Heat Transfer by Three Types of Packs and Its Implication on the Flexibility of the Lower Back

Study Overview
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Brief Summary
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The purpose of this study is to compare the effects generated by the application of three different packs on the flexibility of the lower back of sedentary students. Method: Three sessions of 15 minutes of superficial heat through a hot pack (moist heat pack-MHP, seed pack-SP or gel pack-GP) were applied on the lower back. Pack and lower back temperatures and erythema were registered every 5 minutes. Schober test was performed before first session and after the third session.

Detailed Description
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A different type of hot pack was applied in the lower back of each subject: moist heat pack (MHP) , seed pack (SP) or gel pack (GP) as directed by each manufacturer and in accordance with clinical practice for 15 minutes for 3 consecutive days. On day one, prior to the application of the pack, the initial evaluation of flexibility of the lumbar spine of each subject was recorded using Schober test. On day 3, after the application of each pack, the final evaluation of the flexibility of the lower back was performed using the same test. During the sessions, the temperature of the corporal area, the temperature of the pack and the pigmentation change of the corporal area were assessed every 5 minutes through a photographic record.The method used to assess the flexibility was the Schober Test. In order to perform the evaluation, the patient was placed in standing position with its bare feet slightly apart; two points were marked on the skin, one above the spinous apophysis S1 and another point, 10 cm above that mark. The patient performed a maximal trunk flexion without flexing the knees and the increase of the distance between the two marks was recorded. After this evaluation, the packs were applied on the lower back, wrapped in two layers of towels in order to avoid skin injuries by the heat. The temperature of the lower back and of each type of pack was recorded at minutes 0 (baseline measurement), 5, 10 and 15. Temperature was measured through a digital pyrometer at a set distance of 50 cm and it was held perpendicular to patient skin and the pack. The photographic record of the lower back of each subject, before and after each session of superficial thermotherapy, was recorded using a digital camera . The camera was placed perpendicular to the lower back, at a distance of 50 cm. The brightness of the photograph was taken into account so as not to affect the later analysis of the erythema. The erythema analysis of the lower back was performed with the freeware Picture Color Analyzer (Shizuoka, Japan; http://www.isao.com). The software measures the red color intensity of each pixel (attributing a value between 1 and 255) within the chosen area. The average red color value obtained in arbitrary units is the result of the following formula: Average red color = total red color value / (255 X number of pixels in the area).

Official Title
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Heat Transfer by Three Types of Packs and Its Implication on the Flexibility of the Lower Back: a Randomized, Controlled Trial

Conditions
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Physical Therapy Techniques

Intervention / Treatment
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* Other: moist heat pack; ;
* Other: seed pack
* Other: gel pack


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: sedentary subjects (physical activity performed less than 3 times-week) Exclusion Criteria: recent scars or wounds in the lower back region, history of peripheral vascular diseases, impaired sensitivity, body mass index above 25 kg/m2, fat index above 14% according to Faulkner's formula.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: moist heat pack group<br>Three sessions of 15 minutes of superficial heat through a moist heat pack on the lower back of healthy subjects | Other: moist heat pack; ;<br>* Three sessions of 15 minutes of superficial heat through a moist heat pack-MHP applied on the lower back.<br>|
| Experimental: seed pack group<br>Three sessions of 15 minutes of superficial heat through a seed pack on the lower back of healthy subjects | Other: seed pack<br>* Three sessions of 15 minutes of superficial heat through a seed pack-SP applied on the lower back.<br>|
| Experimental: gel pack group<br>Three sessions of 15 minutes of superficial heat through a gel pack on the lower back of healthy subjects | Other: gel pack<br>* Three sessions of 15 minutes of superficial heat through a gel pack-GP applied on the lower back.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of lower back flexibility (Schober test) | Schober test | Before first session (day 1) and after the third session (day 3-final day). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of pack and lower back temperatures |  | every 5 minutes during each one of the three 15 minutes sessions | 
| Change of lower back erythema |  | every 5 minutes during each one of the three 15 minutes sessions | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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superficial heat, hot pack, thermotherapy, physiotherapy, Schober Test