Trunk and Lower Limb Movement Quality and Stability Improvement in People With Chronic Low Back Pain Following Different Types of Isometric Trunk Muscle Training
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Segmental movement stability
Study Overview
Brief Summary
The goal of this project is to assess if Chronic Low Back Pain (CLBP) participant's movement quality and balance variables can change after training that decreases their pain and disability. It will also compare the difference between structural exercise (SE) and isolated trunk exercise (ITE). The main questions it aims to answer are:
- What are the effect of the training on the participant's movement quality and balance.
- What are the difference between different types of trunk muscle training on people with CLBP.
Researchers will compare SE, ITE and control. Control group will receive back school education that was shown not to be effective in reducing pain and disability.
Participants will:
- Do home and in-lab based SE or ITE training, or maintain active daily living over 2 months.
- Complete the pain and disability questionnaire and do several physical functioning tests while having their trunk and lower limb movement and muscle activation measured.
Detailed Description
Both ITE and SE training are equalized in terms of training intensity based on rate of perceived exertion, training duration per session, training frequency, and intervention period. Training intensity measurement does not use other methods of quantification as ITE training does not increase heart rate or blood lactate significantly regardless of the intensity.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 55 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •body mass index (BMI) 18-25 kg/m2
- •experiencing intermittent pain lasting at least 3 months
- •had Oswestry Disability Index (ODI) score ranging between 17% and 45%.
Exclusion Criteria
- •exercise contraindication based on physical activity readiness questionnaire
- •indication or diagnosis of other chronic diseases (such as cancer, cardiovascular disease, diabetes, bone fracture, or infection)
- •artificial lower limb joints, history of spinal surgery, walking aid use
- •personal mobility restrictions (due to connective tissue diseases, rheumatoid arthritis, or central nervous system disorders)
- •pregnancy or within 1 year post partum
Arms & Interventions
Structural Exercise
Single armed dumbbell row, push up and single legged deadlift exercises, done three times per week for eight weeks
Intervention: Structural Exercise (Behavioral)
Isolated Trunk Exercise
Plank, side bridge, and bird dog isometric holds, done three times per week over eight weeks training
Intervention: Isolated Trunk Exercise (Behavioral)
Control
Back school education where participants are taught about healthy seating position, how to carry loads, and maintaining an active daily lifestyle.
Intervention: Back school (Behavioral)
Outcomes
Primary Outcomes
Segmental movement stability
Time Frame: Same day as first day of intervention and within one week after intervention
lumbar-to-pelvis and pelvis-to-femur movement stability as quantified by deviation phase during five-repetitions sit-to-stand. Greater number indicates lesser segmental movement stability.
Lower lumbar active range of motion
Time Frame: Same day as first day of intervention and within one week after intervention
active range of motion of the lower lumbar area during five-repetitions sit-to-stand test.
5RSTS time
Time Frame: Same day as first day of intervention and within one week after intervention
Time required to complete five-repetitions sit-to-stand with smaller time indicating better performance.
Segmental movement coordination
Time Frame: Same day as first day of intervention and within one week after intervention
Lumbar-to-pelvis and pelvis-to-femur movement coordination as quantified by mean absolute relative phase angle during five-repetitions sit-to-stand. Smaller number indicates greater coordination between the two segments.
Postural stability
Time Frame: Same day as first day of intervention and within one week after intervention
Center-of-pressure normalized mean velocity during Y-balance test. Smaller number indicate greater stability
Postural Control
Time Frame: Same day as first day of intervention and within one week after intervention
normalized leg reach during y-balance test, with larger number indicating greater postural control.
Perceived pain
Time Frame: Same day as first day of intervention and within one week after intervention
score from numerical pain rating scale from zero (0) to ten (10), with 0 indicating no pain.
Perceived disability
Time Frame: Same day as first day of intervention and within one week after intervention
Score based on oswestry disability index scoring from zero (0) to one hundred (100) percent, with zero indicating no disability.
Secondary Outcomes
- LAP performance(Same day as first day of intervention and within one week after intervention)
- Muscle synergy(Same day as first day of intervention and within one week after intervention)
Investigators
SUTANTO Dhananjaya
Post-Doctorate Fellow
The Hong Kong Polytechnic University