RecruitingNCT05851196

The Forgotten Role of Back Muscle Characteristics to Tailor Exercise Therapy for Recurrent Non-specific Low Back Pain

Back to Back: the Forgotten Role of Back Muscle Characteristics to Tailor Exercise Therapy for Recurrent Non-specific Low Back Pain

Sponsor

Hasselt University

Enrollment

100 participants

Start Date

Jan 15, 2024

Study Type

OBSERVATIONAL

Conditions

Low Back Pain Back Pain Lower Back Chronic

Summary

Patients with non-specific low back pain will be compared to healthy, age- and sex-matched controls to determine the most discriminating back muscle characteristics and to delineate possible phenotypes of patients with non-specific low back pain showing impaired proprioceptive postural control. Additionally, the group of patients with non-specific low back pain will receive a 16-week, high-load proprioceptive training program. The effects of this training program on the different back muscle characteristics and proprioceptive postural control will be evaluated.

Eligibility

Min Age: 18 YearsMax Age: 60 Years

Inclusion Criteria12

Patients with non-specific low back pain:
Aged 18-60 years
Non-specific low back pain without radicular leg pain
Mechanical low back pain with episodes of \<4 on the numerical pain rating scale and episodes of \>6 on the numerical pain rating scale
Non-specific low back pain for three months or more
Score of 20% or more on the Modified Low Back Pain Disability Questionnaire
Informed consent to participate
Healthy controls:
Aged 18-60 years
No history of low back pain needing medical treatment or resulting in a limited activity level
No low back pain in the previous six months
Informed consent to participate

Exclusion Criteria8

Pregnancy
Previous trauma or surgery to the spine, pelvis or lower limbs
Structural spinal deformity (e.g., scoliosis)
Neurological, neuromuscular, respiratory or systemic disease
Central sensitization: score of 50/100 or more on the Central Sensitization Inventory
Specific vestibular or balance problems
Acute lower limb or neck problems
Body mass index of 30 kg/m² or more

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Interventions

OTHERProprioceptive training

A physiotherapist tailors the exercises to the patient's functional demands and pain- or fear-inducing activities. Guided by the therapist, patients look for ways to integrate the exercises into their daily life activities. Each week, patients receive feedback from the physiotherapist, and the training program is gradually progressed. The patients are instructed to perform the exercises daily, integrated into their daily activities, hobbies, and work. The program contains: (1) exercises to improve the sense of posture and movement, (2) exercises to correct the reference frame from which patients control posture and movement, (3) muscle control exercises, (4) exercises to increase variability in postures and movement patterns, (5) functionality: patients search for ways to correct and integrate alternative postures and movement patterns into their daily life, (6) high training frequency and high load, (7) focus on sensing, localizing and differentiating, rather than movement control.