Changes in Motor Cortex Following Exercises for Chronic Low Back Pain

Phase 1

Completed

• Conditions: Chronic Low Back Pain
• Interventions: Behavioral: Skilled motor training; Behavioral: Walking exercise

• Registration Number: NCT00864422
• Lead Sponsor: The University of Queensland

Brief Summary

The motor cortex of the brain changes following chronic pain and injury, and this is linked to pain-associated changes in motor behaviour. This study aimed to investigate whether therapeutic exercises in patients with chronic pain can induce reorganisation of the motor cortex and restore normal motor behaviour. The investigators hypothesised that motor training can induce reorganisation of the motor cortex and that these changes are related to improved motor behaviour.

Detailed Description

The sensory and motor systems can reorganize following injury and learning of new motor skills. Recently we observed adaptive changes in motor cortical organization in patients with chronic back pain, which are closely linked to changes in motor behavior. Although pain-related alterations in behavior can be trained and are associated with improved symptoms, it remains unclear whether these meaningful functional outcomes are related to motor cortical reorganization. Here we investigate the effects of two interventions in people with chronic back pain: skilled motor training and a control intervention of self-paced walking exercise. We measured motor cortical excitability (motor threshold (MT)) and organization (center of gravity (CoG) and map volume) of the deep abdominal muscle, transversus abdominis (TrA), using transcranial magnetic stimulation (TMS). In addition, motor behavior of TrA was assessed during single rapid arm movements. The study helps to elucidate the mechanisms of specific motor exercises in chronic back pain management.

Study Timeline

• Study Start: 2006-10
• Primary Completion: 2007-09
• Study Completion: 2007-09
• Status Verified: 2009-03
• Study First Submitted: 2009-03-17
• Study First Submitted QC: 2009-03-17
• Last Update Submitted: 2009-03-17
• Study First Posted: 2009-03-18
• Last Update Posted: 2009-03-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• Sustained or episodic non-specific low back pain lasting longer than 3 months

Exclusion Criteria

• Orthopaedic, neurological, circulatory or respiratory conditions
• History or family history of epilepsy
• Recent or current pregnancies
• Previous surgery to the abdomen or back
• Abdominal or back exercises in the preceding 12 months

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
1	Skilled motor training	-
2	Walking exercise	-

Primary Outcome Measures

Name	Time	Method
Motor cortical map and excitability from transcranial magnetic stimulation	Pre and 2 weeks post-intervention

Secondary Outcome Measures

Name	Time	Method
Motor activation of the abdominal muscles during functional arm movement task	Pre and 2 weeks post-intervention
Self-reported pain (VAS scale) and functional scale (patient-specific functional scale)	Pre and 2 weeks post-intervention

Trial Locations

Locations (1)

Centre for Clinical Research Excellence in Spinal Pain, Injury and Health; 🇦🇺 Brisbane, Queensland, Australia