Anticipatory Muscle Control and Effect of Stabilizing Exercises in Patients With Subacute and Chronic Low Back Pain

Study Overview
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Brief Summary
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Muscular stability is essential to the spinal column to avoid harmful strain and injury to its structures. Sudden postural disturbances impose reactive internal forces through the spine. If the muscles do not react before the internal reactive forces propagate through the spine, there is a short fraction of time where the spinal column may lack sufficient muscular support. Studies have shown that in patients with low back pain deep abdominal and back muscle have a delayed response to reactive forces. The purpose of this study is to verify these findings and to investigate whether tailored interventions can improve the reaction time in stabilizing muscle around the lower spinal column i patients with subacute and chronic low back pain.

Official Title
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Randomized Controlled Trial of Stabilizing Exercises and Effect on Anticipatory Muscle Control in Patients With Subacute and Chronic Low Back Pain

Conditions
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Low Back Pain

Intervention / Treatment
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* Behavioral: Isolated Transversus abdominis (TrA) exercise
* Behavioral: sling exercise
* Behavioral: group exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Unspecific subacute, subacute remitting and chronic LBP Both sexes, 20-60 yrs of age LBP between 2-8 on a 11-pt numeric rating scale Exclusion Criteria: Previous back surgery Sick listed more than one year Radiating pain below knee or motor deficits Systemic diseases and red flags Diagnosed psychiatric disease Ingoing insurance claim Pregnancy

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: TrA exercise<br>Isolated Transversus abdominis (TrA) exercises (low load) | Behavioral: Isolated Transversus abdominis (TrA) exercise<br>* Eight weeks Isolated Transversus abdominis (TrA) exercise(low load) program; Isolated TrA control through biofeedback<br>|
| Experimental: sling exercise<br>Sling exercises (high load) | Behavioral: sling exercise<br>* Eight weeks sling(high load) exercise program; Isolated TrA control through biofeedback<br>|
| Active Comparator: group exercise<br>Non-specific group exercises | Behavioral: group exercise<br>* Eight weeks non-specific group exercise program; Isolated TrA control through biofeedback<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle activity onset in transversus abdominal muscle |  | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain |  | 2 years | 
| Function (Oswestry v2) |  | 2 years | 
| Fear of avoidance belief |  | 1 year | 
| Assessment of isolated transversus abd. and multifidus control |  | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Muscle, Skeletal, Neuromuscular control, Stability, Exercise, Anticipatory muscle control