Effects of Association of Trunk Stretching and Segmental Stabilization Exercises in Chronic Unspecific Low Back Pain
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      The incidence of chronic nonspecific low back pain is the highest in the world population and
      can lead to disability. One of the standards treatments for this condition is the segmental
      stabilization exercises, as well as trunk stretching. However, there is no study that
      associates these two treatments for nonspecific low back pain. This study will be a
      controlled clinical trial, randomized, prospective, single-blind with a quantitative approach
      that compares the efficacy of the association between segmental stabilization + trunk
      stretching with segmental stabilization + placebo stretching in patients with chronic
      nonspecific low back pain.
    

Detailed description: 
      BACKGROUND: Chronic nonspecific low back pain (LCI) has a high incidence in the world
      population and can lead to disability. Several therapeutic approaches have been studied to
      treat this pathology, but most investigate only the efficacy of one form of treatment per
      group. Studies show the effect of Segmental Stabilization in patients with LCI, but there is
      a gap on the effects of the association of trunk stretches with segmental stabilization
      exercises on pain and disability with LCI. Therefore, the objective of this study is to
      investigate the effects of the association of trunk stretching and segmental stabilization
      exercises on chronic non-specific low back pain in the short and medium term.

      Method / Design: It will be a controlled, randomized, prospective, blinded clinical trial
      with quantitative approach, performed at the Clinical School of Physiotherapy of the UFPB.
      Participants in the study were 34 subjects of both sexes, aged 18 to 80 years, with pain
      equal to or greater than 3 by the Numerical Pain Scale (0/10) randomized into two groups:
      Placebo Stretching Group + Segmental Stabilization (n = 17) who will only do exercises of
      placebo stretching and segmental stabilization; And Segmental Stretching-Stabilization Group
      (n = 17), submitted to segmental stabilization exercises associated with trunk stretches;
      Both groups with 12 sessions. The results on pain intensity, functional capacity, overall
      effect perception, and clinical-psycho-functional assessment, as per the IMMPACT
      recommendations for clinical trials of effectiveness and efficacy of treatment for chronic
      pain, will be made by a blind After the intervention, three and six months after
      randomization.

      Discussion: Because of its design, it will be possible to blind the evaluator, the
      randomizer, and the patient. At the end of the research we hope to contribute to the clinical
      decision-making process in the choice of therapies that improve pain and disability in
      patients with non-specific chronic low back pain.
    

Intervention name(s): SSASG; SSPSG
Intervention type(s): Other; Other
Intervention description(s): Both groups will perform segmental stabilization exercises (SS), which emphasis is for the lumbar multifidus muscles (ML) and transversus abdominis (TAR), using protocol proposed by Richardson et al. Four types of exercises will be carried out with four sets of ten exercises. Muscle contractions will be held for ten seconds and followed by ten seconds rest. Between each type of exercise patients will rest for one-minute interval.
Patients of segmental stabilization active stretching group (SSASG) will perform stretch exercises in four sets of 30 seconds for each muscle. The active stretching exercises will last 15 minutes. The muscles that will be stretched are pectorals, latissimus dorsi, latissimus dorsi, teres major, rectus abdominis, external and internal oblique.; Both groups will perform segmental stabilization exercises (SS), which emphasis is for the lumbar multifidus muscles (ML) and transversus abdominis (TAR), using protocol proposed by Richardson et al. Four types of exercises will be carried out with four sets of ten exercises. Muscle contractions will be held for ten seconds and followed by ten seconds rest. Between each type of exercise patients will rest for one-minute interval.
Patients of segmental stabilization placebo stretching group (SSPSG) will perform exercises that simulate stretching, but the muscles will not suffer effective stretch. The placebo stretching exercises will last 15 minutes. The muscles that will be stretched are wrist flexors and extensors muscles and fingers flexors and extensors muscles.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Physical therapy; Muscle Stretching Exercises; Low Back pain