Effects of postural specific sensorimotor training in patients with chronic low back pain: study protocol for randomised controlled trial

Trials. 2015 Dec 15:16:571. doi: 10.1186/s13063-015-1104-4.

Abstract

Background: Sensorimotor training (SMT) is popularly applied as a preventive or rehabilitative exercise method in various sports and rehabilitation settings. Yet, there is only low-quality evidence on its effect on pain and function. This randomised controlled trial will investigate the effects of a theory-based SMT in rehabilitation of chronic (>3 months) non-specific low back pain (CNLBP) patients.

Methods/design: A pilot study with a parallel, single-blinded, randomised controlled design. Twenty adult patients referred to the clinic for CNLBP treatment will be included, randomised, and allocated to one of two groups. Each group will receive 9 x 30 minutes of standard physiotherapy (PT) treatment. The experimental group will receive an added 15 minutes of SMT. For SMT, proprioceptive postural exercises are performed on a labile platform with adjustable oscillation to provoke training effects on different entry levels. The active comparator group will perform 15 minutes of added sub-effective low-intensity endurance training. Outcomes are assessed on 4 time-points by a treatment blinded tester: eligibility assessment at baseline (BL) 2-4 days prior to intervention, pre-intervention assessment (T0), post-intervention assessment (T1), and at 4 weeks follow-up (FU). At BL, an additional healthy control group (n = 20) will be assessed to allow cross-sectional comparison with symptom-free participants. The main outcomes are self-reported pain (Visual Analogue Scale) and functional status (Oswestry Disability Index). For secondary analysis, postural control variables after an externally perturbed stance on a labile platform are analysed using a video-based marker tracking system and a pressure plate (sagittal joint-angle variability and centre of pressure confidence ellipse). Proprioception is measured as relative cervical joint repositioning error during a head-rotation task. Effect sizes and mixed-model MANOVA (2 groups × 4 measurements for 5 dependent variables) will be calculated.

Discussion: This is the first attempt to systematically investigate effects of a theory-based sensorimotor training in patients with CNLBP. It will provide analysis of several postural segments during a dynamic task for quantitative analysis of quality and change of the task performance in relation to changes in pain and functional status.

Trial registration: Trial registry number on cliniclatrials.gov is NCT02304120 , first registered on 17 November 2014.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chronic Pain / diagnosis
  • Chronic Pain / physiopathology
  • Chronic Pain / rehabilitation*
  • Clinical Protocols
  • Disability Evaluation
  • Feedback, Sensory*
  • Humans
  • Low Back Pain / diagnosis
  • Low Back Pain / physiopathology
  • Low Back Pain / rehabilitation*
  • Pain Measurement
  • Pain Threshold*
  • Physical Therapy Modalities*
  • Pilot Projects
  • Posture*
  • Proprioception*
  • Research Design
  • Self Report
  • Single-Blind Method
  • Switzerland
  • Time Factors
  • Treatment Outcome
  • Video Recording

Associated data

  • ClinicalTrials.gov/NCT02304120