Chronic Low Back Pain Clinical Trial
Official title:
Influence of Cryotherapy Combined to TENS Burst in Pain, Functional Capacity and Quality of Life Patients With Non-specific Chronic Lombar Pain: A Blind Controlled Randomized Clinical Trial
The purpose of this study is to analyze the effects of TENS Burst combined Cryotherapy on
painful sensation, functional capacity and quality of life of patients with non-specific
chronic pain.
Study hypothesis:
The TENS Burst combined with Cryotherapy offers a better response in the pain sensation,
functional capacity and quality of life of patients with non-specific chronic low back pain
when compared to the application of these resources in isolation.
This is a blind, randomized, controlled clinical trial. The first investigator (PI) will be
responsible for evaluations and reassessments; The second investigator (PII) for the process
of randomization and instruction of the subjects in the intervention protocol and the third
investigator (PIII) for the statistical analyzes. The study collections will take place from
April 2017 until November 2017, after approval by the Ethics and Research and Qualification
Committee and will be developed at the Rehabilitation Outpatient Clinic of the University
Hospital Onofre Lopes - HUOL.
The investigators will select 48 individuals recruited non-probabilistically for convenience
in HUOL. The sample calculation performed in G POWER software version 3.0.0.1 with 80%
"power" defined the number of 40 individuals, adding to that number the 20% of possible
losses during the survey. Allocation of the groups will be random, through the website
http://www.randomization.com, which will include information such as sample size and number
of groups. From this, the site will generate a specific coding for each group, randomly and
in the form of blocks, with the following characteristics: sex, women in active cycle and
use of oral contraceptives and use of analgesics. In this study, four groups will be
considered: control-placebo group (gCP), cryotherapy group (gCrio), TENS Burst group
(gTENSb) and Cryotherapy + TENS Burst group (gCrioTENSb). The four groups will receive
educational sessions on chronic low back pain. The gCP will also undergo TENS bound in
placebo mode, gCrio will undergo cryotherapy, gTENSb will undergo TENS in Burst mode and
gCrioTENSb will undergo TENS Cryotherapy + Burst (combined). This protocol is in compliance
with the recommendations of the Consolidated Standards of Reporting Trials - CONSORT
(http://www.consort-statement.org/) for the execution of randomized clinical trials.
At the outset, all subjects will receive general instructions on the procedures to be
performed, as well as information about the possible risks and benefits of all stages of the
research. Individuals will then be enrolled in the survey through a specially prepared
assessment form containing information on identification, sex, age, body mass index, level
of education, work activity, employment status, stress, and beliefs about pain, marital
status, time of onset of symptoms, presence of dermal conditions, sensitivity, ice allergy
and treatment perspective. These subjects will be subject to the evaluation measures under
the IP instruction, the IP will not know to which group the subjects belong. The evaluations
will be performed before the 1st intervention session and will consist of the evaluation of
the pain through the EVA when performing the movement and the pressure pain; Functional
ability by the Roland-Morris Questionnaire, Functional Oswestry Index and Finger-to-Ground
Distance; Quality of life, questionnaire SF 36 and pleasure / dissatisfaction of the
intervention by Felling Scale. To maintain the blindness of the study, each individual at
the time of intervention will spend 30 minutes in the intervention room and each group will
have a corresponding color for the convenience of P2 (being white, blue, green and yellow).
The remaining AV2 and AV3 evaluations will be performed two days after the 10th treatment
session and 4 weeks after the last treatment session, respectively, for gCP, gCrio, gTENSb
and gCrioTENSb. The women will be evaluated and reassessed in the same phase, the follicular
phase of the menstrual cycle to present higher thresholds of sensory perception, and will be
used to identify the phases of the cycle of each volunteer following the proposed calendar
method and the confirmation of regularity by, at least Less, six posterior menstrual cycles.
The evaluations and interventions will be carried out in the evening shift and in the same
room with a standard temperature of 24º C. A pilot study will be carried out in order to
reproduce what will be done during the evaluation and intervention processes, in order to
identify and correcting possible flaws with regard to the proposed procedures.
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