Central Proprioceptive Processing and Postural Control in LBP

NCT ID: NCT03097718

Last Updated: 2019-02-05

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 40 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2016-01-31
• Study Completion Date: 2018-07-31

Brief Summary

This project aims to elucidate neural correlates of proprioceptive deficits in patients with recurrent non-specific low back pain, by studying whether brain activation patterns during the processing of proprioceptive signals from the ankle muscles and lower back muscles are altered compared to healthy control subjects.

Detailed Description

Low back pain is a highly prevalent health condition, with a reported lifetime prevalence of up to 84% worldwide. Currently, it induces more disability than any other health condition, such as depression, diabetes, chronic obstructive pulmonary disease or other musculoskeletal disorders. Approximately 85% of all low back pain complaints are non-specific, meaning that the pain cannot be attributed to a recognizable specific pathology such as an infection or vertebral fracture. While many patients with low back pain recover within a month, a large number of patients report a recurrence within one year. Current treatment interventions often remain unsuccessful, which highlights the current lack of knowledge on the underlying mechanisms of non-specific low back pain.

Postural control deficits have been identified as a key factor in the development and recurrence of non-specific low back pain. To achieve optimal postural control, the central nervous system needs to process, integrate and weigh proprioceptive signals from different body regions (e.g. ankle muscles and lower back muscles) with vestibular and visual inputs. Several studies have shown that patients with non-specific low back pain have a decreased ability to optimally weigh proprioceptive signals during standing, which leads to reduced postural robustness compared to pain-free individuals. More specifically, patients with low back pain dominantly rely more on proprioceptive signals from the ankle muscles and are not able to up-weigh proprioceptive signals from the lower back muscles when needed. This might be due to an impaired central processing of proprioceptive signals. However, up to now no studies have investigated central proprioceptive processing in patients with recurrent non-specific low back pain.

Therefore, this project aims to elucidate whether patients with recurrent non-specific low back pain showed altered brain activation patterns during the processing of proprioceptive signals from the ankle muscles and lower back muscles compared to healthy controls, by applying local muscle vibration during functional magnetic resonance imaging (fMRI).

Conditions

Low Back Pain

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

Non-specific low back pain

Individuals with recurrent non-specific low back pain

No interventions assigned to this group

Healthy control subjects

Healthy individuals without low back pain

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• Age: 20 - 50 years old
• At least six months of low back pain with or without referred pain to the buttock or thigh
• At least three episodes of disabling low back pain
• A score of at least 14% on the Oswestry Disability Index
• Willing to sign the informed consent
• Meets specific criteria related to MRI-research

• Age: 20 - 50 years old
• No history of low back pain
• A score of 0% on the Oswestry Disability Index
• Willing to sign the informed consent
• Meets specific criteria related to MRI-research

Exclusion Criteria

• History of major trauma and/or major orthopedic surgery of the spine, the pelvis or the lower quadrant
• One of the following conditions: Parkinson's disease, multiple sclerosis, Stroke with sequelae
• Radicular symptoms
• Using strong opioid medication or antidepressants
• Neck pain
• Ankle problems

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Agentschap voor Innovatie door Wetenschap en Technologie

OTHER

Sponsor Role: collaborator

KU Leuven

OTHER

Sponsor Role: lead

Responsible Party

Simon Brumagne

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Katholieke Universiteit Leuven

Leuven, , Belgium

Countries

Belgium

References

Brumagne S, Janssens L, Janssens E, Goddyn L. Altered postural control in anticipation of postural instability in persons with recurrent low back pain. Gait Posture. 2008 Nov;28(4):657-62. doi: 10.1016/j.gaitpost.2008.04.015. Epub 2008 Jun 9.

Reference Type: BACKGROUND

PMID: 18541428 (View on PubMed)

Claeys K, Dankaerts W, Janssens L, Pijnenburg M, Goossens N, Brumagne S. Young individuals with a more ankle-steered proprioceptive control strategy may develop mild non-specific low back pain. J Electromyogr Kinesiol. 2015 Apr;25(2):329-38. doi: 10.1016/j.jelekin.2014.10.013. Epub 2014 Oct 31.

Reference Type: BACKGROUND

PMID: 25467548 (View on PubMed)

Claeys K, Brumagne S, Dankaerts W, Kiers H, Janssens L. Decreased variability in postural control strategies in young people with non-specific low back pain is associated with altered proprioceptive reweighting. Eur J Appl Physiol. 2011 Jan;111(1):115-23. doi: 10.1007/s00421-010-1637-x. Epub 2010 Sep 8.

Reference Type: BACKGROUND

PMID: 20824281 (View on PubMed)

Brumagne S, Janssens L, Knapen S, Claeys K, Suuden-Johanson E. Persons with recurrent low back pain exhibit a rigid postural control strategy. Eur Spine J. 2008 Sep;17(9):1177-84. doi: 10.1007/s00586-008-0709-7. Epub 2008 Jul 2.

Reference Type: BACKGROUND

PMID: 18594876 (View on PubMed)

Other Identifiers

2016_SBrumagne_PropriocProcess

Identifier Type: -

Identifier Source: org_study_id