Additional Gluteal Control Training for Low Back Pain With Functional Leg Length Inequality

Additional Gluteal Control Training for Low Back Pain With Functional Leg Length Inequality: A Ramdomized Controlled Trail

Low back pain (LBP) is a prevalent musculoskeletal disorder. A variety of exercise interventions which were designed as randomized control trails (RCTs) have been studied and shown effectiveness in improving pain and disability. These exercises typically focus on the abdominal and back musculature strength. However, many LBP patients did not show any improvement in their symptom after they carry out those exercise programs.

Study Overview

• Status: Completed
• Conditions: Low Back Pain, Recurrent
• Intervention / Treatment: Other: GC group; Other: CG group

Detailed Description

Low back pain (LBP) is a prevalent musculoskeletal disorder. A variety of exercise interventions which were designed as randomized control trails (RCTs) have been studied and shown effectiveness in improving pain and disability. These exercises typically focus on the abdominal and back musculature strength. However, many LBP patients did not show any improvement in their symptom after they carry out those exercise programs. Some authors consider that this type of low back pain may be caused by leg length inequality (LLI) in these patients, which resulted from poor gluteal neuromuscular control or muscles' imbalance.

In consideration of few studies have been done for investigating the effects of gluteal muscles control training in LBP. Thus, the purpose of this study is to investigate the effect of additional gluteal muscles control training on improving functional LLI in patients with LBP. We hypothesized that gluteal muscle control training would be more effective in self-reported pain, and their functional disability would be improve after 6-week training program than control training group.

• Study Type: Interventional
• Enrollment (Actual): 48
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Taiwan
  • Taipei, Taiwan, 11221
    • National Yang Ming University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• non-specific LBP (from inferior rib margin to the gluteal fold)
• more than 3 months
• Visual Analog Scale ≧5 (in past one month)
• pelvic innominate rotation (anterior rotation in dominant side)

Exclusion Criteria:

• history of fracture or surgery
• congenital anomalies in the spine, pelvis, or lower limbs
• recent trauma, tumor, pregnancy or scoliosis
• lower extremity paresthesia, unknown weakness
• bowel and bladder dysfunction
• predominant lower extremity pain with standing
• presence of system illness, no reasoning weight loss, predominant night pain
• specific sacroiliac joint dysfunction

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: GC group; It mainly involve core stability exercise, stretching exercise and gluteal control training. All of above will be arranged 3 times a week for a total 6 weeks.	Other: GC group; core stability training: hold 5s/rep, 20 reps/timessupine, pelvic posterior tilt with TrA contraction.supine, pelvic posterior tilt and maintain bil. knee on 90 degrees.All four position with leg raise; Stretching ex. : hold 15 s/reps, 5 reps/timesHamstringQuadriceps; Additional gluteal muscle control training: hold 10 s/reps, 20 reps/times 1st to 2nd:clam ex. without resistancesingle leg bridge with maintain bil. ASIS even level 3rd to 4th: maintain 1st to 2nd ex. with resistance 5th:maintain 3rd to 4th ex.single leg standing on rock board to maintain balance 6th:maintain 5th ex.lunge ex. without hip internal rotation; Other Names: Additional gluteal muscle control training
Experimental: CG group; It involve core stability exercise and stretching exercise. All of above will be arranged 3 times a week for a total 6 weeks.	Other: CG group; core stability training: hold 5s/rep, 20 reps/timessupine, pelvic posterior tilt with TrA contraction.supine, pelvic posterior tilt and maintain bil. knee on 90 degrees.All four position with leg raise; Stretching ex. : hold 15 s/reps, 5 reps/timesHamstringQuadriceps; Other Names: General core strengthening

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Leg Length Inequality	functional leg length inequality	change from baseline at 6 weeks later
Ilium Anterior Tilt Difference	bilateral ilium anterior tilt difference	change from baseline at 6 weeks later
Pelvic Inclination	bilateral pelvic inclination	change from baseline at 6 weeks later

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity	Visual Analog Scale (VAS) (0-10) Maximum: 10 Minimal: 0 higher scores mean a worse outcome	change from baseline at 6 weeks later
Functional Disability	Oswestry disability index (ODI) Maximum: 100 Minimal: 0 higher scores mean a worse outcome	change from baseline at 6 weeks later
Functional Ability	PSFS (0-10) Maximum: 10 Minimal: 0 higher scores mean a better outcome	change from baseline at 6 weeks later

Collaborators and Investigators

• Sponsor: National Yang Ming University
• Investigators: Study Director: Yi-Fen Shih, PhD, Department of Physical Therapy and Assistive Technology, National Yang-Ming University

Study record dates

Study Major Dates

• Study Start (Actual): December 11, 2017
• Primary Completion (Actual): July 23, 2018
• Study Completion (Actual): September 10, 2018

Study Registration Dates

• First Submitted: May 30, 2018
• First Submitted That Met QC Criteria: June 11, 2018
• First Posted (Actual): June 13, 2018

Study Record Updates

• Last Update Posted (Actual): September 19, 2019
• Last Update Submitted That Met QC Criteria: September 17, 2019
• Last Verified: August 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Pathological Conditions, Anatomical; Bone Diseases; Bone Diseases, Developmental; Back Pain; Low Back Pain; Leg Length Inequality
• Other Study ID Numbers: YM106055F

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No