With this research, we are examining the impact of skin displacement in individuals with chronic low back pain. We are investigating its effects on the mobility of the back and hip, as well as its influence on muscle activity in the back and…
ID
Source
Brief title
Condition
- Other condition
- Musculoskeletal and connective tissue deformities (incl intervertebral disc disorders)
Synonym
Health condition
Myofascia
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Arm 1
• Lumbopelvic flexion range of motion (Inertial Measure Units) [Primary]
• Flexion relaxation ratio (ElectroMyography)
Arm 2
• Shear strain ratio*s (sliding mobility, Ultrasonography)
- Skin relative to underlying fasciae
- Skin relative to the underlying back muscles
Secondary outcome
Arm 1
• Pain level quantification during flexion
Arm 2
• Lumbodorsal fasciae stiffness
Background summary
Manual therapy is frequently utilized by physiotherapists to alleviate stiff
back muscles and reduce pain while simultaneously promoting flexibility. It is
presumed that the skin can influence the back muscles through the connective
tissue. Imagine applying a specific force, such as pushing or pulling. This
force passes through your skin and then through various layers of connective
tissue and muscles in your body, altering the way muscles and other parts of
your body function. This can result in the activation or deactivation of
specific muscles.
This phenomenon seems to occur because there are small sensors in your body,
akin to antennae. It appears that activating or deactivating these sensors may
influence the way we move. Consequently, the way you lift, bend, or move in
general may appear to change.
This study, titled 'Skin- and fascial displacement in nonspecific low back
pain,' investigates how the skin can influence the muscles in the back and
hamstrings. We employ advanced measurement techniques, including ultrasound,
electromyography, and motion tracking, to analyze the effects of these
techniques on connective tissues, muscles, muscle activity, and trunk
flexibility. This research contributes to a better understanding of skin
displacement on muscle activity and trunk flexibility in individuals with
chronic low back pain. We aim for more effective approaches to treating low
back pain.
Study objective
With this research, we are examining the impact of skin displacement in
individuals with chronic low back pain. We are investigating its effects on the
mobility of the back and hip, as well as its influence on muscle activity in
the back and hamstrings, along with the deformation of back muscles due to skin
displacement. The study is divided into two parts and will be conducted in a
single day.
In the first part, we are exploring whether the movement of the skin affects
the mobility of the back and muscle activity in individuals with chronic low
back pain. We are utilizing specialized sensors attached to the skin to measure
the movements of the back and muscle activity. A total of 38 individuals with
low back pain will participate in this part of the research.
The second part of the study investigates whether the movement of the skin
impacts the shape of connective tissue and muscles beneath the skin. We are
comparing individuals with low back pain to healthy individuals. For this
purpose, we are using specialized equipment employing sound waves (ultrasound)
displayed in imaging (echography).
Through this research, we aim to gain a better understanding of the influence
of the skin on muscle activity and the flexibility of the back.
Study design
The study consists of two arms conducted on one day. Arm 1 is a randomized
controlled trial examining the effects of SKD on the flexion relaxation ratio.
This trial focuses on individuals with nonspecific chronic LBP (NSCLBP). Arm 1
comprises an experimental group (n=19) and a sham control group (n=19).
Notably, subjects allocated to the experimental group in arm 1 will also
participate in arm 2 (Figure 1). Arm 2 is an observational case-control study
aiming to compare the effects of SKD on skin-fascia-muscle shear strain ratios,
between individuals with NSCLBP (n=19) and 19 healthy controls.
Intervention
In this study, two skin tests are being compared. The individual conducting the
skin test is aware of the form being applied. However, the participants are not
informed about the specific skin test they will receive. The allocation is done
randomly, akin to drawing lots.
Group 1: Participants in this group will undergo a specific skin displacement
test.
Group 2: Participants in this group will undergo a different skin displacement
test.
Study burden and risks
Non
Boelelaan 7
Amsterdam 1081 BT
NL
Boelelaan 7
Amsterdam 1081 BT
NL
Listed location countries
Age
Inclusion criteria
To be eligible to participate in this study, the NSCLBP subject must meet all
of the following criteria, all in line with patient profile 2, Royal Dutch
Guidelines for LBP [5]: Low back pain >=12 weeks, without dominant presence of
central sensitization measured with the Central Sensitization Inventory (CSI
>=39) [48], at least moderated pain during lumbopelvic flexion measured with the
Numeric Rating Scale (NRS >=4) in the lumbosacral region with or without
radiating pain in the gluteal region and the upper leg classified with the
Quebec Task Force (QTF 1-3) [49], unable in touching the floor (FFD >=4.5cm )
[50], age between 25 and 65 years, Body Mass Index (BMI) range (18,5 <= 30).
Before taking part in this study, a red flag screening for NSCLBP of the
individuals was carried out by a physiotherapist with a master in manual
therapy (Robbert van Amstel). Additionally for arm 2: Healthy individuals with
no current low back pain or a history of LBP in the past 6 months, age between
25 and 65 years, and BMI range (18,5 <= 30). We have chosen this age category
because disability due to low back pain is highest or most severe at the age of
25-65 years [51].
Exclusion criteria
Excluded are those who do not meet the abovementioned criteria and have or had
a specific spinal disease, infection, presence of a tumor, osteoporosis, bone
fracture, inflammatory disorder, or cauda equina syndrome, or a hip
arthroplasty in the last 6 months [6]. Despite our stations for measuring
muscle activity and trunk mobility not having a specific limit, participants
weighing more than 150 kg will be excluded from participation due to the
exclusion criteria related to the use of a physio plinth capable of supporting
a maximum weight of 150 kg. Individuals who previously took part in our
SKD-study [52] and/or are familiar with the DAMT-Test procedure as described in
the 4xT for LBP shall be excluded from participation [53].
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL85530.018.23 |