Balance and Gait on Neuropathic Pain Due to Lumbar Disc Degeneration

Study Overview
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Brief Summary
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Chronic lumbar neuropathic pain, characterized by pain, numbness, tingling and muscle weakness in the lower extremities, is one of the most common neuropathic pain syndromes. It is expected that balance and gait disturbances will occur as a result of motor and sensory problems in patients with neuropathic pain due to lumbar disc degeneration. However, as far as the investigators know, there is no study in the literature describing the effects of neuropathic pain due to lumbar disc degeneration on balance and gait. Therefore, the aim of our study; To examine the effects of neuropathic pain due to lumbar disc degeneration on balance and gait.

Detailed Description
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Chronic lumbar neuropathic pain, characterized by pain, numbness, tingling and muscle weakness in the lower extremities, is one of the most common neuropathic pain syndromes. Since postural balance is controlled by sensory information, central processing, and neuromuscular responses, any change in proprioception due to prolonged neuropathic pain, asymmetrical load of the lower extremities, timing of dysfunctional muscle activation, sequencing, and asymmetry in foot pressure can alter postural balance. Solid evidence for the long-term effects of lumbar neuropathic pain on postural balance is lacking and needs to be addressed in people with lumbar disc degeneration. Gait problems are seen in patients with lumbar neuropathic pain and they walk more slowly than healthy individuals. However, it is not known to what extent neuropathic pain or neurological dysfunction due to disc degeneration affects gait. In the light of this information; It is expected that balance and gait disturbances will occur as a result of motor and sensory problems in patients with neuropathic pain due to lumbar disc degeneration. However, as far as the investigators know, there is no study in the literature describing the effects of neuropathic pain due to lumbar disc degeneration on balance and gait. Therefore, the aim of our study; To examine the effects of neuropathic pain due to lumbar disc degeneration on balance and gait.

Official Title
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Investigation of Balance and Gait in Neuropathic Pain Due to Lumbar Disc Degeneration

Conditions
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Neuropathic Pain

Participation Criteria
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Eligibility Criteria
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Inclusion criteria for individuals with neuropathic pain due to lumbar disc degeneration: Being between the ages of 40-70 Taking 4 points or more from the Douleur Neuropathique en 4 questions (DN4) questionnaire Taking 12 points or more from the Leeds Assessment of Neuropathic Signs and Symptoms (LANSS) scale Inclusion criteria for individuals with lumbar disc degeneration but no neuropathic pain: Being between the ages of 40-70 Taking below 4 points from the Douleur Neuropathique en 4 questions (DN4) questionnaire Taking below 12 points from the Leeds Assessment of Neuropathic Signs and Symptoms (LANSS) scale Inclusion criteria of healthy individuals in the study: Being between the ages of 40-70 Have no pain (Taking 1 point or less according to the Visual Pain Scale) Exclusion Criteria: Individuals with pain complaints of different etiology Individuals with neurological diseases that may cause central neuropathic pain such as stroke, head trauma, multiple sclerosis Individuals who have undergone orthopedic surgery in the last 6 months Individuals using any medication for neuropathic pain Individuals with chronic pain syndrome such as Fibromyalgia Syndrome

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Individuals diagnosed with neuropathic pain due to lumbar disc degeneration<br>Individuals with neuropathic pain due to lumbar disc degeneration were included in this group. | |
| Individuals with lumbar disc degeneration but no neuropathic pain<br>Individuals without neuropathic pain due to lumbar disc degeneration were included in this group. | |
| Healthy Controls<br>Healthy individuals who did not have any problems that would affect gait were included. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| E-LINK FP3 Force Plate | Measuring the symmetrical weight distribution in the anterior-posterior and left-right axes, the system enables the assessment of the ability to maintain postural stability on a static surface. While the patient is standing on the force platform, determine which direction the balance has shifted. | Baseline | 
| KoreBalance Balance Evaluation System | The KoreBalance balance evaluation platform has a variable air pressure bag system and tilt sensor to monitor 360° horizontal and 20° vertical movements. | Baseline | 
| Gait Velocity | Zebris Rehawalk computerized gait evaluation system is used to assess the spatio-temporal characteristics of the gait. The system consists of a treadmill and a computer. While the computer automatically detects the patient's hip, knee, and ankle, measures an individual's foot pressure on the ground. For gait assessment, patients walk at their preferred comfortable walking speed. | Baseline | 
| Step Length | Zebris Rehawalk computerized gait assessment system is used to evaluate the spatio-temporal characteristics of gait and to perform kinetic-kinematic analysis. | Baseline | 
| Foot pressure distribution | The dynamic foot pressure distribution is analyzed with the pedobarography integrated into Zebris Rehawalk computerized gait assessment system. The system consists of a treadmill and a computer. While the computer automatically detects the patient's hip, knee, and ankle, measures an individual's foot pressure on the ground. For gait assessment, patients walk at their preferred comfortable walking speed. | Baseline | 
| Cadence | Zebris Rehawalk computerized gait evaluation system is used to assess the spatio-temporal characteristics of the gait. The system consists of a treadmill and a computer. While the computer automatically detects the patient's hip, knee, and ankle, measures an individual's foot pressure on the ground. For gait assessment, patients walk at their preferred comfortable walking speed. | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neuropathic Pain, Gait Analysis, Spatio-Temporal Analysis, Foot Pressure Distribution