Effectiveness Of Integrated Kinetic Control Training And Deep Core Muscle Activation On Pain, Function, And Movement Control In Individuals With Chronic Low Back Pain: A Randomized Experimental Study

BACKGROUND:

Low back pain (LBP) is a prevalent condition encountered by individuals at various points in their lives, typically presenting as a transient issue that resolves within a few days or weeks. In contrast, chronic low back pain (CLBP) constitutes a significant global contributor to disability, frequently arising from compromised movement control and muscular dysfunction. Research indicates that exercise-based interventions aimed at enhancing motor control, particularly those that engage deep core stabilizers, may effectively alleviate symptoms associated with this condition. Kinetic Control Training (KCT) is designed to address movement impairments, while Deep Core Muscle Activation (DCMA) focuses on improving spinal stability through targeted muscle engagement. Nevertheless, the potential synergistic effects of integrating these methodologies warrant further investigation.

AIM:

The study aims to evaluate the effectiveness of a combined intervention of KCT and DCMA in reducing pain, improving functional ability, and enhancing movement control among individuals with CLBP

OBJECTIVE:

Primary objective:

To evaluate the effectiveness of a combined intervention of Kinetic Control Training and Deep Core Muscle Activation in reducing pain, improving functional ability

Secondary objectives:

To compare the combined KCT and DCMA intervention with standard care in terms of:

Pain intensity reduction (measured by Numeric Pain Rating Scale),

Functional disability improvement (measured by Roland-Morris Disability Questionnaire),

Movement control impairment reduction (measured by Luomajoki’s test battery),

Patient-specific functional improvements (measured by Patient-Specific Functional Scale)

NEED FOR THE STUDY:

Despite available treatments, chronic low back pain (CLBP) persists as a major health burden. Kinetic Control Therapy (KCT) and Dynamic Core Muscle Activation (DCMA) target movement dysfunction and core stability, respectively, but their combined effects remain unknown. This study examines whether integrating KCT and DCMA improves pain, function, and movement control better than single interventions, potentially offering a more effective CLBP management strategy.

PROCEDURE:

Institutional Ethical Committee, SRIHER, will be obtained, and the Study will be registered in the Clinical Trial Registry of India. The participants will be screened for eligibility criteria. Once the participant fulfils the inclusion criteria, informed consent will be obtained and all baseline outcome measures will be recorded. The study will measure pain severity in participants using a Numeric Rating Scale (NRS), ranging from 0 (no pain) to 10 (worst imaginable pain). Next, Participants will be assigned to one of two groups (Group A: Experimental group, Group B: Standard Exercise care)   using block randomization. The allocation sequence will be placed in opaque, sealed envelopes. The therapist treating the participants would open the sealed envelope and administer the treatment according to the group allocation during treatment time. The Interventional group will receive a combined KCT  by Luomajoki’s validated movement control test battery and DCMA protocol by using Pressure BioFeedback. The intervention will be delivered over 6 weeks (3 sessions/week), supervised by trained physiotherapists. The Control group will receive standardised exercise therapy care. Between group comparison will be performed.