Relationship Between Pressure Pain Threshold and Pain Intensity, Affect and Disability in CLBP
Condition: Pain Threshold; Low Back Pain; Pain Measurement
MeSH terms: Back Pain; Low Back Pain; Pain
Study type: Interventional

Summary: 
      The association between pressure pain threshold and different aspects of low back pain has
      garnered attention over the years. However, since most of such studies in the past employed
      cross sectional designs, a longitudinal study design with follow-up measurements is required
      to further investigate this relationship. Studying this relationship will not only offer
      insights into the phenomenon of pain but may also bring us one step closer to achieving the
      seemingly insurmountable goal of objectively measuring back pain and its different
      dimensions.
    

Detailed description: 
      This study is aimed to examine and evaluate the true extent of the relationship between
      pressure pain threshold (PPT) and different aspects of somatic pain, by studying the
      interplay between PPT and different variables, and by further exploring the predictive
      capability of PPT values to estimate pain intensity, pain affect and disability associated
      with chronic low back pain (CLBP). In order to estimate these dimensions a calculator based
      on mathematical equations using different predictive models will be developed. This tool
      (calculator) will take into account PPT reading from the lower back region and some other
      variables having confounding effects on PPT and pain, and will be able to predict pain
      intensity, affect and associated disability with reasonable accuracy. Patients with chronic
      low back pain shall be the target population and shall be recruited through referrals from
      the medical Out-Patients Department of Institute of Physical Medicine & Rehabilitation, Dow
      University of Health Sciences and Department of Rehabilitation Medicine PNS-Shifa Hospital,
      Karachi, Pakistan after initial screening in accordance with the inclusion and exclusion
      criteria. Screened patients shall then be briefed about the research project. After
      explaining the study objectives, procedures, potential benefits and discomforts, written
      informed consent shall be obtained from the patients. Only upon their agreement shall they
      become study participants and undergo assessments. The study participants shall receive
      handouts to document Depression and Anxiety, Pain Intensity, Pain Affect, and Disability.
      Pressure pain threshold (PPT) shall be measured using a manual Algometer. These measurements
      shall be followed by a session of physiotherapy treatment, after which Pain Intensity, Pain
      Affect, and Disability shall be recorded again.
    

Intervention name(s): segmental stability training
Intervention type(s): Other
Intervention description(s): SEGMENTAL STABILISATION TRAINING (SST): This part of the therapy shall involve Isometric co-contraction of Lumbar Transversus abdominis and Lumbar Multifidus. The patient shall perform 10 repetitions of abdominal drawing-in manoeuvre with 30-40% Maximal Voluntary Contraction (MVC) with a 10-second hold in specific prescribed positions.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic