Effectiveness of a Home Rehabilitation Program vs an e-Health Program in Patients With Chronic Low Back Pain
Comparison of Effectiveness of a Home Rehabilitation Program vs an e-Healt Program on Disability, Pain, Fear of Movement, Quality of Life and Spinal Mobility in Patients With Chronic Low Back Pain.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Andalucía
-
Almería, Andalucía, Spain, 04120
- University of Almeria
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Low back pain ≥ 3 months.
- Age between 30 and 67 years old.
- Score ≥ 4 points on the Roland Morris Disability Questionnaire.
- Not being receiving physical therapy.
Exclusion Criteria:
- Presence of lumbar stenosis.
- Diagnosis of spondylolisthesis.
- Diagnosis of fibromyalgia.
- Treatment with corticosteroids or oral medication in recent weeks.
- History of spine surgery.
- Contraindication of analgesic electrical therapy.
- Have previously received a treatment of electrical analgesia or exercise.
- Central or peripheral nervous system disease.
- Agoraphobia
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Home rehabilitation program
It consists in a home rehabilitation program.
Patients will recieve electroanalgesia with TENS and an exercise program following the McKenzie method.
At first and second sessions, patients will be instructed on how to use electroanalgesia and how to perform the exercises.
Then, patients will perform the therapy at home.
Patients will perform the treatment 3 times per week, for 4 weeks, with a total of 24 sessions
|
It consists in a home rehabilitation program performing electroanalgesia and an exercise program following the Mckenzie method.
Patients will be instructed in the use of the TENS device using 5x9cm electrodes at the bilateral paravertebral level, the patients that present radicular pain, the electrodes will be placed in the path of the affected nerve.
The realization of exercises will be through the application of an Mckezie protocol.
The duration will be the same as that used to carry out the Mckenzie protocol.
Mckenzie exercises are designed to make changes in the internal components periarticular of the spine.
|
|
Active Comparator: e-Health program
It consists in a support system for the treatment of chronic low back pain based on web technologies.
The system can register a subject and provide a treatment of electroanalgesia and exercise through the Mckenzie method.
Video applications of electroanalgesia and exercises will be shown to patients who use their computer or mobile device to access the platform through the Internet.
The treatments will be recommended by the system based on the database that is configured to accommodate the application of electroanalgesia and McKenzie exercises based on the diagnosis according to the McKenzie method.patients
will perform the treatment 3 times per week, for 4 weeks, with a total of 24 sessions
|
It consists in an e-Health rehabilitation program through a web platform performing electroanalgesia and an exercise program following the Mckenzie method.
Patients will be instructed in the use of the TENS device using 5x9cm electrodes at the bilateral paravertebral level, the patients that present radicular pain, the electrodes will be placed in the path of the affected nerve.
The realization of exercises will be through the application of an Mckezie protocol.
The duration will be the same as that used to carry out the Mckenzie protocol.
Mckenzie exercises are designed to make changes in the internal components periarticular of the spine.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from baseline in Roland Morris Disability Questionnaire (RMDQ).
Time Frame: At baseline, at 8 weeks and at 6 months
|
This is a self-reported questionnaire consisting in 24 items reflecting limitations in different activities of daily living attributed to low back pain including walking, vending over, sitting, lying down, dressing, sleeping, self-care and daily activities.
|
At baseline, at 8 weeks and at 6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from baseline in lumbar mobility flexion.
Time Frame: At baseline, at 8 weeks and at 6 months
|
For the quantification of lumbar flexion an angular inclinometer is used (Fleximeter UM 8320-3 RJ Code Research Institute, Brazil).
|
At baseline, at 8 weeks and at 6 months
|
|
Changes from baseline in Lumbar electromyography.
Time Frame: At baseline, at 8 weeks and at 6 months
|
The degree of electromyographic activation of the lumbar paravertebral musculature will be carried out by using a set of electrodes of 3x7 dimensions that will be applied uniformly in the lumbar region from the spinal level from L2 to L5.
|
At baseline, at 8 weeks and at 6 months
|
|
Change from baselina in range of motion and lumbar segmental mobility
Time Frame: At baseline, at 8 weeks and at 6 months
|
This variable is quantified using the SpinalMouse ® device (Phisiotech, Spain).
It is an electronic computer-aided measuring device that measures sagittal spinal amplitude of movement (ROM) and intersegmental angles in a non-invasive way.
|
At baseline, at 8 weeks and at 6 months
|
|
Change from baseline in disability. Oswestry Low Back Pain Disability Idex.
