Clinical trial NCT05585294: Water Versus Land Based Perturbation Exercises in Elderly Participants With Back Pain
Official title: The Effectiveness of Perturbation Exercises in Elderly Back Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Back Pain
Back Pain With Radiation
Back Pain Without Radiation
Back Pain Lower Back Chronic
Keywords: Back Pain
Old Age
Exercises
Hydrotherapy
Rehabilitation
Lead sponsor: Gulf Medical University
Sponsor class: OTHER
Collaborators: name: Srinivas University
First posted: 2022-10-18
Enrollment: 24
Sex: ALL
Minimum age (years): 55
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: pre and post outcomes comparison after clinical intervention
Primary purpose: TREATMENT

Brief summary: The aim of this study was to compare the effectiveness of land based versus water based perturbation exercises on the pain, disability, fear of falling, and fear avoidance beliefs in elderly participants. Overweight/obese subgroup was compared with healthy weight with chronic low back pain participants to investigate any effect on BMI on both interventions. The results of the study revealed that both exercise groups i.e., land and water based exercise had a significant reduction in pain level, fear of falling, fear avoidance belief related to work, disability and improved SLR.

Detailed description: Twenty-four grouped into 12 per group participated water based and land based exercise protocol. Both groups were given McKenzie Method of exercises in 1st week based on the treatment-based classification (TBC) approach or personalized to the need of participants as per TBC.

Perturbation-based postural exercises were given to participants, which were performed on land or water for 6 weeks.

The perturbation based exercises were categorized into four levels, where level 1:static postural control, 2:dynamic postural control 3:Extremity loaded postural control and 4: cognitive task associated postural control. The perturbation were provided at shoulder and hip level, by intervention providers progressive enough to initiate anticipatory or compensatory postural adjustments.

Both groups were educated on pain assurance and spinal ergonomics feedback. The Outcomes were measured using a Visual analog scale, Oswestry disability index, Fear avoidance belief questionnaire, Straight leg raise, Modified fall efficacy scale, and Borg scale. The pain level were assessed for personalized progression from level 1 to level 4 progression of perturbation exercises.

Both the exercise groups of land and water showed improvement in measured clinical outcomes in terms of reduction in pain level, fear of falling, fear avoidance belief related to work, SLR, and disability. Water-based group showed additional benefits and significant improvement in fear avoidance belief related to physical activity and exercised with low rate of perceived exertion.

Eligibility criteria: Inclusion Criteria:

* Pain history of minimum 12 weeks duration in below labels
* Participants with the diagnostic labels of spondylosis
* Non-specific chronic low back pain
* Back pain radiating to leg or sciatica
* Subacute back pain

Exclusion Criteria:

* Unstable blood pressure
* Cardiac failure
* Incontinence
* Uncontrolled epilepsy
* Open wounds
* Acute infections
* Neurological disorders
* Orthopedic conditions affecting exercise participation in pool and land
* Cardio-respiratory conditions affecting exercise participation in pool and land.

Primary outcomes:
measure: Low back pain
timeFrame: 6 weeks
measure: Disability caused by the chronic low back pain
timeFrame: 6 weeks
measure: Physical activity associated fear avoidance behavior
timeFrame: 6 weeks
measure: Fall risk
timeFrame: 6 weeks
Secondary outcomes:
measure: Rate of perceived exertion
timeFrame: 6 weeks
measure: Impairment - Straight Leg Raise as hip joint range of motion
timeFrame: 6 weeks
Other outcomes:
Locations:
city: Ajman
country: United Arab Emirates
facility: Gulf Medical University, Thumbay Physical Therapy and Rehabiliation Hospital, Thumbay University Hospital
city: Ajman
country: United Arab Emirates
facility: Gulf Medical University
Study officials:
affiliation: Gulf Medical Univesity
name: Dr. Ramprasad Muthukrishnan, Ph.D
role: PRINCIPAL_INVESTIGATOR
References: