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Effects and Mechanisms of Specific Trunk Exercises in Low Back Pain

16 oktober 2017 uppdaterad av: Sharon M. Henry, University of Vermont
Low back pain affects 80% of Americans at some time during their lives. Although recovery usually occurs within 6 months, there is a 50% recurrence within one year's time. It has long been thought that poor control of trunk muscle may lead to abnormal forces across the spine, which then damage local spinal structures, thus, leading to low back pain. However, the investigators know little about the function of specific trunk muscles in healthy subjects during various activities of daily life. Furthermore, the precise muscle dysfunction associated with low back pain has not been well characterized at all. In addition, the investigators know little about which exercise protocol is most beneficial for particular subgroups of people with low back pain. Thus, the purposes of this study are to learn more about: 1) how trunk muscles are affected by low back pain; 2) which exercises might be most beneficial for people with certain kinds of low back pain; and 3) how these exercises influence trunk muscle function. By having a better understanding of which trunk muscles are affected by low back pain, rehabilitation specialists can design exercise programs and therapeutic interventions that are more specific and more effective.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Faktisk)

58

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Förenta staterna
    • Vermont
      • Burlington, Vermont, Förenta staterna, 05405
        • Human Motion Analysis Laboratory

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

21 år till 55 år (Vuxen)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • a history of chronic LBP with or without recurrences for a minimum of 12 months
  • between 21 - 55 years of age
  • able to stand and walk without assistance
  • have an Oswestry Disability Score of 19% or higher

Exclusion Criteria:

  • any major structural spinal deformity including scoliosis, kyphosis, or stenosis
  • spinal fracture or dislocation
  • osteoporosis
  • ankylosing spondylitis
  • rheumatoid arthritis
  • disc herniation with corroborating clinical signs and symptoms
  • serious spinal complications such as tumor or infection
  • previous spinal surgery
  • frank neurological loss, i.e., weakness and sensory loss
  • pain or paresthesia below the knee
  • etiology of LBP other than the lumbar spine, e.g., hip joint
  • history of neurological disease which required hospitalization
  • active treatment for cancer
  • history of unresolved cancer
  • pregnancy or less than 6 months post-partum or less than 6 months post weaning
  • magnified symptom-behavior
  • worker's compensation or disability case
  • in litigation for the LBP problem
  • have a BMI ≥ 30

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Stabilization
Övrig: Stabilization exercise protocol
The stabilization exercise protocol consists of exercises focused on improving the ability of trunk muscles to stabilize the spine, beginning with training to isolate the deeper abdominal muscles as well as deep dorsal trunk muscles. Then patients were progressed to exercises that added leverage of the limbs while maintaining the co-contraction of the deeper abdominal muscles and deep dorsal trunk muscles while breathing normally. Various positions (e.g., supine and quadruped positions) were used to challenge the patients based on their tolerance. Finally, patients were progressed to exercises in more functional positions that included tasks/activities that were reported as challenging and/or painful; patients performed the tasks at the speed demanded by the particular task. Maintenance of the co-contraction of deep trunk muscles was emphasized during these functional activities.
Andra namn:
  • Bålstabiliseringsövningar
  • Segmentella stabiliseringsövningar
Aktiv komparator: Strengthening and Conditioning
Övrig: Strength and conditioning exercise protocol
This protocol contained trunk strengthening and endurance exercises. It consisted of 3 phases: 1) initial strengthening of trunk flexors/extensors in single plane movements, 2) trunk and lower-extremity stretching as well as progression of trunk-strengthening exercises to include multi-planar trunk movements. Aerobic exercises were progressed as tolerated and patient education about body biomechanics were reinforced, and 3) trunk-strengthening exercises under dynamic conditions (e.g., unstable support surface and in multi-planar trunk movements). During the 10 week protocol, exercises became more challenging, and each subject had to complete at least the first phase before moving onto the next phase in order to be included in post-testing analyses. There was no specific focus on the deep abdominal or deep dorsal trunk muscles during any of these exercises.
Andra namn:
  • General trunk exercise
  • General strength training

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change From Baseline to 11 Weeks in Oswestry Disability Scale (0-100%)
Tidsram: Baseline and 11 weeks
Disability; Scale 0-100% Lower score is considered better/improved Negative value indicates improvement
Baseline and 11 weeks
Change From Baseline to 6 Months in Oswestry Disability Scale (0-100%)
Tidsram: Baseline and 6 Months
Disability; Sacle 0-100% Lower score is considered better/improved; Negative value indicates improvement
Baseline and 6 Months
Change From 11 Weeks to 6 Months in Oswestry Disability Scale (0-100%)
Tidsram: 11 Weeks and 6 Months
Disability; Sacle 0-100% Lower score is considered better/improved; Negative value indicates improvement
11 Weeks and 6 Months
Change From Baseline to 11 Weeks in Numeric Pain Rating Scale (0-10 Points)
Tidsram: Baseline and 11 weeks
Current Pain Scale 0-10 Lower score is better/improved; Negative value indicates improvement
Baseline and 11 weeks
Change From Baseline to 6 Months in Numeric Pain Rating Scale (0-10 Points)
Tidsram: Baseline and 6 months
Current Pain Scale 0-10 Lower score is better/improved; Negative value indicates improvement
Baseline and 6 months
Change From 11 Weeks to 6 Months in Numeric Pain Rating Scale (0-10 Points)
Tidsram: 11 weeks and 6 months
Current Pain Scale 0-10 Lower score is better/improved; Negative value indicates improvement
11 weeks and 6 months

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

University of Vermont

Samarbetspartners

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Utredare

  • Huvudutredare: Sharon M Henry, PT, PhD, University of Vermont

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 mars 2003

Primärt slutförande (Faktisk)

1 juni 2008

Avslutad studie (Faktisk)

1 juni 2008

Studieregistreringsdatum

Först inskickad

1 juni 2012

Först inskickad som uppfyllde QC-kriterierna

4 juni 2012

Första postat (Uppskatta)

5 juni 2012

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

18 oktober 2017

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

16 oktober 2017

Senast verifierad

1 oktober 2017

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • NIH/NCMRR/R01-HD040909

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

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