Chronic Low-back Pain Clinical Trial
Official title:
Confinement Effect on Low Back Pain Intensity in Chronic Low Back Pain Patients
The current situation, linked to the pandemic of the new coronavirus SARS-CoV-2 generates
health concerns, but is also accompanied by many other psychological, social, economic,
professional, etc. consequences as well as numerous changes in behavior and lifestyles,
notably due to confinement.
While the prevention of chronic low back pain and its management are primarily based on the
practice of regular physical and sports activity, other psychological factors (stress,
anxiety, depression), socioeconomic (low level of education, resources), professionals
(physical workload, job dissatisfaction), etc. also have a major role in the onset and the
persitence of low back pain.
Thus, it is to be supposed that the current context, and more particularly the confinement to
which the population has been constrained for almost 2 months, have and will have notable
consequences on the evolution of lumbar symptoms in chronic low back pain patients. However,
the entanglement of different factors related to containment will potentially have different
consequences depending on the individual. It therefore seems difficult to predict how the
lumbar symptoms will develop in this population. Indeed, if it can imagined that the decrease
in regular physical activity and the increase in anxiety in this context of insecurity could
lead to an increase in pain, it could just as well consider that the decrease in stress work,
strenuous physical work or travel time from work to home can, on the contrary, have a
favorable effect.
The objective of this study is to assess the confinement effect on low back pain intensity in
chronic low back pain patients.
This is an observational, descriptive, transversal and pluricentric study conducted by a
single questionnaire.
Patients who consulted one of the study investigators (rheumatologist and algologist) for the
management of a common chronic low back pain between January 1, 2020 and March 17, 2020
(begining of the French confinement) and who meet inclusion criteria will be offered to
participate to the study.
Eligible subjets will be preselected by the study investigators (from the medical file). The
initial solicitation of a potential subject will be made by a phone contact by the
investigator who treat him/her for his chronic low back pain. Subjects who agree to
participate in the study will be offered to respond to a questionnaire by phone.
The questionnaire (no more than 10 minutes) will assess the sociodemographic status, the
confinement conditions, the new coranavirus infection status, changes in low back pain
intensity during the confinement, incapacity related to low back pain, physical activities
practice before and during the confinement, anxiety and depression, continuation of
occupational activity and teleworking practice during the confienment .
The main objective of this study is to assess the impact of confinement on change in low back
pain intensity. The main endpoint is the proportion of subjects with a significant change in
their low back pain during confinement, defined by the items "much worse" and "moderately
worse", or "much improved" and "moderately improved" respectively.
The secondary objectives are to assess:
1. the association between the conditions of confinement and low back pain intensity;
2. the association between the confinement conditions and disability related to low back
pain;
3. the association between infection with the new SARS-CoV-2 coronavirus and change in low
back pain intensity;
4. the association between the confinement conditions and the quality of life as well as
the state of psychological health;
5. the impact of confinement on the use of care and the consumption of medication and
psychoactive substances for low back pain;
6. the association between working conditions and / or teleworking and the low back pain
intensity;
7. the association between socio-economic factors and modalities as well as the experience
of confinement.
Given the exploratory nature of this study, the required number of subjects is empirically
estimated at 350 subjects in total.
Qualitative and quantitative data will be described (averages or percentages). A chi² test
will be performed to compare the percentages between the different subgroups studied. A
Student test will be carried out to compare the means between the different subgroups
studied. An alpha risk of less than 5% will be considered significant.
For each of the parameters of interest studied, the bivariate analysis may be supplemented by
a multivariate analysis adapted to the criterion to be explained if the conditions of
validity of this multivariate analysis are met.
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