A Follow-up Comparison of Sensory Discrimination in Patients With Low Back Pain

Study Overview
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Brief Summary
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To determine if there is any carry over difference with sensation training to the low back for patients with low back pain with the addition of a training at home. This will be looked at to see if there is a difference in pain or back / leg movement right after the training and in a few days after doing some exercises at home.

Detailed Description
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In a previous case series patients with chronic Low Back Pain (LBP) who received tactile acuity training to their lower back in the absence of movement, experienced immediate positive changes in pain ratings and spinal movements. These changes, however, where only measured immediate post-intervention. This study aims to use a similar design of sensory discrimination for LBP, but will include a sensory discrimination home exercise program and compare groups at a follow-up visit for any difference between groups (48-96 hours) of the immediate changes. Changes will be assessed for pain and back and leg movement.

Official Title
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A Follow-up Comparison of Sensory Discrimination in Patients With Low Back Pain: a Randomized Control Trial

Conditions
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Low Back Pain

Intervention / Treatment
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* Other: Home exercise program only
* Other: Home exercise program and home program of sensory discrimination


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adults over the age of 18 patients presenting at PT with a primary complaint of LBP LBP being present for 3 months or more fluent in English willing to participate in the study They also will need someone who can assist with a sensory discrimination HEP. Exclusion Criteria: under age 18 not able to read/understand the English language prisoners no medical issues precluding physical therapy treatment (red flags) if they had undergone spinal surgery if they had any skin or medical condition preventing them from receiving tactile stimuli on the lower back or had specific movement-based precautions, i.e., no active spinal flexion. - Patients presenting with leg pain only Patients with neurological deficit only in the lower extremity

Ages Eligible for Study
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Minimum Age: 18 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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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized Control Trial
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: No Home Sensory training<br>Patients who perform a home exercise program only | Other: Home exercise program only<br>* After 5 minutes of sensory discrimination (using a 9 point grid) in the clinic patients will perform a home exercise program only<br>|
| Experimental: Home sensory training<br>Patients who perform home exercise and home sensory training | Other: Home exercise program and home program of sensory discrimination<br>* After 5 minutes of sensory discrimination (using a 9 point grid) in the clinic patients will perform a home exercise program and two 5 minutes sessions of sensory training at home each day.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Low Back Pain Rating | Numeric Pain Rating Scale for Back pain (0 = no pain and 10 = worst pain) | Change from baseline to following treatment immediately upon completion of initial session | 
| Low Back Pain Rating | Numeric Pain Rating Scale for Back pain (0 = no pain and 10 = worst pain) | Change from end of treatment initial session to 2-4 days | 
| Lumbar Flexion | Active trunk forward flexion measured in cm (finger tips to floor) | Change from baseline to treatment immediately upon completion of initial session | 
| Lumbar Flexion | Active trunk forward flexion measured in cm (finger tips to floor) | Change from end of treatment initial session to 2-4 days | 
| Straight Leg Raise | Neurodynamic measurement of leg raise (lower limb tension test) | Change from baseline to treatment immediately upon completion of initial session | 
| Straight Leg Raise | Neurodynamic measurement of leg raise (lower limb tension test) | Change from end of treatment initial session to 2-4 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sensory, Low back pain, Tactile, Education