The Neural Basis of Lumbosacral Proprioceptive Impairment in Recurrent Low Back Pain

Study Overview
=================
Brief Summary
-----------------
Low back pain (LBP) is a well known health problem in Western society that is significantly responsible for socio-economic problems like absenteeism and disability. The lifetime prevalence of LBP is 60-80% and approximately 85% of this LBP has a non-specific character whereby the underlying causes and risk factors cannot be demonstrated. While many people recover within a month, most individuals will have recurrence within a year with more severe symptoms. This might be due to insufficient knowledge of the underlying mechanisms. Impaired proprioception, the ability to discern body/limb positions and movements, may cause and maintain LBP shown by an altered postural control strategy. Specifically, patients with LBP rely more on proprioceptive signals from the ankles due to less reliable proprioceptive input of proximal segments. Moreover, they show a decreased variability in postural control and less postural robustness, while variability is a prerequisite for optimal functioning of biological systems. However, further clarification of the neural correlates is necessary. Deficits in proprioception, as found in a subgroup of patient with LBP, are associated with a decreased ability of the brain to process proprioceptive inputs. The aim of this project is to clarify the central changes in individuals with recurrent non-specific low back pain and healthy controls. To evaluate these central changes MRI techniques (3DTFE, DTI and RS-fMRI) will be used. In addition, the association between central changes and postural control tasks will be evaluated.

Official Title
-----------------
The Neural Basis of Lumbosacral Proprioceptive Impairment in Recurrent Low Back Pain

Conditions
-----------------
Low Back Pain

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria persons with low back pain: Age: 20-50 year At least 6 months of low back pain with/without referred pain in buttock/thigh At least 3 episodes of disabling low back pain At least a score of 14% on the Oswestry Disability Index Willingness to sign the informed consent Met the MRI related requirements Inclusion Criteria healthy persons: Age: 20-50 year No history of low back pain A score of 0% on the Oswestry Disability Index Willingness to sign the informed consent Met the MRI related requirements Exclusion Criteria: History of major trauma and/or major orthopedic surgery of the spine, the pelvis or the lower quadrant One of the following conditions: Parkinson, MS, Stroke with sequels.... Radicular symptoms Not Dutch-speaking Strong opioids Neck pain Ankle problems Smoking

Ages Eligible for Study
-----------------
Minimum Age: 20 Years
Maximum Age: 50 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Persons with low back pain<br> | |
| Healthy persons<br> | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Structural changes in white matter pathways (3DTFE and DTI) (in individuals with recurrent non-specific low back pain compared to healthy controls) |  | One time point | 
| Changes in resting state activity between individuals with recurrent non-specific low back pain and healthy controls) |  | One time point | 
| Proprioceptive postural control (center of pressure displacement in response to muscle vibration) |  | One time point | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Low back pain, Proprioception, Postural control, Spine, Variability, MRI, Vibration, Brain