NCT07713082

Brief Summary

This study will evaluate a new treatment program for patients with ongoing or long-term low back pain who receive care at primary care physiotherapy units. Participants with subacute or chronic nonspecific low back pain will be randomly divided into three groups for comparison of their progress. The first group will receive an eight-week program of therapeutic exercise and health education, which will be delivered entirely online. The second group will receive the same exercise and education program in face-to-face sessions. The third group will receive standard physiotherapy care. The study will last eight weeks, and researchers will follow up with participants three months later. The project's main goal is to measure changes in participants' daily disability levels. The researchers will also examine other important factors, such as pain intensity, fear of movement, anxiety, depression, quality of life, and overall satisfaction with the care received. Measurements will be taken before the study begins, immediately after the eight-week program ends, and at the three-month follow-up. This trial aims to find more accessible, evidence-based ways to treat back pain, reduce hospital waiting lists, and improve patient well-being by combining digital and in-person care.

Trial Health

65
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
132

participants targeted

Target at P75+ for not_applicable low-back-pain

Timeline
18mo left

Started Mar 2027

Typical duration for not_applicable low-back-pain

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 14, 2026

Completed
6 days until next milestone

First Posted

Study publicly available on registry

July 20, 2026

Completed
7 months until next milestone

Study Start

First participant enrolled

March 1, 2027

Expected
9 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2027

9 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2028

Last Updated

July 21, 2026

Status Verified

July 1, 2026

Enrollment Period

9 months

First QC Date

July 14, 2026

Last Update Submit

July 17, 2026

Conditions

Keywords

low back paintherapeutic exercisepain educationprimary health carerandomized controlled trial

Outcome Measures

Primary Outcomes (1)

  • Change in disability level

    Functional disability will be measured using the Spanish version of the Oswestry Disability Index (ODI). The ODI is a 10-item questionnaire with six response options each (0-5 points) that assess limitations in activities of daily living.

    From the time of enrollment in the study through the end of treatment (eight weeks) and the follow-up period (12 weeks after the end of treatment).

Secondary Outcomes (9)

  • Changes in Pain Intensity

    From the time of enrollment in the study through the end of treatment (eight weeks) and the follow-up period (12 weeks after the end of treatment).

  • Changes in Activity Avoidance Attitudes

    From the time of enrollment in the study through the end of treatment (eight weeks) and the follow-up period (12 weeks after the end of treatment).

  • Change in Catastrophizing Level

    From the time of enrollment in the study through the end of treatment (eight weeks) and the follow-up period (12 weeks after the end of treatment).

  • Changes in Self-Efficacy Levels

    From the time of enrollment in the study through the end of treatment (eight weeks) and the follow-up period (12 weeks after the end of treatment).

  • Changes in Anxiety and Depression

    From the time of enrollment in the study through the end of treatment (eight weeks) and the follow-up period (12 weeks after the end of treatment).

  • +4 more secondary outcomes

Study Arms (3)

Online Therapeutic Exercise and Education Group

EXPERIMENTAL

Participants will carry out an eight-week protocol consisting of education on managing the condition and therapeutic exercises for the lumbopelvic and abdominal muscles. This will be performed progressively. All exercises will be performed at a perceived exertion level of 6-7 out of 10, leaving approximately three repetitions in reserve per exercise. If exertion values are lower, the exercise intensity will increase. If the intensity exceeds 7, the exercise intensity will decrease. Elastic bands and exercise variations will be used to achieve this. Rest periods between sets and exercises will be 1.5 minutes. These sessions will be carried out synchronously online using the Google Meets platform. This allows the physiotherapist to supervise and guide four to six participants per group online.

Other: Therapeutic ExerciseBehavioral: Education on the self-management of low back pain

Face-to-Face Therapeutic Exercise and Education Group

EXPERIMENTAL

This group will receive the same educational protocol for condition management and therapeutic exercise as the previous one, but it will be carried out in a face-to-face group format supervised by a physiotherapist from the Primary Care Physiotherapy Units.

Other: Therapeutic ExerciseBehavioral: Education on the self-management of low back pain

Conventional Treatment Group

ACTIVE COMPARATOR

This group will undergo interventions typically applied in primary care physiotherapy units, including electrotherapy and exercise training. The following electrotherapy techniques will be applied: * Microwave therapy: 15 minutes at 100 watts, continuous TENS: 80 Hz, 150 microseconds, 20 minutes. Regarding exercises, a general program incorporating mobility, strength, and stretching work will be included. The physiotherapist will explain the program during the first treatment session, after which the patient will perform the exercises independently in subsequent sessions. During these sessions, patients will receive a sheet with a complete list of exercises and their explanations. They will also have the opportunity to consult the physiotherapist if they have any questions.

