Efficacy of a multidimensional versus usual care physiotherapy on pain and electroencephalography (EEG) spectrum in chronic nonspecific low back pain: study protocol for a randomized controlled trial

Sanaz Bemani, Shohreh Noorizadeh Dehkordi, Javad Sarrafzadeh, Saeed Talebian, Reza Salehi, Jamileh Zarei, Sanaz Bemani, Shohreh Noorizadeh Dehkordi, Javad Sarrafzadeh, Saeed Talebian, Reza Salehi, Jamileh Zarei

Abstract

Background: Non-specific chronic low back pain (NSCLBP) is a major public health and global socioeconomic burden associated with a complex interplay of biopsychosocial factors. Despite scientific signs of progress, treatment of NSCLBP often tends to stick to a biomechanical model, without targeting psychological and social factors. To enhance the clinical efficacy of usual physiotherapy for NSCLBP, the development of clinical strategies is to be pursued. This study aims to assess the effectiveness of multidimensional physiotherapy based on a biopsychosocial approach compared to usual care physiotherapy, on clinical findings and electroencephalography spectrum in non-specific chronic low back pain.

Methods: This study is a triple-blind, two-arm (1:1) randomized controlled trial with a 4 months follow-up. Seventy NSCLBP patients will be randomly allocated to either the experimental (multidimensional physiotherapy) or the active control group (usual physiotherapy); each group will receive 6 weeks of physiotherapy. The main outcome is pain and secondary outcomes are brain function, quality of life, disability, lumbar flexion range of motion, and psychosocial correlates. Assessment will be performed at baseline, post-treatment, and at 1 and 4 months follow-up.

Discussion: Findings may provide evidence on the effectiveness of multidimensional physiotherapy on clinical findings and brain characteristics and might provide evidence towards showing the role of brain and biopsychosocial factors on chronic pain.

Trial registration: ClinicalTrials.gov NCT04270422 , Registered on 17 February 2020, IRCT Identifier: IRCT20140810018754N11.

Keywords: Biopsychosocial; Chronic low back pain; Electroencephalography; Fear of movement; disability.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Flow chart of research design (CNSLBP, chronic non-specific low back pain; NRS, Numerical Rating Scale; PCS, Pain Catastrophizing Scale; SF-36, Medical outcomes 36 Health Service Survey; TSK, Tampa Scale for Kinesiophobia; ODI, Oswestry Disability Index; FABQ, Fear Avoidance Beliefs Questionnaire; ROM, range of motion)
Fig. 2
Fig. 2
Schedule of enrolment, interventions, and assessments (according to SPIRIT)

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