The Effect of Secondary Prevention in Patients With Recurrent Low Back Pain

NCT ID: NCT03852667

Last Updated: 2021-11-30

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

COMPLETED

Clinical Phase

NA

Total Enrollment

76 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-09-29

Study Completion Date

2020-06-30

Brief Summary

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This study investigates the effect of a secondary intervention program for low back pain in patients with recurrent low back pain. One third of the subject will receive no therapy, one third wil receive 2 sessions of pain neuroscience education (PNE) and one third will receive two sessions of PNE and 5 sessions of exercise therapy over 6 weeks.

Detailed Description

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Participants:

60 individuals with recurrent non-specific LBP were recruited through advertisement in sport facilities, social media and among friends and family.

Testing:

The testing was performed before and after a six week period by three blinded 2nd master students of physiotherapy of University of Ghent. The pre and post testing were almost identical and lasted 1 hour, only for the first testing an anamnesis was conducted to evaluate inclusion and exclusion criteria. The identical parts were tests for motor control, muscle performance and psychosocial factors.

Intervention:

The subjects were divided into 3 groups, only group B and C were given treatment. Group B had 2 sessions PNE over a period of two weeks. Group C received 2 sessions of PNE and 5 sessions of exercise therapy over a period of six weeks. Each of the sessions lasted 30 minutes and took place at the clinical practice room at the university of Ghent. Group C began the exercise therapy a week after the second session of PNE.

Conditions

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Low Back Pain, Recurrent

Keywords

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low back pain recurrent non-specific secondary prevention pain neuroscience education exercise therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The randomization schedule was extracted from the website www.sealedenvelope.com . The randomization was expected to have the same amount of one gender in each group. The control group was group A, the group that only received PNE was group B and the group who received PNE and exercise therapy was group C.
Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
The leading investigators, as well as the outcome assessors are masked and do not know to which arm the subjects are allocated to.

Study Groups

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Control

No intervention between the two test sessions

Group Type NO_INTERVENTION

No interventions assigned to this group

Pain Neuroscience Education

Two sessions (30 min) of Pain Neuroscience Education

Group Type ACTIVE_COMPARATOR

Pain Neuroscience Education

Intervention Type BEHAVIORAL

The PNE intervention consisted of 2 sessions of 30 minutes. In the first session, the main goal is to explain the patient why pain is important and why people can't live without it. Besides it is explained why objective findings such as x-rays, MRI, CT scans, etc. often lack significant findings despite the pain that the patient experiences. This first session of pain education might help the patient understand that pain is necessarily a result from tissue damage. Furthermore, the session explains the right approach to conquer pain and to avoid going down in this vicious circle of low back pain. The second session of PNE, is a revision of the first session, continuing on what was unclear from the first session.

Pain neuroscience education - exercise

2 sessions of PNE and 5 sessions of exercise therapy.

Group Type EXPERIMENTAL

Pain Neuroscience Education

Intervention Type BEHAVIORAL

The PNE intervention consisted of 2 sessions of 30 minutes. In the first session, the main goal is to explain the patient why pain is important and why people can't live without it. Besides it is explained why objective findings such as x-rays, MRI, CT scans, etc. often lack significant findings despite the pain that the patient experiences. This first session of pain education might help the patient understand that pain is necessarily a result from tissue damage. Furthermore, the session explains the right approach to conquer pain and to avoid going down in this vicious circle of low back pain. The second session of PNE, is a revision of the first session, continuing on what was unclear from the first session.

Exercise therapy

Intervention Type OTHER

The exercise therapy varies form analytical exercises in the first sessions, to functional and sports related exercises near the following sessions. The first session focuses on the lumbar neuromuscular control of the patients: first a voluntary contraction of the Transversus Abdominis muscle, the Multifidus muscle and the pelvic floor muscles is learned. When the subject is able to maintain the combined contraction for 10 times, the exercises evolve to more complicated tasks. In the final stage, more functional and sport specific tasks will be exercised.

Interventions

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Pain Neuroscience Education

The PNE intervention consisted of 2 sessions of 30 minutes. In the first session, the main goal is to explain the patient why pain is important and why people can't live without it. Besides it is explained why objective findings such as x-rays, MRI, CT scans, etc. often lack significant findings despite the pain that the patient experiences. This first session of pain education might help the patient understand that pain is necessarily a result from tissue damage. Furthermore, the session explains the right approach to conquer pain and to avoid going down in this vicious circle of low back pain. The second session of PNE, is a revision of the first session, continuing on what was unclear from the first session.

Intervention Type BEHAVIORAL

Exercise therapy

The exercise therapy varies form analytical exercises in the first sessions, to functional and sports related exercises near the following sessions. The first session focuses on the lumbar neuromuscular control of the patients: first a voluntary contraction of the Transversus Abdominis muscle, the Multifidus muscle and the pelvic floor muscles is learned. When the subject is able to maintain the combined contraction for 10 times, the exercises evolve to more complicated tasks. In the final stage, more functional and sport specific tasks will be exercised.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* In remission during testing
* recurrent low back pain (RLBP) \>6months
* 2 or more episodes in the past year
* Pain flare of ≥24 hours, characterized by an increase of ≥2 on an Numeric Rating Scale (NRS) scale and/or ≥5 on the Roland Morris Disability Questionnaire
* Followed by a pain-free episode of ≥1 month, characterized by a 0/10 on an NRS scale and/or \<2 on the Roland Morris Disability Questionnaire
* Non-specific RLBP (no cause for Low back pain (LBP); \>3y post discus herniation)
* 1 year or more post-natal

Exclusion Criteria

* Use of antidepressants or analgesics (except for NSAIDs or paracetamol), taken 2 weeks before the testing
* Neurologic, respiratory, circulatory, or severe orthopedic diseases
* Pregnancy
* Specific LBP causes
* A history of cognitive exercise therapy and/or specific motor control training
* current treatment or new therapies starting \<6 weeks before baseline assessment
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Ghent

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lieven Danneels, PhD

Role: STUDY_CHAIR

University Ghet

Locations

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Vakgroep Revalidatiewetenschappen

Ghent, Oost-Vlaanderen, Belgium

Site Status

Countries

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Belgium

Other Identifiers

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EC/GK2017/1508

Identifier Type: -

Identifier Source: org_study_id