Gait in Low Back Pain Patients After Spinal Mobilization (SpinMob)

University of Ioannina

Status: Completed

Conditions: Chronic Low Back Pain

Treatments: Procedure: swedish type massage; Procedure: sham treatment; Device: TENS; Procedure: spinal mobilization; Procedure: static hamstring stretch

Study type: Interventional

Funder types: Other

Identifiers

NCT02645123

721α/11-10-2011

Details and patient eligibility

About

Introduction: patients with chronic back pain as a result of degenerated disc disease, besides pain also present with impaired gait. The purpose of this study is to evaluate both the clinical data using clinical rating scales, such as Oswestry Disability Index Greek version (ODI), Numerical Pain Rating Scale for low back pain and leg pain (NPRS) and the Roland Morris Disability Questionnaire Greek Version, and kinetic and kinematic characteristics during gait analysis in patients with chronic low back pain as a result of the degenerated disc disease (Disc Degenerative Disease), before and after application of manual therapy techniques.

Methodology: for the purposes of the study, 75 patients suffering from chronic low back pain were randomly divided into 3 groups of 25 each. Each group received five sessions with the first group receiving manual therapy treatment (spinal mobilisation), the second a sham treatment and the third, classic physiotherapy (stretching exercises, TENS and massage). To evaluate the effectiveness of each treatment, the visual analog pain scale, two questionnaires (Oswestry and Roland Morris) and also an optoelectronic system for recording and analysis of gait (kinetic and kinematic data) were utilized.

Full description

This was a randomized controlled trial comparing the efficacy of spinal mobilization with other physiotherapy interventions (stretching, TENS application and Swedish type massage) and sham treatment in a group of chronic low back pain patients. The outcome measures included three dimensional gait analysis (kinetic and kinematic data) as well as clinical indicators (numerical pain rating scale, Oswestry disability index, Roland-Moris Disability questionnaire).

Enrollment: 75 patients

Sex: All

Ages: 21 to 78 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• low back pain for over 3 months
• recent lumbar MRI (up to 12 months)
• able to walk without the need of walking aids

Exclusion criteria

• leg length discrepancy of over 2 cm
• history of spinal surgery
• history of autoimmune disease
• history of spondylolysis and spondylolisthesis
• spinal fractures
• pregnancy
• respiratory and/or cardiac disease
• history of stroke
• hip, knee or ankle osteoarthritis
• cauda equina syndrome
• spinal inflammation
• spinal tumor
• steroid drug use in the last month
• osteoporosis

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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75 participants in 3 patient groups

Spinal mobilization

Experimental group

Description:

The individuals of the group received 5 treatments in total for 10 minutes that included: posterior to anterior spinal accessory mobilization passive physiological inter vertebral rotation The above was applied to the level that the MRI showed disc degeneration

Treatment:

Procedure: spinal mobilization

Sham Treatment

Sham Comparator group

Description:

The investigator touched the skin overlying the low back statically for 10 minutes

Treatment:

Procedure: sham treatment

Classic Physiotherapy

Active Comparator group

Description:

This group received static hamstring stretch for 5 minutes, TENS (2 channels biphasic pulse, 90Hz, 100μs pulse width) for 20 minutes and 15 minutes of Swedish type massage (effleurage, petrissage, kneading)

Treatment:

Device: TENS

Procedure: swedish type massage

Procedure: static hamstring stretch