Time Frame: At baseline, at 8 weeks and at 6 months.
|
It has 10 items associated to activities of daily living, each ítem has a puntuation fron 0 to 5 points.
|
At baseline, at 8 weeks and at 6 months.
|
|
Change from baseline in pain intensity. Visual analogue scale.
Time Frame: At baseline, at 8 weeks and at 6 months
|
A 10-point Numerical Pain Scale (0: no pain, 10: maximum pain) assesses the intensity of pain
|
At baseline, at 8 weeks and at 6 months
|
|
Change from baseline in Fear of Movement. Tampa Scale of kinesiophobia.
Time Frame: At baseline, at 8 weeks and at 6 months
|
Is a 17-item questionnaire that measures the fear of movement and (re)injury.
|
At baseline, at 8 weeks and at 6 months
|
|
Change from baseline on Quality of Life. SF-36 Health questionnaire.
Time Frame: At baseline, at 8 weeks and at 6 months
|
. SF-36 Health questionnaire scores range from 0 to 100% and indicate the self-perceived health-related quality of life.
|
At baseline, at 8 weeks and at 6 months
|
|
Change from Mcquade Test.
Time Frame: At baseline, at 8 weeks and at 6 months
|
It measures the isometric endurance of trunk flexion muscles.
|
At baseline, at 8 weeks and at 6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Adelaida María Castro-Sánchez, PhD, Universidad de Almeria
Publications and helpful links
General Publications
- Walker BF. The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord. 2000 Jun;13(3):205-17. doi: 10.1097/00002517-200006000-00003.
- Khadilkar A, Odebiyi DO, Brosseau L, Wells GA. Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain. Cochrane Database Syst Rev. 2008 Oct 8;2008(4):CD003008. doi: 10.1002/14651858.CD003008.pub3.
- Von Korff M, Moore JC. Stepped care for back pain: activating approaches for primary care. Ann Intern Med. 2001 May 1;134(9 Pt 2):911-7. doi: 10.7326/0003-4819-134-9_part_2-200105011-00016.
- Schaafsma FG, Whelan K, van der Beek AJ, van der Es-Lambeek LC, Ojajarvi A, Verbeek JH. Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with back pain. Cochrane Database Syst Rev. 2013 Aug 30;2013(8):CD001822. doi: 10.1002/14651858.CD001822.pub3.
- Becker A, Held H, Redaelli M, Strauch K, Chenot JF, Leonhardt C, Keller S, Baum E, Pfingsten M, Hildebrandt J, Basler HD, Kochen MM, Donner-Banzhoff N. Low back pain in primary care: costs of care and prediction of future health care utilization. Spine (Phila Pa 1976). 2010 Aug 15;35(18):1714-20. doi: 10.1097/brs.0b013e3181cd656f.
- Elfering A, Semmer N, Birkhofer D, Zanetti M, Hodler J, Boos N. Risk factors for lumbar disc degeneration: a 5-year prospective MRI study in asymptomatic individuals. Spine (Phila Pa 1976). 2002 Jan 15;27(2):125-34. doi: 10.1097/00007632-200201150-00002.
- Haladay DE, Miller SJ, Challis J, Denegar CR. Quality of systematic reviews on specific spinal stabilization exercise for chronic low back pain. J Orthop Sports Phys Ther. 2013 Apr;43(4):242-50. doi: 10.2519/jospt.2013.4346. Epub 2013 Jan 14.
- Palacin-Marin F, Esteban-Moreno B, Olea N, Herrera-Viedma E, Arroyo-Morales M. Agreement between telerehabilitation and face-to-face clinical outcome assessments for low back pain in primary care. Spine (Phila Pa 1976). 2013 May 15;38(11):947-52. doi: 10.1097/BRS.0b013e318281a36c.
- Descarreaux M, Normand MC, Laurencelle L, Dugas C. Evaluation of a specific home exercise program for low back pain. J Manipulative Physiol Ther. 2002 Oct;25(8):497-503. doi: 10.1067/mmt.2002.127078.
- Petersen T, Kryger P, Ekdahl C, Olsen S, Jacobsen S. The effect of McKenzie therapy as compared with that of intensive strengthening training for the treatment of patients with subacute or chronic low back pain: A randomized controlled trial. Spine (Phila Pa 1976). 2002 Aug 15;27(16):1702-9. doi: 10.1097/00007632-200208150-00004.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CFS/apg
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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