Effects of Lumbar Repositioning Feedback and Transversus Abdominis Training on Lumbar Propricption in Patients With Chronic Mechanical Low Back Pain

Study Overview
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Brief Summary
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This study is conducted to answer the following question: What is the effect of lumbar repositioning feedback and transverses abdominis training on lumbar proprioception in patients with chronic mechanical low back pain?

Detailed Description
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Chronic low back pain is a chronic pain syndrome in the lower back region, lasting for at least twelve weeks. Chronic low back pain represents the leading cause of disability worldwide and is a major welfare and economic problem. Low back pain represents a major social and economic problem. The prevalence of chronic low back pain is estimated to range from fifteen to forty-five percent in French healthcare workers. Low back pain symptoms can derive from many potential anatomic sources, such as nerve roots, muscle, fascial structures, bones, joints, intervertebral discs, and organs within the abdominal cavity. Moreover, symptoms can also spawn from aberrant neurological pain processing causing neuropathic low back pain. Low back pain has been associated with motor control dysfunction. Indicators of this dysfunction include decreased contraction of the transversus abdominis and multifidus muscles, the reduced cross-sectional area of the multifidus, and fat infiltration. An association of chronic low back pain with altered muscle recruitment patterns and transversus abdominis activation delay was also found, as well as increased back muscle fatigue and altered kinematic patterns in the hips and lumbar area. This was further supported in two recent systematic reviews that reported that proprioception deficits were found in patients with chronic low back pain compared to healthy controls

Official Title
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Effects of Lumbar Repositioning Feedback and Transversus Abdominis Training on Lumbar Propricption in Patients With Chronic Mechanical Low Back Pain

Conditions
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Orthopedic Disorder

Intervention / Treatment
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* Device: including sham


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with CMLBP referred from orthopedic surgeon with no radicular pain Their age is ranged between 35-55 years old (Martim etal.,2008) BMI 24-28 kg/m2 Exclusion Criteria: Patients who have a history of diabetic peripheral neuropathies Patients who have a history of sciatica Spinal or lower limb deformity or any pathology within the spine. Patients who have neurological disorders Patients who have a history of previous lumbar surgery Patients who have visual problems

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Study 1<br>Twelve patients in study group 1 receiving lumbar repositioning feedback training | Device: including sham<br>* Repositiong feedback training and biofeedback pressure training unit<br>|
| Experimental: Study 2<br>Twelve patients in study group 2 receiving transverses abdominis training | Device: including sham<br>* Repositiong feedback training and biofeedback pressure training unit<br>|
| Experimental: Study 3<br>Twelve patients in study group 3 receiving both lumbar repositioning feedback training and tranversus abdominis training | Device: including sham<br>* Repositiong feedback training and biofeedback pressure training unit<br>|
| Experimental: Control<br>Twelve patients in control group receiving conventional lumbar propriception physical therapy program . | Device: including sham<br>* Repositiong feedback training and biofeedback pressure training unit<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pressure biofeedback unit | Assessment of transversus abdominis activation | up to 45 days | 
| feedback laser tracker | Assessment of lumbar repositioning error | up to 45 days |