Effectiveness of 'Functional Range Conditioning' in Treating Patients With Chronic Non-specific Low Back Pain
Condition: Chronic Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      The aims of this study are to examine the effectiveness of functional range conditioning in
      patients with chronic non-specific low back pain in terms of improving hip internal rotation
      and strength of the hip abductors, and reducing pain and disability.
    

Detailed description: 
      It will be a single blind two-arm randomized controlled trial. Saudi men and women aged
      between 25 - 45 years with a diagnosis of chronic non-specific low back pain will be invited
      to participate in this study. Subjects who will fulfill the study's criteria and who are
      willing to participate in this study will be asked to sign an informed consent form. The
      primary outcome will be the active and passive range of motion (ROM) of the hip internal
      rotators and it will be measured using digital inclinometer. The secondary outcomes in this
      study will be the maximum torque of the hip abductors (gluteus medius), concentric at a
      constant, low-speed, and high-speed. The peak torque and strength will be measured using
      isokinetic dynamometry, pain intensity will be assessed using a visual analog scale and
      disability will be assessed using Oswestry disability index. All participants will have their
      information taken by the principal investigator. Subsequently, participants will randomly be
      assigned to either the FRC group or the conventional treatment group by the principal
      investigator. Concealed randomization will be performed by means of a computer-generated
      table of random numbers. Outcomes will be measured at baseline, week 4 and week 8 for all
      participants in both groups by an assistant researcher.
    

Intervention name(s): FRC exercise; Conventional Exercise
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The program will consist of hip joint controlled articular rotations (CARs) in standing position for 3 - 5 repetitions. Then, the participant will sit on the floor in what is called 90/90 position which is sitting in hip and flexion in 90 degrees for both the lead (front) and trail (side) leg. The participant will perform a Progressive and regressive angular isometric loadings (PAILs and RAILs) for the trail leg to increase the range of internal rotation, the contraction will be performed three times and the holding of the position will be for two minutes. After expanding the range, the participant will perform Progressive and regressive angular loadings (PALs and RALs) isometric contractions in form of a passive range hold for internal rotation and abduction, for 3 - 5 times.; The conventional training program in this study will be the routine training for increasing the hip rotation. By screening the scientific literature, the conventional training found to consists of static stretching and strengthening using body weight and/or a band and the time of holding a stretch is about 30 seconds. For that the flexibility exercise will consist of progressive stretching from a prone position (leg fall in a stretch), the participant will perform 3 - 5 repetitions with 30 seconds hold or as tolerated. The strengthening exercise consists of hip abduction (hip opening) using a band or ankle weight from side lying for 10 - 12 repetitions 3 times.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary purpose: Treatment