Low Back Pain Clinical Trial
Official title:
Post Market Study of the Electrophysiological Course of Low Back Pain Using CERSR Technology
The purpose of this research study is:
1. to measure with CERSR® (Computerized Electrophysiological Reconstruction of the Spinal
Regions) the electrical signals made by the muscles in the lower back during the
treatment of the low back pain, and
2. to study the changes which take place in these muscles with treatment. The device is
non-invasive which means nothing is put into your body. The CERSR® pad is an adhesive
(sticky) array (ordered rows) of electrodes.
The investigators hope to find information about the quality of the muscles' electrical
signals in reaction to injury causing back pain, which will improve understanding of the
nature of back pain and back injury. The investigators also hope to improve treatment by
creating a simple test, which will tell us objectively (through computerized measurement)
whether the treatment is helping.
Verium Diagnostics, Inc., has developed a non-invasive device to aid the Physician in the
diagnosis of muscle disease and muscle dysfunction. CERSR® (Computerized
Electrophysiological Reconstruction of the Spinal Regions), is a non-invasive diagnostic
procedure to "Monitor and display the bioelectric signals produced by muscles to aid in the
diagnosis and prognosis of muscular disease and dysfunction." The technology captures
electrophysiological data and introduces it into reconstructive algorithms similar to those
used in Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET). The
technology has been developed to overcome the problems associated with surface EMG
technology. SEMG is limited by a resolution problem related to distance separating the
electrodes from the muscle (subcutaneous thickness), number and location of electrodes
applied, as well as limits on the minimum distance separating the electrodes, and on cross
interference between electrode pairs.
The CERSR® scan is a procedure which monitors and displays the bioelectric signals produced
by the paraspinal neuromuscular system. A disposable large surface array of 63 sensors (7
across x 9 down) is placed on the back, using T7 & L4 as landmarks. The array is connected
to a computer that is calibrated to read the neuromuscular activity covered by the electrode
grid. Three scans are captured by the software in each of three different positions: A)
Standing relaxed with arms at sides; B) Body flexed at the hips to a 20° angle and C)
Standing with the arms outstretched in front holding a 3 lb. weight in each hand. The
electrophysiological information is processed with a highly proprietary imaging software
program. The scans collect 1,953 bioelectric signals generated by the 96 muscles and 60
nerves that make up the paraspinal neuromuscular system, and within two seconds results in
an image that reflects the muscle recruitment pattern of the paraspinal region.
The reconstructed physiological data are presented to the physician in a multitude of
readily interpreted images of the lower back with data-inclusive reports. The software
translates the registered activity into a color grid, with slight activity represented by
blue and red signifying intense contractility. Normal back musculature activity is
characterized by a centralized, symmetrical image pattern. Abnormal low back musculature
activity is characterized by non-symmetric and/or multi-focal images signifying abnormal
muscular activity. In addition to the images, which reflect the recruitment of muscle
associated with the bioelectric signals, the software has been developed to calculate a Root
Mean Square voltage (RMS) between each electrode as well as a mean for the entire electrode
array. This Power Value increases as the bioelectric signals increase, and decreases as the
bioelectric signals decrease. The images and associated Power Values can aid the Physician
in the diagnosis and prognosis of muscle disease and dysfunction.
A previous clinical pilot study of the CERSR® technology using 201 subjects with and without
low back pain1 and an analysis of data gather by CERSR® methodology in a trial of 161
healthy volunteers and 44 acute low back pain patients2, have demonstrated that:
1. Persons with acute onset of low back pain have abnormal EMG signals, which can be
reliably mapped using CERSR® technology 1.
2. The scan results generated by CERSR for a normal subject (no low back pain), differs
from the scan results for a not normal subject (low back pain present) 1,2,
3. The abnormal EMG signals will return to normal as medical treatment results in
resolution of pain and dysfunction 1.
4. Root Mean Square (RMS) values from subjects with low back pain are different than RMS
values from normal pain-free subjects 1,2.
The purpose of the proposed study is to assess the efficacy of using the CERSR® imagining
technology to 1) identify individuals with low back pain, 2) to investigate whether the use
of the CERSR® technology can successfully aid the physician to direct a therapeutic regimen
that can provide relief to treated subjects, and 3) to demonstrate that the CERSR®
technology can be used to track and document progress and success of the directed therapy
regime. It is believed that the use of the CERSR® methodology, and the resulting physician
directed therapy being investigated in this study, will result in significant cost savings
through reduced diagnostic procedure and medical treatment related costs, and shorter
treatment lengths. CERSR® data from serial scanning may also be able to be compared to
baseline CERSR® results to assist the Physician in determining Maximum Medical Improvements.
The purpose of this research study is
1. to measure with CERSR® (Computerized Electrophysiological Reconstruction of the Spinal
Regions) the electrical signals made by the muscles in the lower back during the
treatment of the low back pain, and
2. to study the changes which take place in these muscles with treatment. The device is
non-invasive which means nothing is put into your body. The CERSR® pad is an adhesive
(sticky) array (ordered rows) of electrodes.
The investigators hope to find information about the quality of the muscles' electrical
signals in reaction to injury causing back pain, which will improve understanding of the
nature of back pain and back injury. The investigators also hope to improve treatment by
creating a simple test, which will tell us objectively (through computerized measurement)
whether the treatment is helping.
;
Observational Model: Cohort, Time Perspective: Prospective
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