Integral movement therapy versus local movement therapy approach in patients with idiopathic chronic low-back pain: study protocol for a randomized controlled trial

Abstract

Background: Chronic low-back pain (CLBP) is one of the most common reasons for seeking medical care and it imposes a significant burden on individuals and society at large. Systematic reviews evaluating the effectiveness of supervised exercise therapies commonly conclude that, to date, there is no evidence to support the superiority of one form of exercise over another. Randomized controlled trials (RCT) to date included mostly trunk strengthening exercises (e.g. bird dog, plank) and there is no evidence about supervised, individually graded integral movement therapy program for patients with CLBP.

Methods: The research design is a RCT with parallel-group design including two intervention groups: integral movement therapy and conventional local movement therapy. Participants in each group will receive 20 supervised sessions in a 10-week period, twice per week, for approximately 1 h per session. Outcome assessments will occur at baseline and immediately after intervention, follow-up will take place at six months and 12 months after the intervention. Prespecified analyses will evaluate the main effects of the treatment.

Discussion: This trial will use a novel, previously unexplored integral approach to CLBP through exercises. In contrast to commonly used exercise programs, the integral program does not include specific local strength exercises for hip and trunk flexors and extensors. However, learning dynamic trunk muscle control in various body positions with added limb movements could be beneficial because of the parallels to everyday work. The study will contribute to clinical practice by providing evidence to guide professionals when deciding for the proper and efficient treatment of patients with CLBP.

Trial registration: ClinicalTrials.gov, NCT03623802 . Registered on 9th August 2018.

Keywords: Chronic low-back pain; Integral movement therapy; Local movement therapy; Supervised training.

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the National Medical Ethic Committee, registration number: 0120–93/2018/6. Consent is obtained from all participants in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1

Schedule of enrollment, interventions, and assessments (Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) flow chart). IPAQ International Physical Activity Questionnaire, ODI Oswestry Disability Index questionnaire, NRS numeric rating scale, TUG timed up and go test (3 m), CSR chair seat and reach, 6MWT 6-min walk test, BS Biering-Sorensen test, mSCH Modified Schober flexibility test, SRB Sharpened Romberg balance test, Tflex trunk flexion strength, Text trunk extension strength, Tlat trunk lateral flexion strength, REPerror trunk reposition error test, MaxPELincl maximal pelvic inclination at full trunk flexion