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Using Non-Weightbearing Stationary Elliptical Machines for Patients with Chronic Low Back Pain

Not Applicable
Completed
Conditions
Chronic Low-back Pain
Low Back Pain
Interventions
Other: Using sitting ellipticals
Other: Physiotherapy Protocol
Registration Number
NCT05724160
Lead Sponsor
Massachusetts General Hospital
Brief Summary

The goal of this clinical trial is to assess the effect of non-weightbearing stationary ellipticals (Cubii, Fitness Cubed, Inc.) on patient well-being with chronic lower back pain (CLBP). The main questions it aims to answer are:

1. Assess the effect of non-weightbearing stationary ellipticals on clinical outcomes inclduing vital signs, pain, disability, analgesic use, mental health, abdominal muscle strength, and compliance in patients with CLBP.

2. Assess the effect of placing the patients into an interactive virtual environment during the exercise sessions on the outcomes of the program

Participants will participate in 60 minute training sessions to see if there are effects to their CLBP.

Detailed Description

There are controversies on whether exercise is more effective than placebo among different clinical studies specifically in acute LBP; however, in CLBP cases, evidence strongly recommends that exercise is more effective than conservative treatment on pain and functional abilities, especially individually designed exercise programs for stabilizing and strengthening. The aims of the present study are:

1. to assess the effect of non-weightbearing stationary ellipticals (Cubii, Fitness Cubed Inc.) on clinical outcomes including vital signs, pain, disability, analgesic use, mental health, abdominal muscle strength, and compliance in patients with CLBP

2. to assess the effect of placing the patients into an interactive virtual environment during the exercise sessions on the outcomes of the program.

The training sessions will be up to 60 minutes and will include a) introduction to the goals of the session (5 minutes), b) warm-up and stretching (10 minutes), c) low resistance flat road cycling (low resistance, low cadence; 10 minutes), d) flat road cycling (high resistance, low cadence; 10 minutes), e) flat road sprint (low resistance, high cadence; 10 minutes), f) warm-down, whole-body stretching, questions and answers (Q\&A; 10-15 minutes) obtained from investigations on the similar topic. The training sessions will be supervised by both an expert clinical researcher with MD degree who is familiar with healthcare principles for these patients and also by a US licensed board-certified orthopaedic surgeon, who is responsible for providing routine orthopaedic care for the patients in this study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
64
Inclusion Criteria
  • Adults aged 18 to 70 years and CLBP (>12 wk) located between the costal margins and inferior gluteal folds.
Exclusion Criteria
  • The presence of a postural abnormality contributing to the diagnosis reported by an expert spine surgeon
  • Pain radiating below the knee, past medical history or current symptomatic lumbar disc hernia or fracture based on expert reports (i.e. orthopedic surgeon or radiologist)
  • History of back surgery, inflammatory joint disease, severe osteoporosis
  • A metabolic disease affecting the CLBP, or neuromuscular disease (as assessed by the American College of Sports Medicine pre-exercise screening tool for cardiovascular risk factors prior to entry into an exercise program)
  • Pregnancy
  • Ankle and foot injuries inhibiting them from cycling recently (<3 mo.)
  • Participation in another exercise program or physiotherapy (i.e., manipulation, mobilization, range of motion, massage).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
NSLBP treated with Physiotherapy + Sitting ellipticalsUsing sitting ellipticals32 patients with non-specific low back pain receiving routine protocol-based physiotherapy care by an expert together with planned training using sitting ellipticals
NSLBP treated with Physiotherapy + Sitting ellipticalsPhysiotherapy Protocol32 patients with non-specific low back pain receiving routine protocol-based physiotherapy care by an expert together with planned training using sitting ellipticals
NSLBP treated with PhysiotherapyPhysiotherapy Protocol32 patients with non-specific low back pain receiving routine protocol-based physiotherapy care by an expert.
Primary Outcome Measures
NameTimeMethod
Pain Visual Analogue Scale (VAS)8 weeks

Pain scores based on the Visual Analogue Scale 0-10

Pain Catastrophizing Scale (PCS)8 weeks

Mental health based on the Pain Catastrophizing Scale (PCS). 13-item questionnaire to identify catastrophic thoughts or feelings in relation to painful experiences. The total score ranges from 0 to 52, with high scores indicating that more catastrophic thoughts or feelings are experienced.

Oswestry Low Back Pain Disability Index (ODI)8 weeks

Measure of disability based on the Oswestry Low Back Pain Disability Index (ODI). Version 2, 10-item questionnaire on how LBP affects aspects of their life (0%-100% scoring.

Heart rate8 weeks

Heart rate in beats/minute

Fear-Avoidance Beliefs Questionnaire (FABQ)8 weeks

Patient's beliefs about the potential harm of work or general physical activity to their back pain. Two subscales within the FABQ have been identified, a 7-item work subscale score (FABQw, score range 0-42), and a 4-item physical activity subscale score (FABQa, score range 0-24)

Patient reported outcome measures (PROM)8 weeks

PROMIS-29 profile v1.0 (for Physical function, anxiety, depression, fatigue, sleep disturbance, satisfaction with social role, pain inference (+pain inference short form 6b), pain intensity, depression, mood and anxiety.

Transversus abdominis endurance (TAE)8 weeks

Abdominal strength based on Transversus abdominis endurance (TAE). Holding or tonic capacity of transversus abdominis measured by the number of 10-second holds (up to 10) using pressure biofeedback in prone position.

Secondary Outcome Measures
NameTimeMethod
Distance passed on the stationary elliptical8 weeks

Distance passed on the stationary elliptical as elliptical measurement in kilometers

Satisfaction rate (0-10)8 weeks

Satisfaction rate (0-10) as feedback on the session

Duration of exercise in each session8 weeks

Duration of exercise in each session as feedback on the session

Compliance (duration of continuing the sessions)8 weeks

Compliance (duration of continuing the sessions) as feedback on the session

Intention to continue the sessions (0-10)8 weeks

Intention to continue the sessions (0-10) as feedback on the session

Total strides8 weeks

Total strides as elliptical measurement

Time series of the stride/minute8 weeks

Time series of the stride/minute as elliptical measurement

Average strides/minute8 weeks

Average strides/minute as elliptical measurement

Distance traveled in each section8 weeks

Distance traveled in each section as elliptical measurement in kilometers

Trial Locations

Locations (1)

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

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