Abstract

BackgroundPrefabricated foot orthoses are used to treat chronic nonspecific low back pain, however their effectiveness and potential mechanism of action is unclear. The primary aims of the study are to investigate the effectiveness of prefabricated foot orthotic devices for reducing pain and improving function in people with chronic nonspecific low back pain over 52 weeks.MethodsThis study is a participant and assessor blinded, parallel-group, superiority randomised (1:1) controlled trial. The study will recruit 60 participants aged 18 to 65 years with chronic nonspecific low back pain. Participants will undergo randomisation to a control group (The Back Book) or an intervention group (prefabricated foot orthoses and The Back Book). The primary outcome measures will be change in pain and function from baseline to 12 (primary time point), 26, and 52 weeks. Secondary outcome measures include: gluteus medius muscle activity and transversus abdominis muscle thickness from baseline to 12 weeks, physical activity over 12, 26, and 52 weeks, and correlation between foot type and change in measures of pain and function. Number of hours per day and week that the prefabricated orthoses are worn, as well as, adverse events will be self-reported by participants. Data will be analysed using the intention-to-treat principle.DiscussionThis trial will primarily evaluate the effectiveness of prefabricated foot orthotic devices for reducing pain and improving function in people with chronic nonspecific low back pain over 52 weeks. It is expected that this study will provide clinicians and researchers with an understanding of the role that prefabricated foot orthoses may have in the treatment of chronic nonspecific low back pain and a potential mechanism of action, and whether foot type influences the outcome.Trial registrationACTRN12618001298202.

Highlights

  • Prefabricated foot orthoses are used to treat chronic nonspecific low back pain, their effectiveness and potential mechanism of action is unclear

  • Where significant correlations are found, a regression analysis will be performed to determine the ability of foot type to predict treatment outcomes. This randomised controlled trial will be undertaken to determine the effectiveness of prefabricated foot orthoses for reducing pain and improving function in people with chronic nonspecific low back pain (LBP) over 12, 26, and 52 weeks

  • Previous research investigating the effectiveness of foot orthotic devices for the treatment of chronic nonspecific LBP has generally been of moderate methodological quality and high heterogeneity [16]

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Summary

Introduction

Prefabricated foot orthoses are used to treat chronic nonspecific low back pain, their effectiveness and potential mechanism of action is unclear. Due to the varied nature of LBP, up to 85% of cases are classified as nonspecific [5], with the majority of these lasting for periods of greater than 3 months [6]. In such cases the LBP is referred to as chronic nonspecific LBP. Chronic nonspecific LBP is associated with high levels of pain, disability, depression, and reduced quality of life [7]. The evidence for the extensive range of chronic nonspecific LBP treatments has mixed levels of quality and shows highly variable outcomes [8,9,10]

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