Clinical trial NCT00201513: Anticipatory Muscle Control and Effect of Stabilizing Exercises in Patients With Subacute and Chronic Low Back Pain
Official title: Randomized Controlled Trial of Stabilizing Exercises and Effect on Anticipatory Muscle Control in Patients With Subacute and Chronic Low Back Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Low Back Pain
Keywords: Muscle, Skeletal
Neuromuscular control
Stability
Exercise
Anticipatory muscle control
Lead sponsor: Norwegian University of Science and Technology
Sponsor class: OTHER
Collaborators: name: Norwegian Fund for Postgraduate Training in Physiotherapy
First posted: 2005-09-20
Enrollment: 99
Sex: ALL
Minimum age (years): 20
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: 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.


Eligibility criteria: 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

Primary outcomes:
measure: Muscle activity onset in transversus abdominal muscle
timeFrame: 1 year
Secondary outcomes:
measure: Pain
timeFrame: 2 years
measure: Function (Oswestry v2)
timeFrame: 2 years
measure: Fear of avoidance belief
timeFrame: 1 year
measure: Assessment of isolated transversus abd. and multifidus control
timeFrame: 1 year
Other outcomes:
Locations:
city: Trondheim
country: Norway
facility: Norwegian University of Science and Technology, National center for spinal diseases
Study officials:
affiliation: National center for spinal diseases
name: Ottar Vasseljen, PhD
role: STUDY_CHAIR
References:
citation: Unsgaard-Tondel M, Fladmark AM, Salvesen O, Vasseljen O. Motor control exercises, sling exercises, and general exercises for patients with chronic low back pain: a randomized controlled trial with 1-year follow-up. Phys Ther. 2010 Oct;90(10):1426-40. doi: 10.2522/ptj.20090421. Epub 2010 Jul 29.
citation: Vasseljen O, Fladmark AM. Abdominal muscle contraction thickness and function after specific and general exercises: a randomized controlled trial in chronic low back pain patients. Man Ther. 2010 Oct;15(5):482-9. doi: 10.1016/j.math.2010.04.004.
citation: Vasseljen O, Unsgaard-Tondel M, Westad C, Mork PJ. Effect of core stability exercises on feed-forward activation of deep abdominal muscles in chronic low back pain: a randomized controlled trial. Spine (Phila Pa 1976). 2012 Jun 1;37(13):1101-8. doi: 10.1097/BRS.0b013e318241377c.
citation: Unsgaard-Tondel M, Lund Nilsen TI, Magnussen J, Vasseljen O. Is activation of transversus abdominis and obliquus internus abdominis associated with long-term changes in chronic low back pain? A prospective study with 1-year follow-up. Br J Sports Med. 2012 Aug;46(10):729-34. doi: 10.1136/bjsm.2011.085506. Epub 2011 Jul 26.