Effects and Mechanisms of Specific Trunk Exercises in Low Back Pain
2017年10月16日 更新者：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.
研究概览
地位
完全的
条件
研究类型
介入性
注册 (实际的)
58
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
-
Vermont
-
Burlington、Vermont、美国、05405
- Human Motion Analysis Laboratory
-
-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
21年 至 55年 (成人)
接受健康志愿者
是的
有资格学习的性别
全部
描述
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
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：Stabilization
|
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.
其他名称：
|
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有源比较器：Strengthening and Conditioning
|
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.
其他名称：
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Change From Baseline to 11 Weeks in Oswestry Disability Scale (0-100%)
大体时间：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%)
大体时间：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%)
大体时间：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)
大体时间：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)
大体时间：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)
大体时间：11 weeks and 6 months
|
Current Pain Scale 0-10 Lower score is better/improved; Negative value indicates improvement
|
11 weeks and 6 months
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Sharon M Henry, PT, PhD、University of Vermont
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Jacobs JV, Henry SM, Jones SL, Hitt JR, Bunn JY. A history of low back pain associates with altered electromyographic activation patterns in response to perturbations of standing balance. J Neurophysiol. 2011 Nov;106(5):2506-14. doi: 10.1152/jn.00296.2011. Epub 2011 Jul 27.
- Jones SL, Henry SM, Raasch CC, Hitt JR, Bunn JY. Individuals with non-specific low back pain use a trunk stiffening strategy to maintain upright posture. J Electromyogr Kinesiol. 2012 Feb;22(1):13-20. doi: 10.1016/j.jelekin.2011.10.006. Epub 2011 Nov 18.
- Stokes IA, Gardner-Morse MG, Henry SM. Abdominal muscle activation increases lumbar spinal stability: analysis of contributions of different muscle groups. Clin Biomech (Bristol, Avon). 2011 Oct;26(8):797-803. doi: 10.1016/j.clinbiomech.2011.04.006. Epub 2011 May 14.
- Stokes IA, Gardner-Morse MG, Henry SM. Intra-abdominal pressure and abdominal wall muscular function: Spinal unloading mechanism. Clin Biomech (Bristol, Avon). 2010 Nov;25(9):859-66. doi: 10.1016/j.clinbiomech.2010.06.018. Epub 2010 Jul 23.
- Jones SL, Henry SM, Raasch CC, Hitt JR, Bunn JY. Responses to multi-directional surface translations involve redistribution of proximal versus distal strategies to maintain upright posture. Exp Brain Res. 2008 May;187(3):407-17. doi: 10.1007/s00221-008-1312-1. Epub 2008 Feb 26.
- Teyhen DS, Gill NW, Whittaker JL, Henry SM, Hides JA, Hodges P. Rehabilitative ultrasound imaging of the abdominal muscles. J Orthop Sports Phys Ther. 2007 Aug;37(8):450-66. doi: 10.2519/jospt.2007.2558.
- Henry SM, Teyhen DS. Ultrasound imaging as a feedback tool in the rehabilitation of trunk muscle dysfunction for people with low back pain. J Orthop Sports Phys Ther. 2007 Oct;37(10):627-34. doi: 10.2519/jospt.2007.2555.
- Anderson-Worth SG, Henry SM, Bunn JY. Use of real time ultrasound feedback enhances learning the abdominal hollowing exercise in patients with low back pain. New Zealand J Physiotherapy. 35(1):4-11, 2007.
- Henry SM, Hitt JR, Jones SL, Bunn JY. Decreased limits of stability in response to postural perturbations in subjects with low back pain. Clin Biomech (Bristol, Avon). 2006 Nov;21(9):881-92. doi: 10.1016/j.clinbiomech.2006.04.016. Epub 2006 Jun 27.
- Henry SM, Westervelt KC. The use of real-time ultrasound feedback in teaching abdominal hollowing exercises to healthy subjects. J Orthop Sports Phys Ther. 2005 Jun;35(6):338-45. doi: 10.2519/jospt.2005.35.6.338.
- Lomond KV, Henry SM, Hitt JR, DeSarno MJ, Bunn JY. Altered postural responses persist following physical therapy of general versus specific trunk exercises in people with low back pain. Man Ther. 2014 Oct;19(5):425-32. doi: 10.1016/j.math.2014.04.007. Epub 2014 Apr 24.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2003年3月1日
初级完成 (实际的)
2008年6月1日
研究完成 (实际的)
2008年6月1日
研究注册日期
首次提交
2012年6月1日
首先提交符合 QC 标准的
2012年6月4日
首次发布 (估计)
2012年6月5日
研究记录更新
最后更新发布 (实际的)
2017年10月18日
上次提交的符合 QC 标准的更新
2017年10月16日
最后验证
2017年10月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.