Isokinetic Profile of Ankle Joint Muscles in Chronic Non Specific Low Back Pain Patients
15 de julho de 2026 atualizado por: Mohamed Hazem Abdelhakam Elshafey, Cairo University
The Relationship Between Chronic Non-Specific Low Back Pain and Isokinetic Performance of Ankle Joint Muscles
Chronic non-specific low back pain and its resulting infirmity have become a huge health and socioeconomic burden.
Low back pain is reportedly associated with decreased activities of daily living and quality of life.
Previous literature supports the presence of a link between CLBP and lower limb kinematics that can contribute to functional limitations and disability.
For example, CLBP commonly coexist with postural and structural asymmetry.
Ankle muscle performance of individuals with LBP during gait becomes more clinically important as it may provide insights into the mechanisms of ankle strategies.
The isokinetic testing is an assessment method of high effectivity and trustworthiness that can be used to compare bilateral and agonist/ antagonist ankle muscles strength of normal subjects and athletes.
It can be used to analyze muscular performance and differences in muscle performance between dominant and non-dominant limbs.
Visão geral do estudo
Status
Recrutamento
Condições
Intervenção / Tratamento
Descrição detalhada
This study will involve 50 male patients diagnosed with CNSLBP and will correlate between level of pain, disability, psychological status, and overall body fatiguability, core muscles endurance with the strength, endurance, joint angle position, and time parameters of isokinetic testing profile of ankle joint.
Tipo de estudo
Observacional
Inscrição (Estimado)
50
Contactos e Locais
Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.
Contato de estudo
- Nome: Mohamed Hazem Abdelhakam Elshafey, Demonstrator (TA)
- Número de telefone: +201114946552
- E-mail: mohamedhazem3333333333@gmail.com
Estude backup de contato
- Nome: Mahmoud Mohamed Nabhan, Lecturer
- Número de telefone: +201142890404
- E-mail: Mahmoudnabhan37@gmail.com
Locais de estudo
-
-
Gharbia Governorate
-
Tanta, Gharbia Governorate, Egito, 31511
- Recrutamento
- Al-Salam University
-
Contato:
- Ayman Mohammed Elmakakey, Associate Professor
- Número de telefone: +20403386400
- E-mail: info@sue.edu.eg
-
Contato:
- Aya Elkomy, Lecturer
- Número de telefone: +20 106 603 4330
- E-mail: info@sue.edu.eg
-
-
Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
Aceita Voluntários Saudáveis
Não
Método de amostragem
Amostra Não Probabilística
População do estudo
50 male patients aged 20-40 years, diagnosed with CNSLBP through direct referral from their orthopedic surgeon after excluding the previous criteria.
Medical assessment for recruiting, diagnosis, and including or excluding will be done at Kafrelsheikh University Hospitals.
Descrição
Inclusion Criteria:
- 50 male patients diagnosed with Chronic non-specific low back pain through direct referral from their orthopedic surgeon.
- Each patient will be diagnosed by "Waddle sign"
- Age limit 20-40 years.
- BMI: less than 30.
- Pain duration: chronic more than 3 months or 12 weeks.
- Pain location: Between T12- and lower gluteal folds.
- Pain Intensity: At least have 3 out of 10 on VAS.
- Level of functional disability: 21%-40% on MODI.
- Each patient sign an informed consent.
Exclusion Criteria:
- Unexplained weight loss.
- History of malignancy.
- Recent trauma within last 12 months.
- Osteoporosis.
- Cauda Equina Symptoms.
- Herniated discs.
- Radicular signs.
- Spine fractures.
- Spinal Canal Stenosis.
- Myofascial Pain Syndrome.
- Spondylolisthesis.
- Rheumatological history.
- CVS manifestations.
- GIT manifestations.
- Psychiatric disorders.
- Weakness or parathesis in L.L.
- History of back surgery.
- Chronic Ankle Instability.
- Scoliosis or leg length discrepancies.
- Neurological and systemic manifestations such Epilepsy, muscular diseases, or seziures.
