Instability; Back Clinical Trial
Official title:
Corticospinal Excitability of Deep Back and Abdominal Muscles in Individuals With History of Clinical Lumbar Instability
Verified date | February 2020 |
Source | Mahidol University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study aims to understand the roles of corticospinal excitability in controlling the trunk movement, and the clinical utility of clinical observation, as well as the effect of lumbopelvic stabilization during hamstrings muscle stretching.
Status | Completed |
Enrollment | 24 |
Est. completion date | January 6, 2020 |
Est. primary completion date | January 6, 2020 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 20 Years to 40 Years |
Eligibility |
Inclusion Criteria: - The inclusion criteria for individuals without a history of clinical lumbar instability. 1. Between the ages of 20 and 40 2. No history of LBP that interferes with activities of daily living and/or required treatment - The inclusion criteria for individuals with a history of clinical lumbar instability. 1. Between the ages of 20 and 40 2. A recurrent pattern of LBP at least two episodes that interfered with activities of daily living and/or required treatment 3. Presenting aberrant movement pattern during active forward bend test 4. Passive straight leg raising test (SLR) greater than 91 degrees 5. Having hamstrings muscle tightness of both legs (passive knee extension in supine with 90° hip flexion position greater than 20 degrees) Exclusion Criteria: 1. History of seizure for either the subject or any family member 2. Implanted pacemaker 3. Clinical signs of systemic disease 4. Definitive neurologic signs including pain, weakness or numbness in the lower extremity 5. Previous spinal surgery 6. Diagnosed osteoporosis, severe spinal stenosis, and/or inflammatory joint disease 7. Any lower extremity condition that would potentially alter trunk movement 8. Vestibular dysfunction 9. Extreme psychosocial involvement 10. Body mass index (BMI) greater than 30 kg/m2 11. Active treatment of another medical illness that would preclude participation in any aspect of the study 12. Menstruation or pregnancy (for female subject) 13. Diagnosed herniated nucleus pulposus (HNP) 14. Pain medication usage (e.g., NSAID) |
Country | Name | City | State |
---|---|---|---|
Thailand | Faculty of Physical Therapy, Mahidol University | Salaya | Nakhon Pathom |
Lead Sponsor | Collaborator |
---|---|
Mahidol University |
Thailand,
Hicks GE, Fritz JM, Delitto A, McGill SM. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehabil. 2005 Sep;86(9):1753-62. — View Citation
Jandre Reis FJ, Macedo AR. Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending. Asian Spine J. 2015 Aug;9(4):535-40. doi: 10.4184/asj.2015.9.4.535. Epub 2015 Jul 28. — View Citation
Sahrmann S, Azevedo DC, Dillen LV. Diagnosis and treatment of movement system impairment syndromes. Braz J Phys Ther. 2017 Nov - Dec;21(6):391-399. doi: 10.1016/j.bjpt.2017.08.001. Epub 2017 Sep 27. Review. — View Citation
Tsao H, Galea MP, Hodges PW. Reorganization of the motor cortex is associated with postural control deficits in recurrent low back pain. Brain. 2008 Aug;131(Pt 8):2161-71. doi: 10.1093/brain/awn154. Epub 2008 Jul 18. — View Citation
Tsao H, Tucker KJ, Hodges PW. Changes in excitability of corticomotor inputs to the trunk muscles during experimentally-induced acute low back pain. Neuroscience. 2011 May 5;181:127-33. doi: 10.1016/j.neuroscience.2011.02.033. Epub 2011 Feb 17. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Resting and active motor threshold | Resting and active motor threshold (MT) for ipsilateral and contralateral responses for transverse abdominis and lumbar multifidus muscles. | These data will be collected at baseline only. | |
Primary | Motor evoke potentials | Motor evoke potentials (MEP) for transverse abdominis and lumbar multifidus muscles. | These data will be collected at baseline only. | |
Primary | Center of gravity of Topography | Center of gravity coordinate of Topography of transverse abdominis and lumbar multifidus muscles. | These data will be collected at baseline only. | |
Primary | Volume of Topography | Volume of Topography of transverse abdominis and lumbar multifidus muscles. | These data will be collected at baseline only. | |
Primary | Clinical observation of aberrant movement. | Clinical observation of aberrant movement patterns during functional movement will be performed by two physical therapists. | These data will be collected at baseline only. | |
Primary | Motion data. | Clinical motion analysis system will be used to measure lumbar, pelvic, lumbopelvic, and knee motions. This system is composed of triple axis accelerometers (MPU6050, China), data acquisition board (Arduino Uno R3, Italy), and a LabVIEW software version 2012 (National Instrument, USA). The system will be used to measure pre- and post-intervention of angle of lumbar, pelvic, and lumbopelvic motions through a custom LabVIEW program at 100 Hz. | These data will be measure at baseline and immediately after receiving stretching exercise technique. | |
Secondary | Passive straight leg raising to test clinical lumbar instability | Clinical tests will be performed at the baseline because they could be a potential confounding factor. | These data will be collected at baseline only. | |
Secondary | Muscle length based on modified Thomas and Trendelenburg test | Clinical tests will be performed at the baseline because they could be a potential confounding factor. | These data will be collected at baseline only. | |
Secondary | Abdominal and back muscle strength . | Clinical tests will be performed at the baseline because they could be a potential confounding factor. | These data will be collected at baseline only. | |
Secondary | 1-year follow-up. | Participants will be call to check whether they have any episode of low back pain and how often they have low back pain. | 1 year after data collection. |
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