The primary goal is to investigate the ability of an integrated closed-loop identification system to differentiate between chronic a-specific LBP patients and healthy controls in terms of their neuromuscular trunk control. Also the influence of pain…
ID
Source
Brief title
Condition
- Other condition
- Musculoskeletal and connective tissue disorders NEC
Synonym
Health condition
Chronische a-specifieke lage rugpijn
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The main parameter is neuromuscular motor control, which can be described as
trunk stiffness, reflexes in response to external force perturbations and trunk
muscle recruitment.
Secondary outcome
Anthropometrics: body length and weight. Pain level, pain perception and
kinesophobia will be measured with questionnaires. Also pain diaries will be
filled every day for one week prior the measurements to measure pain level.
Sensitisation for pain, the ability to inhibit pain and trunk coordination will
be tested.
Background summary
Low-back pain is one of the most costly health problems in the industrialized
world. Impairments of neuromuscular control may play a key role in LBP. Hence,
identification of neuromuscular control of the trunk is needed to obtain
insight in the adaptive or maladaptive nature of changes in control and to
provide a window on the effects of pain, sensitization for pain and
proprioception.
Study objective
The primary goal is to investigate the ability of an integrated closed-loop
identification system to differentiate between chronic a-specific LBP patients
and healthy controls in terms of their neuromuscular trunk control. Also the
influence of pain, sensitisation for pain and proprioception on the
neuromuscular motor control will be investigated. Test-retest measurements will
be performed to establish the smallest detectable differences of the estimated
parameters. And the short-terms and long-term responsiveness of the integrated
closed-loop identification system will be investigated.
Study design
The neuromuscular motor control of 24 patients from the VU medical centre, 24
patients from Rehabilitation centres Reade and Heliomare, and 25 healthy
controls will be measured at baseline. A test-retest will be performed by
measuring 24 patients < 2 weeks after baseline and the healthy subjects will be
measured < 3 days after baseline. A responsiveness study will be performed by
measuring the patients from the VUmc one week before, <1 week after and two
months after they receive a nerve block (not provided as part of the research).
The patients from Rehabilitation centres Reade and Heliomare will be measured
at the start of a rehabilitation program, 2 months and 4 months after.
Study burden and risks
The risks for the subjects are minimal because the applied perturbations to
will have a maximum of 100 N, which is lower than forces applied in other
studies. The measurements (included explanation and preparation) will take
2,5-3 hours. Filling in questionnaires before each measurement which will take
30-45 minutes. The pain diaries will have to be filled in by the patients every
day for one week before measurement and this takes 5-10 minutes per day.
With this research we hope to gain more insight in the impaired motor control
of LBP patients. Proposed system for identification of trunk muscle control
will allow objective and quantitative monitoring of impairments of
neuromuscular control of the trunk in LBP patients and quantification of the
interaction with pain, sensitisation for pain and proprioception. This will
shed light on the importance of the main prognostic factors for an individual
patient and will support the implementation of more targeted treatment in
chronic LBP patients and reduce the high number of non-responders to treatment.
De boelelaan 1118
Amsterdam 1081 HZ
NL
De boelelaan 1118
Amsterdam 1081 HZ
NL
Listed location countries
Age
Inclusion criteria
Patients have to:
- be between the age of 18 and 70 years
- have a-specific LBPor LBP followed by back surgery for at least 6 weeks, as diagnosed by the patient*s general practioner or
physical therapist. Or, if no prior diagnosis has been made, after screening by an independent physical therapist or orthopaedic surgeon
- be able to understand and speak Dutch;Healthy controls have to:
- be age matched with the LBP patients
- be able to understand and speak Dutch
Exclusion criteria
Patients must not have:
- Radicular pain caused by lumbar nerve root compression or a hernia nuclei pulposi
- Other specifically diagnosed musculoskeletal disorders or any neuroanatomical disorders which might influence motor control of the low back
- any neurological disorders that interfere with trunk posture (e.g. Cerebro Vasculair Accident, Multiple Sclerosis or Parkinson's disease)
- any conditions that render the patient too unfit to be tested (such as pulmonary and/or cardiac disorders)
- any conditions that render the patient unable to understand or adhere to the research (such as cognitive, visual and/or language problems, that render the patient unfit to fill-in the questionnaires)
- Psychopathology
Healthy controls may not have:
- had low back pain longer than 2 weeks
- had low back pain within at least a month before the baseline measurement
- any conditions that render the subject unable to understand or adhere to the research (such as cognitive, visual and/or language problems, that render the subject unfit to fill-in the questionnaires)
Design
Recruitment
Followed up by the following (possibly more current) registration
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In other registers
| Register | ID |
|---|---|
| CCMO | NL42649.029.13 |