Different Learning Methods of Motor Control Exercises

Study Overview
=================
Brief Summary
-----------------
This study evaluates the effects of self-learning exercise from multimedia content on pain and disability in patients with low back pain.

Detailed Description
-----------------
For see the full effect of exercise treatment, exercise adherence should be high. In patients with chronic non-specific low back pain, the complex nature of the core-stabilization exercises decrease the exercise adherence. Some novel studies show that multimedia learning can increase efficiancy of complex skill learning and can be better from classic face to face learning. So this study evaluates the effects of self-learning exercise from multimedia content on pain and disability in patients with low back pain.

Official Title
-----------------
Learning of Motor Control Exercises With Different Methods and Its Effects on Treatment Outcomes in Patients With Chronic Non-specific Low Back Pain: A Randomised Controlled Trial

Conditions
-----------------
Back Pain Without Radiation

Intervention / Treatment
-----------------
* Other: Multimedia Learning of Exercises
* Other: Face-to-face Learning of Exercises
* Other: Manual Therapy
* Other: Home Exercise Program


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Chronic (>3 month), non-specific low back pain 25- 55 years old Have a capacity can understand exercise instructions (Montreal Cognitive Assessment > 21) Being a computer literate Exclusion Criteria: Root nerve signs Cauda equina syndrome Fracture in the vertebra Tumour Have a neurologic disease History of spine surgery Knowing motor control exercises Visual impairment Hearing loss

Ages Eligible for Study
-----------------
Minimum Age: 25 Years
Maximum Age: 55 Years

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

Accepts Healthy Volunteers
-----------------
No

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

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Face-to-face Learning Group<br> | Other: Face-to-face Learning of Exercises<br>* Physiotherapist teach exercises to patients<br>Other: Manual Therapy<br>* Myofascial Release Techniques and Joint Mobilizations to the Lumbal Area<br>Other: Home Exercise Program<br>* Patients do at least 20 minutes motor control exercise in a day at home.<br>|
| Experimental: Multimedia Learning Group<br> | Other: Multimedia Learning of Exercises<br>* Patients learn exercise from multimedia content.<br>Other: Manual Therapy<br>* Myofascial Release Techniques and Joint Mobilizations to the Lumbal Area<br>Other: Home Exercise Program<br>* Patients do at least 20 minutes motor control exercise in a day at home.<br>|

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

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline Pain Level at Eight Week and Third Month | Full Scale Name: Visual Analog Scale Pain change will be measured throughout Study and Follow-up with Visual Analog Scale. This scale is a 100 millimeter line drawn horizontally on an A4 sheet of paper. The left end of the line shows no pain at all, the right end shows my pain is as bad as it could be, while the remaining part shows the intermediate values. So minimum score was 0, and maximum score was 100. The patient is asked to mark the severity of the pain on the chart. Validity and reliability were made. The minimal clinical significance difference in chronic low back pain was 20 millimeters. | At baseline, eighth week and third month | 
| Change from Baseline Disability Score Level at Eight Week and Third Month | Full Scale Name: Turkish version of the Oswestry Disability Index (ODI) (2.0) The last reliable and validate Turkish Version of Oswestry Disability Index will be used. This version contains 10 multiple-choice questions that question how low back pain affects a person in his or her daily life. Each question has 6 options. As the disability increases, the score of each problem increases. In the worst case you can get 50 points. The last point is the patient's score 100. | At baseline, eighth week and third month | 
| Change in Exercise Adherence Level between Eight Week and Third Month | The Exercise Adherence Rating Scale (EARS), which evaluates exercise compliance, will be administered 2 times to determine change at eight weeks and third month. This scale consists of 3 parts: A, B, C. Section A, consists of 6 items not included in the scale scoring. Section B consists 6 items, and every item have five point likert scale and describes how to do the recommended home exercise. Minimum point for this section 0, and maximum point is 24. The higher score shown exercise adherece is high. Section C is the section that evaluates the reason for the absence of compliance with the recommended home exercise and contains 10 items, every item have five point likert scale. Sections are calculated to result in a possible score between 0 and 40. The higher score shown exercise adherece is high. | At eighth week and third month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline Walking Parameters at Eight Week and Third Month | Mean Step Length and Total Walking Distance in Six Minute Walk Test | At baseline, eighth week and third month | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Back Pain without Radiation, Low Back Pain, Mechanical