Clinical trial NCT02278549: Comparison of Spinal Kinematics Between Asymptomatic Subjects and Patients With Low Back Pain
Official title: Comparison of Spinal Kinematics Between Asymptomatic Subjects and Patients With Low Back Pain Using a Multi-segment Model
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Low Back Pain
Keywords: Spinal kinematics
Lead sponsor: Haute Ecole de Santé Vaud
Sponsor class: OTHER
Collaborators: name: University of Brighton
name: University of Lausanne Hospitals
First posted: 2014-10-30
Enrollment: 22
Sex: ALL
Minimum age (years): 30
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients with recurrent low back pain (more than months in duration) recruited through physiotherapy practices and medical consultations in the area of Lausanne, Switzerland.

Brief summary: Low back pain (LBP) is a complex and common problem with major societal repercussions. Clinical evaluations, and especially functional assessments, are necessary for proper diagnosis and decisions on the most appropriate treatment. The assessment of lumbar kinematics has been frequently described. For instance, measures of range of motion (ROM), angular velocities and acceleration of the total lumbar spine (TLx) have demonstrated some differences between healthy subjects and LBP patients. However, recent evidence has suggested that models evaluating the TLx are insufficient. In fact, regional differences in kinematics have been described between the upper lumbar spine and the lower lumbar spine.

The aim of this study is to evaluate the differences in spinal kinematics between healthy subjects and LBP patients using a multi-segment model of the spine that allows regional analysis.

Detailed description: A case-controlled study will be performed to compare asymptomatics subjects and patients with low back pain. ROM, angular velocities and coordination of the spine will be collected in a laboratory with a camera-based system (VICON). Subjects will have to perform normal ROM assessment in the three anatomical planes, as well as different functional activities such as sit to stand, step and walking. The measurement session will occur on one occasion for each participant.

Eligibility criteria: Inclusion Criteria:

* Sufficient French level
* BMI between 18 and 27
* Non-specific low back pain for more than 3 months (pain provoked by movements, postures or activities)

Exclusion Criteria:

* Pregnancy
* Spondylolisthesis
* Infection
* Rheumatological or neurological diseases
* Spinal fractures
* Known spinal deformation (scoliosis, ...)
* Back surgery
* Tumours
* Radicular symptoms (with neurological signs). Pain irradiating in the lower limbs with decrease strength, sensitivity and reflex.
* High level of pain (severity and irritability) at the time of experiment that prevents repeated movements.
* Other concomitant pain or condition that could compromise the evaluation of lumbar kinematics.

Primary outcomes:
measure: Spinal kinematics
timeFrame: Participants will be measured once
Secondary outcomes:
measure: Score of disability
timeFrame: Participants will be measured once
measure: Score of kinesophobia
timeFrame: Participants will be measured once
measure: Score of risk of poor outcomes
timeFrame: Participants will be measured once
measure: Pain intensity
timeFrame: Participants will be measured once
Other outcomes:
Locations:
city: Lausanne
country: Switzerland
facility: University of Lausanne Hospitals
state: Vaud
Study officials:
affiliation: University of Lausanne Hospitals
name: Julien Favre, PhD
role: STUDY_DIRECTOR
affiliation: University of Brighton
name: Lucy Redhead, PhD
role: STUDY_DIRECTOR
affiliation: Haute Ecole de Santé Vaud
name: Guillaume Christe, PT
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Crosbie J, Nascimento DP, Filho Rde F, Ferreira P. Do people with recurrent back pain constrain spinal motion during seated horizontal and downward reaching? Clin Biomech (Bristol). 2013 Oct;28(8):866-72. doi: 10.1016/j.clinbiomech.2013.09.001. Epub 2013 Sep 9.
citation: Dankaerts W, O'Sullivan P, Burnett A, Straker L. Differences in sitting postures are associated with nonspecific chronic low back pain disorders when patients are subclassified. Spine (Phila Pa 1976). 2006 Mar 15;31(6):698-704. doi: 10.1097/01.brs.0000202532.76925.d2.
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citation: Marras WS, Ferguson SA, Gupta P, Bose S, Parnianpour M, Kim JY, Crowell RR. The quantification of low back disorder using motion measures. Methodology and validation. Spine (Phila Pa 1976). 1999 Oct 15;24(20):2091-100. doi: 10.1097/00007632-199910150-00005.
citation: Parkinson S, Campbell A, Dankaerts W, Burnett A, O'Sullivan P. Upper and lower lumbar segments move differently during sit-to-stand. Man Ther. 2013 Oct;18(5):390-4. doi: 10.1016/j.math.2013.02.001. Epub 2013 Mar 7.
citation: Wade M, Campbell A, Smith A, Norcott J, O'Sullivan P. Investigation of spinal posture signatures and ground reaction forces during landing in elite female gymnasts. J Appl Biomech. 2012 Dec;28(6):677-86. doi: 10.1123/jab.28.6.677. Epub 2012 May 10.