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Optimising conservative management of chronic low back pain: study protocol for a randomised controlled trial

Simson, Katherine J, Miller, Clint T, Ford, Jon, Hahne, Andrew, Main, Luana, Rantalainen, Timo, Teo, Wei-Peng, Teychenne, Megan, Connell, David, Trudel, Guy, Zheng, Guoyan, Thickbroom, Gary and Belavý, Daniel L 2017, Optimising conservative management of chronic low back pain: study protocol for a randomised controlled trial, Trials, vol. 18, pp. 1-13, doi: 10.1186/s13063-017-1913-8.

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Title Optimising conservative management of chronic low back pain: study protocol for a randomised controlled trial
Author(s) Simson, Katherine J
Miller, Clint TORCID iD for Miller, Clint T orcid.org/0000-0001-7743-6986
Ford, Jon
Hahne, Andrew
Main, LuanaORCID iD for Main, Luana orcid.org/0000-0002-9576-9466
Rantalainen, TimoORCID iD for Rantalainen, Timo orcid.org/0000-0001-6977-4782
Teo, Wei-PengORCID iD for Teo, Wei-Peng orcid.org/0000-0003-3929-9778
Teychenne, MeganORCID iD for Teychenne, Megan orcid.org/0000-0002-7293-8255
Connell, David
Trudel, Guy
Zheng, Guoyan
Thickbroom, Gary
Belavý, Daniel LORCID iD for Belavý, Daniel L orcid.org/0000-0002-9307-832X
Journal name Trials
Volume number 18
Article ID 184
Start page 1
End page 13
Total pages 13
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2017-04-20
ISSN 1745-6215
Keyword(s) Exercise therapy
Low back pain
Motor control
Science & technology
Life sciences & biomedicine
Medicine, research & experimental
Research & experimental medicine
Lumbar disc degeneration
Cross-sectional area
Transversus abdominis muscle
Exercise induced hypoalgesia
Intervertebral disc
Motor cortex
Neck pain
Stabilisation exercise
Multifidus muscles
Perceived exertion
Summary Background
Lower back pain is a global health issue affecting approximately 80% of people at some stage in their life. The current literature suggests that any exercise is beneficial for reducing back pain. However, as pain is a subjective evaluation and physical deficits are evident in low back pain, using it as the sole outcome measure to evaluate superiority of an exercise protocol for low back pain treatment is insufficient. The overarching goal of the current clinical trial is to implement two common, conservative intervention approaches and examine their impact on deficits in chronic low back pain.

Methods/design

Forty participants, 25–45 years old with chronic (>3 months), non-specific low back pain will be recruited. Participants will be randomised to receive either motor control and manual therapy (n = 20) or general strength and conditioning (n = 20) exercise treatments for 6 months. The motor control/manual therapy group will receive twelve 30-min sessions, ten in the first 3 months (one or two per week) and two in the last 3 months. The general exercise group will attend two 1-hour sessions weekly for 3 months, and one or two a week for the following 3 months. Primary outcome measures are average lumbar spine intervertebral disc T2 relaxation time and changes in thickness of the transversus abdominis muscle on a leg lift using magnetic resonance imaging (MRI). Secondary outcomes include muscle size and fat content, vertebral body fat content, intervertebral disc morphology and water diffusion measured by MRI, body composition using dual energy X-ray absorptiometry, physical function through functional tests, changes in corticospinal excitability and cortical motor representation of the spinal muscles using transcranial magnetic stimulation and self-reported measure of pain symptoms, health and disability. Outcome measures will be conducted at baseline, at the 3-month follow-up and at 6 months at the end of intervention. Pain, depressive symptomology and emotions will be captured fortnightly by questionnaires.

Discussion

Chronic low back pain is ranked the highest disabling disorder in Australia. The findings of this study will inform clinical practice guidelines to assist with decision-making approaches where outcomes beyond pain are sought for adults with chronic low back pain.
Language eng
DOI 10.1186/s13063-017-1913-8
Field of Research 110399 Clinical Sciences not elsewhere classified
1102 Cardiovascular Medicine And Haematology
1103 Clinical Sciences
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30094318

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.