- Mechanical back pain
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
Intervenção / Tratamento |
|---|---|
|
Study Group
50 patient diagnosed with Chronic non-specific low back pain will be evaluated and assessed by humac isokinetic for ankle profile, Mcgill core endurance tests, level of pain, disability, fatiguability through questionnaires and measuring Lumbosacral angle for each patient, and correlate all variables with each others.
|
Humac isokinetic device will be used for testing and assessing ankle joint profile including torque, endurance, joint position, and time parameters for both limbs for 50 patients diagnosed with chronic non specific low back pain
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Torque parameters for ankle Isokinetic testing of plantar flexors and dorsi flexors for dominant and non-dominant limbs.
Prazo: Baseline (Single assessment session per patient)
|
Ankle torque parameters will be tested at velocity of 30°/s, these parameters will include (peak torque - peak torque / BW - Cof of Variance)
|
Baseline (Single assessment session per patient)
|
|
Endurance and power parameters for ankle Isokinetic testing of plantar flexors and dorsi flexors for dominant and non-dominant limbs.
Prazo: Baseline (single assessment session per patient)
|
Ankle torque parameters will be tested at velocity of 180°/s, these parameters will include (fatigue index - Total work - Average Power/reps)
|
Baseline (single assessment session per patient)
|
|
Position parameters for ankle Isokinetic testing of plantar flexors and dorsi flexors for dominant and non-dominant limbs.
Prazo: Baseline (Single assessment session per patient)
|
Position torque parameters will be tested at two velocities of 30°/s, and 180°/s these parameters will include (Joint angle at peak torque - Range of motion)
|
Baseline (Single assessment session per patient)
|
|
Time parameters for ankle Isokinetic testing of plantar flexors and dorsi flexors for dominant and non-dominant limbs.
Prazo: Baseline (Single assessment session per patient)
|
Time torque parameters will be tested at two velocities of 30°/s, and 180°/s these parameters will include (Time to peak torque - Force decay time - Delay time)
|
Baseline (Single assessment session per patient)
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Lumbo-sacral angle
Prazo: Baseline
|
Will be measured by Fergusson's method on Lateral X-ray films of lumbo-sacral region for each patient
|
Baseline
|
|
Level of pain intensity
Prazo: Baseline
|
Will be measured through Visual Analogue Scale (VAS) VAS is a proven, evaluative tool for measuring both acute and chronic pain as scores is recorded by placing a handwriting mark along a 10-cm line that represents a pain spectrum between "no pain" and "worst pain" as the word descriptions "no pain" on the left and "worst imaginable pain" on the right serve as anchors for the 100-mm long horizontal line.
|
Baseline
|
|
Level of functional disability
Prazo: Baseline
|
Will be assessed through Arabic version of Modified Oswestry Disability Index (MODI). The Oswestry Low Back Pain Disability Index is a 10-item self-assessment questionnaire with 6 levels of answers ranging from 0 to 5. Pain, personal care, lifting and moving objects, walking, sitting, standing, sleep disorders caused by LBP, sex life, social life, and traveling are among these items. A total score is computed, and the percentage of disability (score obtained divided by 50 and multiplied by 100) ranges from 0% (no disability) to 100% (complete disability) (complete disability). The following scores are used to interpret this scale: 0 to 20%: minimal disability; 20 to 40%: moderate disability; 40 to 60%: severe disability; 60 to 80%: crippling low back pain; and above 80%: the person is confined to bed. To obtain the score, the sum of the scores is divided by the total possible score (i.e., 50). To obtain the percentage of a patient's disability, the resulting total is multiplied by 100 |
Baseline
|
|
Kinesiophobia and fearing of physical activity and work
Prazo: Baseline
|
Will be assessed through Fear Avoidance Beliefs Questionnaire (FABQ) The questionnaire consists of 16 items in which a patient rates their agreement with each statement on a 7-point Likert scale.
Where 0= completely disagree, 6=completely agree.
There is a maximum score of 96.
A higher score indicates more strongly held fear avoidance beliefs.
There are two subscales within the FABQ; the work subscale (FABQw) with 7 questions (maximum score of 42) and the physical activity subscale (FABQpa) with 4 questions (maximum score of 24).
The numbers in parentheses below designate which items from the FABQ are included in each subscale.
The questionnaire takes approximately 10 minutes to complete.
