Efficacy of Manual Therapy Techniques and Electrotherapy Modalities in Individuals With Non-specific Low Back Pain

NCT ID: NCT05562648

Last Updated: 2023-02-08

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 50 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-10-03
• Study Completion Date: 2023-02-07

Brief Summary

Low back pain is the fifth most common reason for doctor visits, affecting about 60-80% of people in their lifetime. Despite this, there are not enough diagnostic and treatment methods in the literature to fully elucidate non-specific low back pain. In this case, the research showed that non-specific low back pain should be handled with a biopsychosocial approach, and its relationship with fascia and myofascial meridians should be investigated.

Detailed Description

According holistic that approach patients with non-specific low back pain. Instead of examining the problem of low back pain in the society only in the form of muscles, joints, ligaments, etc.; should evaluate low back pain over the fascia. It is seen that most studies in the literature only examine the painful area and tissue problems in its immediate vicinity, and therefore they approach low back pain with symptomatic treatment. In recent studies, however, the main problem is not limited to the painful area only; It has been determined that the tissue response caused by the problems in different parts of the body is transmitted to more distant regions via the fascia and myofascial meridians.

Conditions

Back Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Manual therapy techniques

Myofascial release is a soft tissue method that provides removal of adhesions and tissue tension in tissues due to overload and repetitive use. These adhesions and unbalanced tissue tensions in the tissues can cause muscle weakness, numbness, pain, tingling and burning sensation. The soft tissue is palpated by the physiotherapist and pressure is applied directly to the skin until the tissue barrier is felt in the direction of restriction. Once the tissue barrier is present, it is applied for 90-120 seconds, without slipping on the skin or forcing the tissue, until the fascia complex begins to loosen and a softening sensation is achieved.

Group Type: EXPERIMENTAL

Manual therapy techniques

Intervention Type: OTHER

Myofascial trigger points are determined and the physiotherapist applies a light and continuous local pressure on them with his/her finger, usually not more than 30 seconds, until the moment of muscle relaxation, and as a result, the pain is expected to decrease to 0 (zero) and he withdraws his finger. He can do 3-5 repetitions until he sees relaxation in the muscle and reduction/disappearance of the pain.

Spinal mobilization is defined as low-speed, non-trust, passive movement within or at the limit of joint range of motion. Mobilization is low-speed, non-trust, passive joint movement.

MUSCLE ENERGY TECHNIQUES The muscle energy technique is a treatment technique that includes alternating periods of resistant muscle contractions and active-assist stretching, mostly used by osteopaths, physiotherapists, and chiropractors.

Electrophysical agents

Evidence levels for approaches commonly used in the clinic for the treatment of chronic low back pain were generally very low to moderate. TENS (Transcutaneous Electrical Nerve Stimulation) is the most preferred application in the treatment of chronic pain in patients who receive conventional treatment in the clinic. TENS is a physiotherapy modality used to inhibit pain by stimulating the sensory nerves by applying a low frequency electrical current.

Group Type: ACTIVE_COMPARATOR

Electrophysical agents

Intervention Type: OTHER

TENS TENS is a low-frequency electrical current applied to the stimulation of sensory nerves, used for the inhibition of pain sensation. Pain inhibition of TENS is based on 3 basic mechanisms. These; gate control mechanism (segmental inhibition), release of endogenous opioids and reduction of excitability with repetitive stimulation (inhibition from pattern).

Ultrasound is an effective electrotherapy modality with a deep heating feature. In addition, it has been suggested that the analgesic effect of ultrasound occurs with the stimulation of sensory afferents and the activation of the gate control mechanism in the posterior horn of the spinal cord.

Interventions

Manual therapy techniques

Myofascial trigger points are determined and the physiotherapist applies a light and continuous local pressure on them with his/her finger, usually not more than 30 seconds, until the moment of muscle relaxation, and as a result, the pain is expected to decrease to 0 (zero) and he withdraws his finger. He can do 3-5 repetitions until he sees relaxation in the muscle and reduction/disappearance of the pain.

Spinal mobilization is defined as low-speed, non-trust, passive movement within or at the limit of joint range of motion. Mobilization is low-speed, non-trust, passive joint movement.

MUSCLE ENERGY TECHNIQUES The muscle energy technique is a treatment technique that includes alternating periods of resistant muscle contractions and active-assist stretching, mostly used by osteopaths, physiotherapists, and chiropractors.

Intervention Type: OTHER

Electrophysical agents

TENS TENS is a low-frequency electrical current applied to the stimulation of sensory nerves, used for the inhibition of pain sensation. Pain inhibition of TENS is based on 3 basic mechanisms. These; gate control mechanism (segmental inhibition), release of endogenous opioids and reduction of excitability with repetitive stimulation (inhibition from pattern).

Ultrasound is an effective electrotherapy modality with a deep heating feature. In addition, it has been suggested that the analgesic effect of ultrasound occurs with the stimulation of sensory afferents and the activation of the gate control mechanism in the posterior horn of the spinal cord.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Being between the ages of 18-60
• Volunteering to work
• The person has a complaint of low back pain for more than 3 months
• Diagnosis of chronic low back pain by the doctor
• Being able to read and write and be cooperative.
• Not having received treatment for the lumbar region in the last 3 months
• having an MRI in the last 6 months.

Exclusion Criteria

• Not having any lumbar surgery or vertebral fracture
• Having neurological, radiculopathy, inflammatory, etc. disease
• Having spinal deformities such as scoliosis, kyphosis
• Having a vestibular or respiratory disorder
• Having auditory or cognitive impairment
• Medication that will affect the balance (sedatives, etc.)
• Patients with lower extremity amputation
• Those who want to quit working during the study period, those who do not attend regularly.
• Conditions such as cancer, infection, etc. in the spinal region

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Istanbul Medipol University Hospital

OTHER

Sponsor Role: lead

Responsible Party

hazal genc

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Medipol hospital

Istanbul, Istanbul Avrupa Kitasi, Turkey (Türkiye)

Countries

Turkey (Türkiye)

Study Documents

Document Type: data

Rozzi, P., Bongiorno, D., \& Vitturini, C. (2011). Fascial release effects on patients with non-specific cervical or lumbar pain. Journal of bodywork and movement therapies, 15(4), 405-416.

View Document

Other Identifiers

back pain

Identifier Type: -

Identifier Source: org_study_id