Clinical trial NCT00864422: Changes in Motor Cortex Following Exercises for Chronic Low Back Pain
Official title: Driving Plasticity in the Motor Brain in Chronic Back Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Chronic Low Back Pain
Keywords: low back pain
motor training
motor cortex
brain plasticity
Lead sponsor: The University of Queensland
Sponsor class: OTHER
First posted: 2009-03-18
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Maximum age (years): 55
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: BASIC_SCIENCE

Brief summary: The motor cortex of the brain changes following chronic pain and injury, and this is linked to pain-associated changes in motor behaviour. This study aimed to investigate whether therapeutic exercises in patients with chronic pain can induce reorganisation of the motor cortex and restore normal motor behaviour. The investigators hypothesised that motor training can induce reorganisation of the motor cortex and that these changes are related to improved motor behaviour.

Detailed description: The sensory and motor systems can reorganize following injury and learning of new motor skills. Recently we observed adaptive changes in motor cortical organization in patients with chronic back pain, which are closely linked to changes in motor behavior. Although pain-related alterations in behavior can be trained and are associated with improved symptoms, it remains unclear whether these meaningful functional outcomes are related to motor cortical reorganization. Here we investigate the effects of two interventions in people with chronic back pain: skilled motor training and a control intervention of self-paced walking exercise. We measured motor cortical excitability (motor threshold (MT)) and organization (center of gravity (CoG) and map volume) of the deep abdominal muscle, transversus abdominis (TrA), using transcranial magnetic stimulation (TMS). In addition, motor behavior of TrA was assessed during single rapid arm movements. The study helps to elucidate the mechanisms of specific motor exercises in chronic back pain management.

Eligibility criteria: Inclusion Criteria:

* Sustained or episodic non-specific low back pain lasting longer than 3 months

Exclusion Criteria:

* Orthopaedic, neurological, circulatory or respiratory conditions
* History or family history of epilepsy
* Recent or current pregnancies
* Previous surgery to the abdomen or back
* Abdominal or back exercises in the preceding 12 months

Primary outcomes:
measure: Motor cortical map and excitability from transcranial magnetic stimulation
timeFrame: Pre and 2 weeks post-intervention
Secondary outcomes:
measure: Motor activation of the abdominal muscles during functional arm movement task
timeFrame: Pre and 2 weeks post-intervention
measure: Self-reported pain (VAS scale) and functional scale (patient-specific functional scale)
timeFrame: Pre and 2 weeks post-intervention
Other outcomes:
Locations:
city: Brisbane
country: Australia
facility: Centre for Clinical Research Excellence in Spinal Pain, Injury and Health
state: Queensland
Study officials:
affiliation: The University of Queensland
name: Paul W Hodges, MedDr (Neurosci) PhD BPhty
role: STUDY_DIRECTOR
affiliation: The University of Queensland
name: Henry Tsao, PhD MPhty (Manipulative) BPhty
role: PRINCIPAL_INVESTIGATOR
References: