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Screening Protocol for Standing-Induced Low Back Pain in Pain Developers

11. november 2026 opdateret af: Ala BabajanTabar, University of Tehran

Validation of a Combined Screening Protocol for Predicting Prolonged Standing Induced Low Back Pain in Pain Developers

The goal of this observational study is to learn whether a short screening test can identify healthy young adults who develop low back pain during prolonged standing ("pain developers"). The study includes university students aged 20 to 35 years with no history of clinical low back pain.

The main questions it aims to answer are:

  • How accurately does a combined screening protocol (three simple clinical hip and movement tests plus a 15-minute muscle activity recording of the gluteus medius) identify people who develop low back pain during 2 hours of standing?
  • Can this short protocol be used instead of the standard 2-hour standing test?

Participants will attend two sessions on separate days:

  • Session 1: Participants will complete three clinical tests (self-reported difficulty of a side-lying leg-lifting task, hip rotation range of motion, and a single-leg squat), fill out a pain catastrophizing questionnaire, and stand for 15 minutes while performing a simple manual task, with surface electrodes recording hip muscle activity.
  • Session 2: Participants will stand for 2 hours while performing simple manual tasks and will rate their low back pain every 15 minutes.

Participants who report an increase of at least 10 mm on a 100 mm visual analog scale during the 2-hour standing session will be classified as pain developers. The screening results will be compared with this classification to calculate sensitivity, specificity, and overall accuracy.

Studieoversigt

Status

Aktiv, ikke rekrutterende

Betingelser

Intervention / Behandling

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

113

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Tehran Province
      • Tehran, Tehran Province, Iran, infosport@ut.ac.ir
        • Faculty of Sport Sciences and Health, University of Tehran

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

20 år til 35 år (Voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Healthy university students aged 20 to 35 years living in University of Tehran dormitories, recruited through electronic and paper announcements in dormitories, the faculty, and dormitory online groups.

Beskrivelse

Inclusion Criteria:

  • Age 20 to 35 years
  • Body mass index between 20 and 28 kg/m2
  • No lifetime history of clinical low back pain (defined as low back pain that led to consulting a physician or physiotherapist, more than 3 days of absence from work or study, or limitation of daily activities)
  • No previous surgery of the lumbar spine, pelvis, or lower extremities
  • No known neuromuscular, vestibular, or visual disorders
  • Able to stand for 2 hours

Exclusion Criteria:

  • Employment in a job requiring prolonged static standing (more than 1 hour per day) during the past 12 months
  • Any pain in the low back or lower extremities at the start of the standing protocol
  • Inability to complete the questionnaires or perform the movement tests
  • Pregnancy

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiver: PROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
healthy young adults

University students aged 20-35 years without a history of clinical low back pain, assessed with the combined screening protocol and the 2-hour prolonged standing test.

Three clinical tests (self-reported active hip abduction, total hip internal rotation range of motion, single-leg squat) and 15-minute surface EMG of the left gluteus medius during standing.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Diagnostic Accuracy (Sensitivity and Specificity) of the Combined Screening Protocol
Tidsramme: Index tests at Session 1 (Day 1) compared with the reference standard at Session 2 (within 2-28 days)

Sensitivity, specificity, and overall accuracy (with 95% confidence intervals) of the combined screening protocol (three clinical tests plus gluteus medius EMG gaps) for identifying pain developers, compared with the reference standard (an increase of at least 10 mm on a 100 mm visual analog scale from baseline at any 15-minute timepoint during 2 hours of standing).

Index tests at Session 1 (Day 1) compared with the reference standard at Session 2 (within 2-28 days)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Pain Developer Status During a 2-Hour Prolonged Standing Test
Tidsramme: Baseline (minute 0) and every 15 minutes up to 120 minutes during the 2-hour prolonged standing test (Session 2, 2 to 28 days after Session 1)

Low back pain intensity is rated on a 100-mm Visual Analogue Scale (VAS; 0 = no pain, 100 = worst imaginable pain). Participants reporting an increase of ≥10 mm relative to baseline at any measurement point are classified as Pain Developers; all others are classified as Non-Pain Developers. This classification serves as the reference standard.

Baseline (minute 0) and every 15 minutes up to 120 minutes during the 2-hour prolonged standing test (Session 2, 2 to 28 days after Session 1)
Folkins Three-Test Clinical Cluster Scores
Tidsramme: Session 1 (Day 1)

Three clinical tests: (1) self-rated active hip abduction difficulty (0-5 per side, summed 0-10; positive if ≥4); (2) total bilateral passive hip internal rotation measured with a universal goniometer (degrees; positive if >81.6°); (3) non-dominant single-leg squat, trunk score from video analysis (0, 5, 10, 15; positive if >5).

Session 1 (Day 1)
Number of Gluteus Medius EMG Gaps
Tidsramme: During a 15-minute standing EMG recording at Session 1 (Day 1)

Number of gaps in glutes medius surface EMG activity during 15 minutes of standing,A gap is defined as a period in which normalized EMG activity falls below 0.5% of maximum voluntary contraction for more than 0.2 seconds. The total number of gaps is reported, compared between pain developers and non-pain developers

During a 15-minute standing EMG recording at Session 1 (Day 1)

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Pain Catastrophizing Scale (PCS) Total Score
Tidsramme: Session 1 (Day 1)

Correlation between Pain Catastrophizing Scale total score (range 0-52; higher scores indicate greater catastrophizing) and maximum VAS pain in an exploratory subgroup of participants reaching at least 20 mm VAS.

Session 1 (Day 1)

Samarbejdspartnere og efterforskere

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Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

23. juli 2026

Primær færdiggørelse (Anslået)

13. november 2026

Studieafslutning (Anslået)

13. november 2026

Datoer for studieregistrering

Først indsendt

1. november 2026

Først indsendt, der opfyldte QC-kriterier

11. november 2026

Først opslået (Faktiske)

12. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

11. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • UT-LBPD-SCREEN-2026
  • IR.UT.SPORT.REC.1405.047 (Anden identifikator: Ethics Committee of Sport Sciences, University of Tehran)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

individual participant data will not be shared publicly to protect participant confidentiality, as data sharing was not included in the informed consent. Aggregate results will be reported in publications.

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