Low Back Pain Clinical Trial
Official title:
Home Program Education for Patients With Low Back Pain: Does it Matter? A Prospective Study
The primary purpose of this study is to assess the effect size of the change in Oswestry
Disability Questionnaire (ODQ) score over the 8 week follow-up period between the video based
instruction or standard of care hand-out with pictures and written instructions for subjects
meeting the clinical prediction rule for lumbar stabilization.
The second purpose will be to determine if there is a subset of physical examination and
self-reported variables that are associated with having a successful result (ODQ improvement
by at least 6 points) and if the subset of variables are affected by whether or not the
subject was in the intervention (video) or control (handout) group.
Approximately fifty percent of patients seeking help in outpatient orthopedic clinics and
roughly thirty percent of people will experience some low back pain (LBP) at some time in
their life.(1) LBP is the second leading cause of missed days of work per year and results in
around ninety billion dollars per year in medical costs. (1) Physical therapy interventions
for LBP could include manual therapy, exercise, traction, range of motion, modalities,
postural education, or a combination of these interventions.(2-5) Medical treatment for LBP
could include medications, imaging, laboratory studies, injections, surgery, or counseling
through pain psychology.(6-7) Many research studies are inconclusive regarding effective
treatment.
In 1995 a treatment based classification system for patients with acute low back pain was
published.(8) Patients were categorized into one of four categories: manipulation,
directional exercises (flexion, extension, lateral shift correction), immobilization, or
traction. (8)This classification system led to further validation of the categories and
clinical prediction rules (CPR) related to best treatment outcomes.(9-11) In 2005, Hicks
built upon the initial classification system for immobilization when he published a
preliminary CPR identifying which patients were most likely to benefit from lumbar
stabilization.(10) Hicks identified the following predictors for patient response to
stabilization exercises: individuals younger than age forty, straight leg raise greater than
ninety-one degrees, and aberrant motions or a positive prone instability test.(10) Hicks
reported a presence of three or more of these variables had a positive likelihood ratio of
4.0 for a 95% confidence interval.(10) However, no studies to date have confirmed such
results nor validated this clinical prediction rule.
Home program prescription background Evidence for using video for home program prescription
is limited. However, video based home programs have been successfully used for patients with
Huntington's disease, traumatic brain injury (TBI), spinal cord injury, brachial plexus
injuries, and general shoulder strengthening.(12-15) Medical studies demonstrate that
patients comprehend information better when communicated via educational videos as opposed to
educational pamphlets about various disorders.(16-18)
Problem Statement:
Currently, there is no literature evaluating the use of video home programs for patients with
LBP or identifying who may benefit from this form of clinical education. Home program
handouts frequently depict photographs or figures with incorrect form or instructions. Video
based home programs demonstrating the stabilization techniques for patients may provide
correct form and accurate instructions. With such programs, patient comprehension and
technical reproduction of the exercises may improve. Video-based home programs could lead to
fewer clinic visits and decreased cost per episode of care.
Given the numerous factors that contribute to limited clinic visits in LBP patients, more
effective communication should be beneficial during treatment. We do not know if patient
learning styles may influence compliance with varying modes of home exercise program
prescriptions. Video based home exercise programs may also be a better fit for patients who
are more auditory or visual learners as defined by the Visual, Auditory, Reading, Kinesthetic
(VARK) learning inventory. (19) Auditory learners prefer information being transferred by
listening. Visual learners prefer maps, charts, and perhaps videos over written charts or
instructions.
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT03916705 -
Thoraco-Lumbar Fascia Mobility
|
N/A | |
Completed |
NCT04007302 -
Modification of the Activity of the Prefrontal Cortex by Virtual Distraction in the Lumbago
|
N/A | |
Completed |
NCT03273114 -
Cognitive Functional Therapy (CFT) Compared With Core Training Exercise and Manual Therapy (CORE-MT) in Patients With Chronic Low Back Pain
|
N/A | |
Recruiting |
NCT03600207 -
The Effect of Diaphragm Muscle Training on Chronic Low Back Pain
|
N/A | |
Completed |
NCT04284982 -
Periodized Resistance Training for Persistent Non-specific Low Back Pain
|
N/A | |
Recruiting |
NCT05600543 -
Evaluation of the Effect of Lumbar Belt on Spinal Mobility in Subjects With and Without Low Back Pain
|
N/A | |
Withdrawn |
NCT05410366 -
Safe Harbors in Emergency Medicine, Specific Aim 3
|
||
Completed |
NCT03673436 -
Effect of Lumbar Spinal Fusion Predicted by Physiotherapists
|
||
Completed |
NCT02546466 -
Effects of Functional Taping on Static Postural Control in Patients With Non-specific Chronic Low Back Pain
|
N/A | |
Completed |
NCT00983385 -
Evaluation of Effectiveness and Tolerability of Tapentadol Hydrochloride in Subjects With Severe Chronic Low Back Pain Taking Either WHO Step I or Step II Analgesics or no Regular Analgesics
|
Phase 3 | |
Recruiting |
NCT05156242 -
Corticospinal and Motor Behavior Responses After Physical Therapy Intervention in Patients With Chronic Low Back Pain.
|
N/A | |
Recruiting |
NCT04673773 -
MY RELIEF- Evidence Based Information to Support People Aged 55+ Years Living and Working With Persistent Low-back Pain.
|
N/A | |
Completed |
NCT06049251 -
ELDOA Technique Versus Lumbar SNAGS With Motor Control Exercises
|
N/A | |
Completed |
NCT06049277 -
Mulligan Technique Versus McKenzie Extension Exercise Chronic Unilateral Radicular Low Back Pain
|
N/A | |
Completed |
NCT04980469 -
A Study to Explore the Effect of Vitex Negundo and Zingiber Officinale on Non-specific Chronic Low Back Pain Due to Sedentary Lifestyle
|
N/A | |
Completed |
NCT04055545 -
High Intensity Interval Training VS Moderate Intensity Continuous Training in Chronic Low Back Pain Subjects
|
N/A | |
Recruiting |
NCT05552248 -
Assessment of the Safety and Performance of a Lumbar Belt
|
||
Recruiting |
NCT05944354 -
Wearable Spine Health System for Military Readiness
|
||
Completed |
NCT05801588 -
Participating in T'ai Chi to Reduce Back Pain and Improve Quality of Life
|
N/A | |
Completed |
NCT05811143 -
Examining the Effects of Dorsal Column Stimulation on Pain From Lumbar Spinal Stenosis Related to Epidural Lipomatosis.
|