The higher the score, the higher the subject's fear-avoidance beliefs
|
Baseline
|
|
Overall body fatiguability status and physical function
Prazo: Baseline
|
Will be assessed through Fatigue Severity Scale (FSS) Arabic version of the FSS is a 9-item scale which measures the severity of fatigue and its effect on a person's activities.
Answers are scored on a seven- point scale where 1 = strongly disagree and 7 = strongly agree.
This means the minimum score possible is nine and the highest is 63.
The higher the score, the more severe the fatigue is and the more it affects the person's activities.
|
Baseline
|
|
Assessment of core muscles endurance
Prazo: Baseline
|
Will be assessed through McGill endurance test For the McGill test, the participant back leaned against a jig in a sit-up position that will be 60 degrees (degrees) off the ground, their knees bent 90 degrees, their hips folded over their chests, their hands on the shoulder across from them, and their feet fastened.
The patient will be instructed to maintain isometric posture for the longest period of time feasible before the researcher pushed the jig back 10 centimeters.
Thus, when the patients' backs touched the jig, it was considered a failure.
The researcher also will note how long the subjects maintained an isometric stance, which is typically between one and two minutes.
|
Baseline
|
|
Core endurance The Sorenson test
Prazo: Baseline
|
The Sorenson test will be carried out with the individuals' upper bodies off the end of the test bench and their pelvises, knees, and hips restrained.
Hands were placed on opposite shoulders while the subjects' upper bodies were held across their chests.
Failure is defined as the moment that a subject's upper body deviated from the horizontal position, and the researcher will note the amount of time that a subject typically maintained a straight posture for between one and two minutes.
|
Baseline
|
|
Core endurance Side Plank test
Prazo: Baseline
|
Side plank test will be conducted with subjects lied on side, then researcher will ask to lift body on elbow, forearm, and feet will be stacked to create a straight line from head to toes.
Thus, failure will be determined when subjects' body would be dropped; and researcher will record time that subjects has hold body straight with normal range of one and two minutes.
|
Baseline
|
Colaboradores e Investigadores
É aqui que você encontrará pessoas e organizações envolvidas com este estudo.
Patrocinador
Investigadores
- Diretor de estudo: Maha Mostafa Alibeiny, Associate Professor, Cairo University
- Diretor de estudo: Hany Mohamed Hamed, Associate Professor, Faculty of Medicine, Kafrelsheikh University
Publicações e links úteis
A pessoa responsável por inserir informações sobre o estudo fornece voluntariamente essas publicações. Estes podem ser sobre qualquer coisa relacionada ao estudo.
Publicações Gerais
- Balague F, Mannion AF, Pellise F, Cedraschi C. Non-specific low back pain. Lancet. 2012 Feb 4;379(9814):482-91. doi: 10.1016/S0140-6736(11)60610-7. Epub 2011 Oct 6.
- Al-Sobayel HI, Al-Hugail HA, AlSaif RM, Albawardi NM, Alnahdi AH, Daif AM, Al-Arfaj HF. Validation of an Arabic version of Fatigue Severity Scale. Saudi Med J. 2016 Jan;37(1):73-8. doi: 10.15537/smj.2016.1.13055.
- Rahimi A, Arab AM, Nourbakhsh MR, Hosseini SM, Forghany S. Lower limb kinematics in individuals with chronic low back pain during walking. J Electromyogr Kinesiol. 2020 Apr;51:102404. doi: 10.1016/j.jelekin.2020.102404. Epub 2020 Feb 17.
- Koch C, Hansel F. Non-specific Low Back Pain and Postural Control During Quiet Standing-A Systematic Review. Front Psychol. 2019 Mar 22;10:586. doi: 10.3389/fpsyg.2019.00586. eCollection 2019.
- Chiarotto A, Maxwell LJ, Terwee CB, Wells GA, Tugwell P, Ostelo RW. Roland-Morris Disability Questionnaire and Oswestry Disability Index: Which Has Better Measurement Properties for Measuring Physical Functioning in Nonspecific Low Back Pain? Systematic Review and Meta-Analysis. Phys Ther. 2016 Oct;96(10):1620-1637. doi: 10.2522/ptj.20150420. Epub 2016 Apr 14.
