Effect of Core Muscles Training On Patients With Chronic Mechanical Low Back Pain According To SALIBA'S Postural Classification System
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Cairo University
- Enrollment
- 60
- Locations
- 2
- Primary Endpoint
- pain intensity.
Study Overview
Brief Summary
This study is designed as a pre and post experimental study. The purposes of this study are to evaluate the effect of core muscles training in patients with chronic mechanical low back pain according to SALIBA'S postural classification system (SPCS) in terms of pain intensity, function, and core muscles endurance.
Detailed Description
Male and female patients diagnosed with chronic mechanical low back pain will be referred to physical therapy department. Patients will then be screened based on the inclusion and exclusion criteria of the current study. They will be asked to sign the informed consent form. Then, participants will be assessed for the severity of pain, functional disability, and core endurance test at baseline and at the end of the treatment by the same physiotherapist.
In addition, participants will be instructed to stand in habitual posture while looking forward and will be photographed from sagittal plane wearing shorts(males) and a thin clothes(female). The photos will be used to subjectively classify the patients into one of the 6 postural classification groups (G1, G2, G3,G4, G5, G6). The Vertical compression test and elbow flexion test will be used to objectively confirm the classification.
Later, photos will be then entered by researcher to Kinovea software for more objective confirmation of the classification.
Then, Participants will be allocated purposive randomly to one of the six groups according to evaluation criteria(saliba's postural classification system).
Then, Patients in each postural category will receive a 4-week program of core muscles training.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Participant)
Eligibility Criteria
- Ages
- 20 Years to 55 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients referred with a diagnosis of CMLBP of at least 3 months.
- •Age ranging from 20 to 55 years old.
- •Both genders will be included.
- •BMI(18.5-24.9).
Exclusion Criteria
- •Lumbar canal stenosis.
- •History of vertebral fractures.
- •patients with neurological deficits such as altered sensation.
- •Spinal surgery or failed back surgery.
- •cardiovascular/ pulmonary disorder
Arms & Interventions
group 3: posterior/ posterior
participant posture: The thoracic block is aligned posterior to the pelvic block and is posteriorly tipped in the sagittal plane. Vertical force leads to an accentuated extension in the lower lumbar region with a forward shear of the pelvis and decreased ability to sustain vertical forces.
Intervention: core muscles training exercises (Other)
group1: vertical/ vertical
participant posture: The thoracic block is vertically aligned over the pelvic block.The angle of the thoracic block is vertical in the sagittal plane allowing for the dome of the diaphragm to rest on top of the abdomen.Vertical force transfers through the musculoskeletal system through the mid-foot and into the standing surface causing no shifts in postural alignment.
Intervention: core muscles training exercises (Other)
group 2: vertical/ posterior
participant posture: The thoracic block is vertically aligned over the pelvic block but is posteriorly tipped in the sagittal plane.Vertical force leads to an accentuated extension in the thoracolumbar and lumbar regions with decreased ability to sustain vertical forces.
Intervention: core muscles training exercises (Other)
group 4: posterior/ anterior
participant posture: The thoracic block is aligned posterior to the pelvic block and is anteriorly tipped in the sagittal plane. Vertical force leads to a slight flexion in the thoracic and lumbar regions with a forward shear of the pelvis and decreased ability to sustain vertical force.
Intervention: core muscles training exercises (Other)
group 5:anterior/ posterior
participant posture: The thoracic block is aligned anterior to the pelvic block and is posteriorly tipped in the sagittal plane. Vertical force leads to extension in the mid and lower lumbar regions with a posterior shear of the pelvis and decreased ability to sustain vertical forces.
Intervention: core muscles training exercises (Other)
group 6: anterior/ anterior
participant posture: The thoracic block is aligned anterior to the pelvic block and is anteriorly tipped in the sagittal plane. Vertical force leads to an overall flexion of the trunk and decreased ability to sustain vertical forces
Intervention: core muscles training exercises (Other)
Outcomes
Primary Outcomes
pain intensity.
Time Frame: one month
Pain intensity will be assessed using the visual analog scale (VAS). The VAS is a unidimensional measure of pain intensity. It is a continuous scale comprises of a horizontal line 10 cm in length. The scale is anchored by "no pain" (score of 0) and "worst imaginable pain" (score of 10). A higher score indicates greater pain intensity
function disability
Time Frame: one month
Functional disability will be estimated using the cross-culturally adapted Arabic version of the Oswestry disability questionnaire.The score is calculated by the addition of the values assigned for each of the 10 individual questions and is used to categorize disability as: mild or no disability (0- 20%); moderate disability (21%-40%); severe disability (41% to 60%); incapacity (61% to 80%); restricted to bed (81% to 100%).
core muscles endurance
Time Frame: one month
The researcher will conduct a series of core stability tests before and after the core training program. The following core tests will be used: trunk flexion test (McGill's test) , Trunk extension (Sorenson Test, Right Side plank test,left side plank and prone plank test. We will record the time (in seconds) the patient can hold the isometric posture, with a normal range of 1-2 minutes
Secondary Outcomes
No secondary outcomes reported
Investigators
Rania Saleh Elemam Yassin
researcher
Cairo University