Sensory Nerve Function and Exercise Therapy Response in Chronic Low Back Pain

Study Overview
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Brief Summary
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This observational study aims to compare measures of sensory nerve function between chronic low back pain patients matched for baseline pain and disability levels who are then classified as responders or non-responders after completing a 12-week tailored exercise program. Measures collected include sural sensory nerve conduction, quantitative sensory testing for pressure and heat pain thresholds, and psychosocial questionnaires. It is hypothesized that baseline sensory nerve dysfunction may be associated with reduced response to exercise therapy in chronic low back pain.

Detailed Description
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While exercise is commonly prescribed for chronic nonspecific low back pain (NSLBP), patient responses are variable. Differences in baseline sensory nerve function could plausibly contribute to exercise therapy outcomes. This cross-sectional quantitative observational study will investigate if baseline sensory nerve conduction amplitudes and quantitative sensory testing (QST) pain thresholds differ between matched NSLBP patients later categorized as responders or non-responders to a 12-week standardized exercise regime. A sample of 50 NSLBP participants with matched baseline pain and disability will undergo a tailored 12-week exercise intervention and 6-month follow-up. Blinded assessors will perform post-intervention sensory nerve conduction and QST measures. It is hypothesized that exercise therapy responders will show greater improvements in sensory thresholds correlating with pain relief. Results aim to elucidate neural factors associated with long-term exercise therapy outcomes in chronic low back pain.

Official Title
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Comparing Sensory Nerve Conduction and Quantitative Sensory Testing Thresholds Between Matched Patients With Nonspecific Low Back Pain Categorized as Responders or Non-Responders to Exercise Therapy

Conditions
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Chronic Low-back Pain

Intervention / Treatment
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* Other: 12-Week Tailored Exercise Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults ages 20-60 years Nonspecific chronic low back pain >3 months Baseline pain ≥6/10 and disability ≥40% Exclusion Criteria: Radicular leg pain Prior lumbar surgery Serious spinal pathology

Ages Eligible for Study
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Minimum Age: 18 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Exercise Responders<br>≥30% improvement in pain with 12 weeks of prescribed exercise | Other: 12-Week Tailored Exercise Intervention<br>* 12-week individually tailored exercise therapy program based on patient presentation. Supervised physiotherapy plus home exercise<br>|
| Exercise Non-responders<br><30% improvement in pain with 12 weeks of prescribed exercise | Other: 12-Week Tailored Exercise Intervention<br>* 12-week individually tailored exercise therapy program based on patient presentation. Supervised physiotherapy plus home exercise<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sural Sensory Nerve Conduction Amplitude | Baseline antidromic sural sensory nerve action potential amplitude (measured in microvolts) assessed through nerve conduction study. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Superficial Peroneal Sensory Nerve Conduction Amplitude | Baseline superficial peroneal sensory nerve action potential amplitude (measured in microvolts) assessed through nerve conduction study. | Baseline | 
| Pressure Pain Threshold | Pressure pain threshold (measured in kg/cm2) assessed using a pressure algometer at the lower back. | Baseline | 
| Heat Pain Threshold | Heat pain threshold (measured in °C) assessed using a thermode applied to the calf. | Baseline |