- Goubert D, De Pauw R, Meeus M, Willems T, Cagnie B, Schouppe S, Van Oosterwijck J, Dhondt E, Danneels L. Lumbar muscle structure and function in chronic versus recurrent low back pain: a cross-sectional study. Spine J. 2017 Sep;17(9):1285-1296. doi: 10.1016/j.spinee.2017.04.025. Epub 2017 Apr 26.
- Claeys K, Dankaerts W, Janssens L, Pijnenburg M, Goossens N, Brumagne S. Young individuals with a more ankle-steered proprioceptive control strategy may develop mild non-specific low back pain. J Electromyogr Kinesiol. 2015 Apr;25(2):329-38. doi: 10.1016/j.jelekin.2014.10.013. Epub 2014 Oct 31.
- Shafshak TS, Elnemr R. The Visual Analogue Scale Versus Numerical Rating Scale in Measuring Pain Severity and Predicting Disability in Low Back Pain. J Clin Rheumatol. 2021 Oct 1;27(7):282-285. doi: 10.1097/RHU.0000000000001320.
- Amundsen PA, Evans DW, Rajendran D, Bright P, Bjorkli T, Eldridge S, Buchbinder R, Underwood M, Froud R. Inclusion and exclusion criteria used in non-specific low back pain trials: a review of randomised controlled trials published between 2006 and 2012. BMC Musculoskelet Disord. 2018 Apr 12;19(1):113. doi: 10.1186/s12891-018-2034-6.
- Gonosova Z, Linduska P, Bizovska L, Svoboda Z. Reliability of Ankle(-)Foot Complex Isokinetic Strength Assessment Using the Isomed 2000 Dynamometer. Medicina (Kaunas). 2018 Jun 4;54(3):43. doi: 10.3390/medicina54030043.
- Wertli MM, Rasmussen-Barr E, Weiser S, Bachmann LM, Brunner F. The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: a systematic review. Spine J. 2014 May 1;14(5):816-36.e4. doi: 10.1016/j.spinee.2013.09.036. Epub 2013 Oct 18.
- Sung PS, Park MS. Ankle reaction times with tray usage following a slip perturbation between subjects with and without chronic low back pain. Gait Posture. 2022 Sep;97:196-202. doi: 10.1016/j.gaitpost.2022.07.260. Epub 2022 Aug 1.
- Shokouhyan SM, Davoudi M, Hoviattalab M, Abedi M, Bervis S, Parnianpour M, Brumagne S, Khalaf K. Distinction of non-specific low back pain patients with proprioceptive disorders from healthy individuals by linear discriminant analysis. Front Bioeng Biotechnol. 2022 Dec 13;10:1078805. doi: 10.3389/fbioe.2022.1078805. eCollection 2022.
- Ruchi., Jagga V., & Pal S. (2024). Prevalence of Non-Specific Chronic Low Back Pain and Its Effects on Activities of Daily Life in College Students. https://www.researchgate.net/publication/381293938.
- McCaskey MA, Schuster-Amft C, Wirth B, Suica Z, de Bruin ED. Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review. BMC Musculoskelet Disord. 2014 Nov 19;15:382. doi: 10.1186/1471-2474-15-382.
- Liporaci RF, Saad M, Grossi DB, Riberto M. Clinical Features and isokinetic Parameters in Assessing Injury Risk in elite Football Players. Int J Sports Med. 2019 Dec;40(14):903-908. doi: 10.1055/a-1014-2911. Epub 2019 Oct 15.
- Kahlaee AH, Ghamkhar L, Arab AM. Effect of the Abdominal Hollowing and Bracing Maneuvers on Activity Pattern of the Lumbopelvic Muscles During Prone Hip Extension in Subjects With or Without Chronic Low Back Pain: A Preliminary Study. J Manipulative Physiol Ther. 2017 Feb;40(2):106-117. doi: 10.1016/j.jmpt.2016.10.009. Epub 2016 Dec 22.
- Estrazulas JA, Estrazulas JA, de Jesus K, de Jesus K, da Silva RA, Libardoni Dos Santos JO. Evaluation isometric and isokinetic of trunk flexor and extensor muscles with isokinetic dynamometer: A systematic review. Phys Ther Sport. 2020 Sep;45:93-102. doi: 10.1016/j.ptsp.2020.06.008. Epub 2020 Jul 17.
