Pain Education vs. Self-management Associated With Movement Control Exercises for Chronic Low Back Pain

NCT ID: NCT03778970

Last Updated: 2019-02-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-20

Study Completion Date

2021-01-30

Brief Summary

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The primary aim of this study is to compare the effects of an exercise program based on movement control exercises associated with self-management advice (SME) or pain neuroscience education (PNE) on the outcomes of pain intensity and pain disability in patients with chronic non-specific low back pain (CLBP).

Detailed Description

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Participants: One hundred and four volunteers (104) aged 18-50 years with chronic non-specific low back pain.

Interventions: The volunteers will be randomized into two treatment groups: self-management education and movement control exercises or pain neuroscience education and exercises based on movement control exercises. Two workshops of 40 minutes each will be administered as education approach and the exercise program along 2 months ( and 12 sessions distributed over 2 months.

Main outcome measures: Primary outcomes will include pain intensity and low back disability, and secondary outcomes will be pain catastrophizing, pain self-efficacy, kinesiophobia, exercise adherence and global perceived effect. These will be measured pre- and post-intervention and at the 1-month follow-up. Statistical analysis will be conducted following treatment intent principles, and treatment effects will be calculated using a mixed linear model, considering intervention groups as a factor and assessments over time as repeated measures.

Conditions

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Chronic Low Back Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled clinical trial, superiority trial
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
The participants will be submitted to Pain Neuroscience Education or Self-Management Education plus movement control exercises. They will not be aware of the education approach they will receive. The assessors will also not be aware whether the participant received Pain Neuroscience Education or Self-Management Education.

Study Groups

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Pain Neuroscience Education + Exercises

The PNE will follow the principles established by Explain Pain, addressing reconceptualization of pain, emphasizing modern neuroscience concepts. The PNE workshop will last 40 minutes (2 sessions). The movement control exercises will consist of active exercises that address posture and control of movements which are impaired and trigger pain. The session will last approximately 30 minutes, starting with the execution of the coordination exercises in the control of movement with an intensity of 10 to 30 repetitions and then performing exercises for stretching in 3 series of 30 seconds. Finally, strengthening exercises in 3 sets of 15 repetitions will be implemented. The exercises will be administered 1 session/week (volunteers will be oriented to execute the same exercises at home twice a week). The volunteers will receive 8 sessions at the clinic.

Group Type EXPERIMENTAL

Pain Neuroscience Education

Intervention Type OTHER

Pain neuroscience education (2 sessions during 40 minutes) administered by an interactive workshop

Movement Control Exercises

Intervention Type OTHER

Eight sessions of movement control exercises (30 minutes each) + advice to perform the exercises at home twice a week.

Self-Management Education + Exercises

The Self-Management Education (SME) strategy will be aligned with the "Back Book" concepts, focused on behavior change and encouraging participants to be active despite of the pain. The SME workshop will last 40 minutes (2 sessions). The movement control exercises will consist of active exercises that address posture and control of movements which are impaired and trigger pain. The session will last approximately 30 minutes, starting with the execution of the coordination exercises in the control of movement with an intensity of 10 to 30 repetitions and then performing exercises for stretching in 3 series of 30 seconds. Finally, strengthening exercises in 3 sets of 15 repetitions will be implemented. The exercises will be administered 1 session/week (volunteers will be oriented to execute the same exercises at home twice a week). The volunteers will receive 8 sessions at the clinic.

Group Type ACTIVE_COMPARATOR

Self-Management Education

Intervention Type OTHER

A self-management education (2 sessions during 40 minutes) administered by an interactive workshop

Movement Control Exercises

Intervention Type OTHER

Eight sessions of movement control exercises (30 minutes each) + advice to perform the exercises at home twice a week.

Interventions

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Pain Neuroscience Education

Pain neuroscience education (2 sessions during 40 minutes) administered by an interactive workshop

Intervention Type OTHER

Self-Management Education

A self-management education (2 sessions during 40 minutes) administered by an interactive workshop

Intervention Type OTHER

Movement Control Exercises

Eight sessions of movement control exercises (30 minutes each) + advice to perform the exercises at home twice a week.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

(1) non-specific chronic low back pain with a mechanical constituent caused by certain postures, activities, and movements, in addition to having at least 3 months of pain and/or episodes for at least half the previous 6 days, located between T12 and the gluteal folds; (2) pain intensity scores greater than 2 and greater than 14% on the Oswestry Low Back Disability Index and (3) positive results in 2 or more of the 6 tests to determine movement control impairment.

Exclusion Criteria

(1) red flags such as tumors or neoplastic diseases in the spine, inflammatory diseases, infections, and fractures; (2) central and peripheral, psychiatric, rheumatologic, and cardiac neurological diseases; (3) acute and symptomatic radiculopathy, lumbar stenosis, and spondylolisthesis; (4) pregnant women; and (5) individuals submitted to physiotherapeutic treatment during the last 6 months. Finally, volunteers will be advised about the non-use of pain medications 24 hours before the evaluations.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Sao Paulo

OTHER

Sponsor Role lead

Responsible Party

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Thais Cristina Chaves

Professor PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Thais Chaves, PhD

Role: STUDY_DIRECTOR

Professor - Ribeirão Preto Medical School - University of São Paulo

Locations

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Physical Therapy Clinic

Jacarezinho, Paraná, Brazil

Site Status RECRUITING

University of Sao Paulo

Ribeirão Preto, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Tiago Del Antônio, MSc

Role: CONTACT

Phone: +554384240199

Email: [email protected]

Thais Chaves, PhD

Role: CONTACT

Phone: +551633154413

Email: [email protected]

Facility Contacts

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Tiago Del Antônio, PhD

Role: primary

Thais C Chaves, PhD

Role: primary

Tiago AG Del Antônio, MSc

Role: backup

Other Identifiers

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69172017.1.0000.5440

Identifier Type: -

Identifier Source: org_study_id