weeks, totaling eight sessions. The participants should dress in bathing, light, or gym clothes to feel comfortable during the sessions. One physiotherapist will be trained to carry out the RPG-SHAM in the CG. The simulation of the method will be carried out with the withdrawal of two important elements of the original method: the technique of contraction-relaxation and the guidelines from the breathing rhythm with prioritization of expiration.

Procedure: Global Postural Reeducation; Procedure: Global Postural Reeducation Sham

Interventions

Global Postural Reeducation PROCEDURE

Global Postural Reeducation, better known as GPR, was developed by Philippe Souchard in the 1980s and involves a sequence of postures or treatment positions, including the main ones: frog on the ground with arms open; frog on the ground with arms closed; frog in the air with arms open; frog in the air with arms closed; standing against the wall; standing at the center; anterior tilt sitting; anterior tilt standing. GPR is based on the concept of proprioception and inhibition. Souchard (2016) describes RPG as a proprioceptive method of inhibition, where proprioception refers to the body's ability to perceive its position in space, and inhibition refers to the muscle relaxation induced after intense contraction. This principle is applied through the postures and techniques used in treatment, aiming to correct postural deviations, promote one bigger conscious body, and relieve pain.

Also known as: GPR or Posture Reeducation

Control Group (CG) - GPR-SHAM; Experimental Group (EG) - GPR

Global Postural Reeducation Sham PROCEDURE

Global Postural Reeducation Sham is the comparator group.

Also known as: GPR-SHAM

Control Group (CG) - GPR-SHAM; Experimental Group (EG) - GPR

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Adults aged between 18 and 55 years with chronic non-specific low back pain,
• Participants who voluntarily agree to participate and sign the Free and Informed Consent Form,
• Participants who have never done any treatment with the GPR method, and
• Participants who have not been undergoing physiotherapy treatment for at least 2 months.

You may not qualify if:

• Patients with pain lumbar acute, or it is, with symptoms gifts there is less of dose weeks, what carried out blocking medicinal in the column us last six months;
• Patients with hernia of disk of type extruded and/or kidnapped;
• Patients in possess or be in investigation of any kind of neoplasia;
• Patients who have undergone any type of surgery with placement of any type of prosthesis in the spine;
• Intellectual or sensory disability that prevents them from understanding commands or describing symptoms;
• Patients who have a significant change in tactile sensitivity that prevents them from reporting any symptoms;
• Patients who have any type of vestibular changes;
• Serious pathologies of the spine;
• Amputation of upper or lower limbs;
• Spinal Cord Injury;
• Low back pain with sacroiliac irradiation; any type of rheumatic diseases, such as: Rheumatoid Arthritis, Fibromyalgia, and others;
• Patients that be performing or carried out last two months any type of conservative treatments, such as: Acupuncture, hydrotherapy, manual therapy, Pilates, conventional physiotherapy, and others; and
• Patients who have travel plans in the coming months.

Sponsors & Collaborators

• Federal University of Bahia: lead

Study Sites (1)

Clínica Escola de Fisioterapia da UFBA - CEF/UFBA

Salvador, Estado de Bahia, 40210905, Brazil

RECRUITING

Related Publications (5)

• Boiko VV, Prasol VA, Peresada II, Karnaukh VF. [Case of successful treatment of gunshot wound of the neck with injury of the carotid artery bifurcation]. Klin Khir. 1995;(7-8):46-7. No abstract available. Russian.

  PMID: 8624945 BACKGROUND

• Ferreira GE, Barreto RG, Robinson CC, Plentz RD, Silva MF. Global Postural Reeducation for patients with musculoskeletal conditions: a systematic review of randomized controlled trials. Braz J Phys Ther. 2016 Apr 1;20(3):194-205. doi: 10.1590/bjpt-rbf.2014.0153.

  PMID: 27437710 BACKGROUND

• Hisanaga K, Onodera H, Kogure K. Changes in levels of purine and pyrimidine nucleotides during acute hypoxia and recovery in neonatal rat brain. J Neurochem. 1986 Nov;47(5):1344-50. doi: 10.1111/j.1471-4159.1986.tb00763.x.

  PMID: 3020172 BACKGROUND

• Johnsn FH, Shimomura O. Preparation and use of aequorin for rapid microdetermination of Ca 2+ in biological systems. Nat New Biol. 1972 Jun 28;237(78):287-8. doi: 10.1038/newbio237287a0. No abstract available.

  PMID: 4402563 BACKGROUND

• Cavalcanti IF, Antonino GB, Monte-Silva KKD, Guerino MR, Ferreira APL, das Gracas Rodrigues de Araujo M. Global Postural Re-education in non-specific neck and low back pain treatment: A pilot study. J Back Musculoskelet Rehabil. 2020;33(5):823-828. doi: 10.3233/BMR-181371.

  PMID: 31929138 BACKGROUND

MeSH Terms

Conditions

Low Back Pain; Chronic Pain

Condition Hierarchy (Ancestors)

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

Study Officials

• KAREN V TRIPPO, PhD, PT

  Federal University of Bahia

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Ramon J Santos, Master, PT

CONTACT

+5571987495136; ramonjesus@ufba.br

KAREN V TRIPPO, PhD, PT

CONTACT

+5571993208681; karentrippo@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD

Study Record Dates

• First Submitted: April 8, 2025
• First Posted: April 15, 2025
• Study Start: June 1, 2025
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: August 5, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

BR (1)