- Dubois JD, Abboud J, St-Pierre C, Piche M, Descarreaux M. Neuromuscular adaptations predict functional disability independently of clinical pain and psychological factors in patients with chronic non-specific low back pain. J Electromyogr Kinesiol. 2014 Aug;24(4):550-7. doi: 10.1016/j.jelekin.2014.04.012. Epub 2014 May 2.
- Brodke DS, Goz V, Lawrence BD, Spiker WR, Neese A, Hung M. Oswestry Disability Index: a psychometric analysis with 1,610 patients. Spine J. 2017 Mar;17(3):321-327. doi: 10.1016/j.spinee.2016.09.020. Epub 2016 Sep 29.
- Brockett CL, Chapman GJ. Biomechanics of the ankle. Orthop Trauma. 2016 Jun;30(3):232-238. doi: 10.1016/j.mporth.2016.04.015.
- Bosquet L, Gouadec K, Berryman N, Duclos C, Gremeaux V, Croisier JL. The Total Work Measured During a High Intensity Isokinetic Fatigue Test Is Associated With Anaerobic Work Capacity. J Sports Sci Med. 2016 Feb 23;15(1):126-30. eCollection 2016 Mar.
- Bonetti, L. V., Grisa, N. C., Palandi, J., Finger, A. L. T., Marchi, T. de, & Tadiello, G. S. (2018). Isokinetic performance of ankle evertor and invertor muscles in adolescent female volleyball athletes. Motriz: Revista de Educação Física, 24(3). https://doi.org/10.1590/s1980- 657420180003e005018.
- Amin, D., Abdelmegeed, M., Sherif, M., & Soliman, E. (2023). Relationship between Core Muscles Endurance and Functional Lower Limb Performance in Patients with Chronic Mechanical Low Back Pain. Egyptian Journal of Physical Therapy, 16(1), 45-51. https://doi.org/10.21608/ejpt.2023.223299.1147.
- Alizamani S, Ghasemi G, Lenjan Nejadian S. Effects of eight week core stability training on stable- and unstable-surface on ankle muscular strength, proprioception, and dorsiflexion in athletes with chronic ankle instability. J Bodyw Mov Ther. 2023 Apr;34:6-12. doi: 10.1016/j.jbmt.2023.04.005. Epub 2023 Apr 9.
- Abdelmegeed, M., Abdelaziz, W., Abdelmajeed, S., & Elhabashy, H. (2023). Relationship between Scapular Upward Rotation and Gluteus Maximus Activity in Subjects with Chronic Nonspecific Low Back Pain. Egyptian Journal of Physical Therapy. 15. 6-11. https://doi.org/10.21608/ejpt.2022.166395.1103.
- Abdelhaleem, M. D., Abdelhay, M. I., Aly, S. M., Abdallah, E. A., & Neamat Allah, N. H. (2023). Effects of 6 weeks of ankle stability exercises on pain, functional abilities, and flexibility in patients with chronic non-specific low back pain: a randomized controlled trial. Bulletin of Faculty of Physical Therapy, 28(1). https://doi.org/10.1186/s43161-023-00126-x.
- Abdelhaleem, M. D., Grase, M. O., Aly, S. M., & Abdallah, E. A. (2022). Association between unilateral functional ankle instability, limited ankle dorsiflexion range of motion and low back pain. SPORT TK-Revista EuroAmericana de Ciencias Del Deporte, 47. https://doi.org/10.6018/sportk.526661.
Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo (Real)
13 de junho de 2026
Conclusão Primária (Estimado)
30 de outubro de 2026
Conclusão do estudo (Estimado)
1 de dezembro de 2026
Datas de inscrição no estudo
Enviado pela primeira vez
4 de junho de 2026
Enviado pela primeira vez que atendeu aos critérios de CQ
4 de junho de 2026
Primeira postagem (Real)
9 de junho de 2026
Atualizações de registro de estudo
Última Atualização Postada (Real)
17 de julho de 2026
Última atualização enviada que atendeu aos critérios de controle de qualidade
15 de julho de 2026
Última verificação
1 de julho de 2026
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Outros números de identificação do estudo
- Ankle Isokinetic in CNSLBP
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
NÃO
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Não
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Não
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .