The Effect of Secondary Prevention in Patients With Recurrent Low Back Pain
Condition: Low Back Pain, Recurrent
MeSH terms: Recurrence; Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      This study investigates the effect of a secondary intervention program for low back pain in
      patients with recurrent low back pain. One third of the subject will receive no therapy, one
      third wil receive 2 sessions of pain neuroscience education (PNE) and one third will receive
      two sessions of PNE and 5 sessions of exercise therapy over 6 weeks.
    

Detailed description: 
      Participants:

      60 individuals with recurrent non-specific LBP were recruited through advertisement in sport
      facilities, social media and among friends and family.

      Testing:

      The testing was performed before and after a six week period by three blinded 2nd master
      students of physiotherapy of University of Ghent. The pre and post testing were almost
      identical and lasted 1 hour, only for the first testing an anamnesis was conducted to
      evaluate inclusion and exclusion criteria. The identical parts were tests for motor control,
      muscle performance and psychosocial factors.

      Intervention:

      The subjects were divided into 3 groups, only group B and C were given treatment. Group B had
      2 sessions PNE over a period of two weeks. Group C received 2 sessions of PNE and 5 sessions
      of exercise therapy over a period of six weeks. Each of the sessions lasted 30 minutes and
      took place at the clinical practice room at the university of Ghent. Group C began the
      exercise therapy a week after the second session of PNE.
    

Intervention name(s): Pain Neuroscience Education; Exercise therapy
Intervention type(s): Behavioral; Other
Intervention description(s): The PNE intervention consisted of 2 sessions of 30 minutes. In the first session, the main goal is to explain the patient why pain is important and why people can't live without it. Besides it is explained why objective findings such as x-rays, MRI, CT scans, etc. often lack significant findings despite the pain that the patient experiences. This first session of pain education might help the patient understand that pain is necessarily a result from tissue damage. Furthermore, the session explains the right approach to conquer pain and to avoid going down in this vicious circle of low back pain. The second session of PNE, is a revision of the first session, continuing on what was unclear from the first session.; The exercise therapy varies form analytical exercises in the first sessions, to functional and sports related exercises near the following sessions. The first session focuses on the lumbar neuromuscular control of the patients: first a voluntary contraction of the Transversus Abdominis muscle, the Multifidus muscle and the pelvic floor muscles is learned. When the subject is able to maintain the combined contraction for 10 times, the exercises evolve to more complicated tasks. In the final stage, more functional and sport specific tasks will be exercised.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The randomization schedule was extracted from the website www.sealedenvelope.com . The randomization was expected to have the same amount of one gender in each group. The control group was group A, the group that only received PNE was group B and the group who received PNE and exercise therapy was group C.
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: low back pain; recurrent; non-specific; secondary prevention; pain neuroscience education; exercise therapy