Other: Usual Care

Interventions

This intervention consists of applying a therapeutic exercise protocol to the lumbopelvic and abdominal muscles. The included exercises are: * Core: Isometric Dead Bug, Dead Bug Leg Lowering, Contralateral Dead Bug, Dead Bug with Leg Abduction and Straight Arm Drop, Band-Resisted Dead Bug. * Core + Abs: Fire Hydrant, Band-Resisted Fire Hydrant, and Band-Resisted Fire Hydrant on Toes * Quadriceps: Chair squat, air squat, asymmetric chair squat, lunge, and chair squat with heel drive. * Gluteus exercises include sun salutation, single-leg dead foot drag, deadlift, skater (extension, external rotation, and abduction), standing donkey kick, and single-leg deadlift. Exercises will be performed at an effort level of 6-7/10 (rate of perceived exertion), leaving three repetitions in reserve per exercise. Participants will perform four to six sets of 15 repetitions for each exercise, with two sessions conducted per week. Rest periods between sets and exercises will be 1.5 minutes.

Face-to-Face Therapeutic Exercise and Education GroupOnline Therapeutic Exercise and Education Group

Participants will receive a total of 16 sessions of usual care, two per week. The interventions included are as follows: * Microwave therapy: 15 minutes at 100 watts, continuous * Transcutaneous electrical nerve stimulation (TENS): 80 Hz, 150 microseconds, 20 minutes * An unsupervised exercise program including mobility, strength, and stretching exercises

Conventional Treatment Group

Participants will receive four weekly education sessions on self-management of low back pain during the first four weeks of the intervention. The contents of these sessions will be as follows: * The multifactorial origin of the condition and the natural course of the disease * The consequences of rest and the benefits of movement * Ergonomic adaptations applicable to daily, work, and sports activities * Interpretation of imaging tests in relation to patient functionality.

Face-to-Face Therapeutic Exercise and Education GroupOnline Therapeutic Exercise and Education Group

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients with non-specific low back pain, aged 18 years or older.
  • Pain duration of more than six weeks
  • Onset or modification of low back pain with maintenance of positions and/or movements
  • Presenting a mild-to-moderate level of disability, as determined by the Oswestry Disability Index (ODI) questionnaire.
  • Presence of limitations or symptoms in at least two range of motion (ROM) or coordination assessment tests, as described in clinical guidelines:
  • Lumbar and/or hip range of motion (ROM) measured with inclinometry Prone instability test
  • Presence of aberrant movements:
  • Painful arc with flexion or return from flexion
  • Instability catch
  • Gower sign
  • Reversal of lumbopelvic rhythm
  • Strength and endurance of the abdominal musculature
  • Email access and a device with an internet connection are required.
  • Availability and willingness to participate in all study sessions.

You may not qualify if:

  • Presence of acute, nociplastic, radicular, and/or referred pain
  • Presence of red flags
  • Previous surgeries in the spine, pelvis, or hip
  • Presence of concomitant cardiovascular, neurological, endocrine, or immune pathologies that prevent physical activity
  • Presence of psychiatric disorders
  • Pregnancy
  • Having received physiotherapy treatment, analgesic blocks, corticosteroid injections, or any other type of intervention within the last three months
  • Changes in lifestyle habits, work conditions, or physical activity levels within the last three months
  • Inability to meet the program's physical or cognitive demands during the eight weeks

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (2)

  • George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021 Nov;51(11):CPG1-CPG60. doi: 10.2519/jospt.2021.0304.

    PMID: 34719942BACKGROUND
  • Delitto A, George SZ, Van Dillen L, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ; Orthopaedic Section of the American Physical Therapy Association. Low back pain. J Orthop Sports Phys Ther. 2012 Apr;42(4):A1-57. doi: 10.2519/jospt.2012.42.4.A1. Epub 2012 Mar 30.

    PMID: 22466247BACKGROUND

MeSH Terms

Conditions

Low Back Pain

Interventions

Exercise Therapy

Condition Hierarchy (Ancestors)

Back PainPainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

RehabilitationAftercareContinuity of Patient CarePatient CareTherapeuticsPhysical Therapy Modalities

Central Study Contacts

Héctor Hernández-Lázaro, PhD

CONTACT

Luis Ceballos-Laita, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

July 14, 2026

First Posted

July 20, 2026

Study Start (Estimated)

March 1, 2027

Primary Completion (Estimated)

December 1, 2027

Study Completion (Estimated)

September 1, 2028

Last Updated

July 21, 2026

Record last verified: 2026-07

Data Sharing

IPD Sharing
Will not share