Low Back Pain Clinical Trial
Official title:
Lumbar Tactile Acuity in Experimentally Induced Acute Low Back Pain
The purpose of this study is to determine whether experimentally induced acute low back pain might lead to alteration in lumbar tactile acuity measured in region affected by pain compared to pain-free side and pain-free controls.
Healthy male participants will be recruited at the Academy of Physical Education in Katowice.
Each participant will be assessed only once. All participants will be asked to provide
written informed consent for participation prior to the experimental procedure and will be
naïve to the experimental hypothesis. The plan for this research project has been previously
approved by the local bioethical committee.
Between-subject (real-injection, sham-injection and control group) and within-subject
(assessment 1 versus assessment 2 and 3) design will be used for the purpose of this
experiment. After the screening procedure and preparation phase, participants will be
randomly assigned to one of three groups: control, saline injection or sham-injection. Groups
will differ only in terms of the specific manipulation: the experimental group will receive
intra-muscular saline injection, the sham-injection group will be stimulated by pinprick
sensation produced by a PinPrick device. No manipulation will take place in the control group
allowing to control for the learning effect. In fact, participants will be informed that the
study includes only two branches so they can be assigned either to the group with pain evoked
as a result of an injection or to the control group without any noxious stimuli. Not
revealing the sham-injection condition will allow for comparison between nociceptive
(injection) and non-nociceptive (sham-injection) condition.
Because no previous studies have investigated tactile acuity changes in acute low back pain,
the sample size calculation was based on the data from our own systematic review and
meta-analysis (Adamczyk et al., under review) and previous cross-sectional data among healthy
controls (Adamczyk et al., 2016). Based on reported mean difference of 9.49mm between chronic
low back pain patients and healthy controls and standard deviation of 9.90mm, a total sample
size of 57 participants (19 per group) is required to detect a significant effect. Power
calculation was performed for specific planned-comparison tests that were described in
detailed under 'statistical analysis' section below. Calculation was performed in G*Power
(G*Power 3.1.9.2 statistical software) with the alpha level set at =0.05 and 80% power.
Baseline differences in descriptive statistics will be analysed by one-way analysis of
variance (ANOVA) with 'group' as the between-subject factor. Further statistical comparisons
will be performed using a repeated-measures ANOVA design, with 'group' (real-injection,
sham-injection, and control group) as between-subject factor and repeated measures
(assessment 1, 2 and 3) as a within-subject factor. In order to test hypothesis on tactile
acuity alteration during pain induction, F-tests will be followed by planned comparisons on
data from assessment 1 versus assessment 2 in experimental group. To determine whether the
magnitude of tactile acuity alteration has differed between the groups, planned comparisons
will be performed on the difference in tactile acuity (assessment 1 vs. assessment 2) between
real-injection and sham-injection group and between real-injection and control group.
Bonferroni correction will be used for multiple planned comparisons. Forward, stepwise
multiple regression will be performed to determine the degree to which tactile acuity change
is predicted by either pain intensity or the size of its distribution. All the analyses will
be conducted using the STATISTICA data analysis software, version 12 (StatSoft Inc., Tulsa,
OK, USA). The level of significance will be set at p < 0.05.
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