Abstract
BackgroundSensorimotor 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/DesignA 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.DiscussionThis 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 registrationTrial registry number on cliniclatrials.gov is NCT02304120, first registered on 17 November 2014.
Highlights
Sensorimotor training (SMT) is popularly applied as a preventive or rehabilitative exercise method in various sports and rehabilitation settings
The aim of this study is to compare the effects of SMT on pain and functional status with sub-effective low-intensity training (SLIT) in patients with CNLBP: Is a sensorimotor training added to physiotherapy (PT) more effective than physiotherapy with added sub-effective low-intensity training regarding pain and functional status in patients with non-specific low back pain? It is first hypothesised that functional status and self-reported pain will reduce significantly in both groups, but the SMT group will show significantly more improvement when compared to SLIT
The list was computedgenerated prior to the trial beginning by a third party, who is not involved in patient recruitment, organisation, assessment, or treatment
Summary
Sensorimotor training (SMT) is popularly applied as a preventive or rehabilitative exercise method in various sports and rehabilitation settings. Dynamic movements are becoming ever more neglected and repetitive tasks seem to dominate most of our activities It has been well-established that occupations requiring prolonged periods of static standing are associated with development of musculoskeletal disorders including CNLBP [7,8,9]. Long-term monotonous afferent input is believed to impair the sensorimotor system; circuits regulating the appropriate amount of symmetric muscle force, needed to adapt the correct posture in any given situations, are thought to be disturbed [6, 10, 11] If not restored, this constant malfunctioning of muscular control and regulation of dynamic movement may lead to inappropriate muscular activity [11, 12] and is thought to contribute to taut muscles, imbalanced muscle activation, poor posture, and to musculoskeletal pain in lumbar regions [13]
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