Low Back Pain: Unveiling the Contribution of Motor Control Adaption Using Biomechanical Modeling and Neuroimaging
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      This project aims to reveal the potential sensorimotor reorganization of sensory input in low
      back pain patients and its association with different motor control strategies in LBP.
    

Detailed description: 
      Background: Low back pain (LBP) is a major health issue. Treatment of chronic LBP is still a
      major challenge due to a lack of pathophysiological understanding. Thus, understanding LBP
      pathophysiology is a research priority. Adaptions of motor control likely play a significant
      role in chronic or recurrent LBP because motor control is crucial for spine posture,
      stability and movement. Different motor adaption strategies exist across individuals with LBP
      and two phenotypes representing the opposite ends of a spectrum have been suggested; i.e.
      "tight" control and "loose" control over trunk movement. The former would be associated with
      reduced trunk motor variability, the later with increased trunk motor variability. This
      conceptual framework is very useful to explain maintenance and aggravating of LBP because
      motor control adaptations are expected to have long-term consequences, such as increased
      spinal tissue loading, associated with degeneration of intervertebral discs and other
      tissues. Several knowledge gaps need to be addressed to test the validity of this framework:
      1) Do loose/tight control phenotypes indeed exist and/or do other motor control adaption
      strategies exist? 2) Is reduced/altered paraspinal proprioceptive input associated with LBP
      related to neuroplastic cortical changes, thereby affecting the organizational structure in
      sensorimotor cortices and top-down trunk motor control? 3) Do psychological factors influence
      the organizational structure in sensorimotor cortices and motor control strategies? To
      address these knowledge gaps, the objectives of the current project are: I) To establish
      motor control phenotypes in LBP. Proprioceptive weighting and biomechanical assessment of
      dynamic movement tasks, including subject-specific spine kinematic variability and its
      relationship to pain duration, negative pain-related cognitions, segmental loadings and
      paraspinal muscle forces, will be performed. II) To test whether cortical proprioceptive maps
      differ between healthy subjects and patients with LBP. Brain activation in response to
      thoracolumbar vibrotactile stimulation will be interrogated using functional magnetic
      resonance imaging data and univariate and multivariate analysis based on machine learning.
      III) To test whether proprioceptive maps demonstrate a relationship to spine kinematic
      patterns, pain duration and negative pain-related cognitions in LBP patients.
    

Intervention name(s): mechanical stimulation; vibrotactile stimulation
Intervention type(s): Other; Other
Intervention description(s): mechanical non-painful low- and high pressure stimuli to thoracolumbar segments of healthy subjects and low back pain patients; non-painful vibrotactile stimulation within a frequency range between 20-150Hz to thoracolumbar segments of healthy subjects and low back pain patients
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Basic Science