Brief Summary

Patients with non-specific low back pain will be compared to healthy, age- and sex-matched controls to determine the most discriminating back muscle characteristics and to delineate possible phenotypes of patients with non-specific low back pain showing impaired proprioceptive postural control. Additionally, the group of patients with non-specific low back pain will receive a 16-week, high-load proprioceptive training program. The effects of this training program on the different back muscle characteristics and proprioceptive postural control will be evaluated.

Conditions

• Low Back Pain
• Back Pain Lower Back Chronic

Intervention / Treatment

• Other: Proprioceptive training

Primary Outcome Measures

• Proprioceptive postural control at baseline 1 (t= 0 weeks) (At baseline 1 (t= 0 weeks))
  Center-of-pressure displacement in response to ankle and/or back muscle vibration and the Relative Proprioceptive Weighting ratio will be calculated.
• Proprioceptive postural control at baseline 2 (t= 8 weeks) (only for patients) (At baseline 2 (t= 8 weeks))
  Center-of-pressure displacement in response to ankle and/or back muscle vibration and the Relative Proprioceptive Weighting ratio will be calculated.
• Proprioceptive postural control after 8 weeks of training (t= 16 weeks) (only for patients) (After 8 weeks of training (t= 16 weeks))
  Center-of-pressure displacement in response to ankle and/or back muscle vibration and the Relative Proprioceptive Weighting ratio will be calculated.
• Proprioceptive postural control after 16 weeks of training (t= 24 weeks) (only for patients) (After 16 weeks of training (t= 24 weeks))
  Center-of-pressure displacement in response to ankle and/or back muscle vibration and the Relative Proprioceptive Weighting ratio will be calculated.
• Proprioceptive postural control 16 weeks after the end of training (t= 40 weeks) (only for patients) (16 weeks after the end of training (t= 40 weeks))
  Center-of-pressure displacement in response to ankle and/or back muscle vibration and the Relative Proprioceptive Weighting ratio will be calculated.
• Macroscopic characteristiscs of the lumbar multifidus and erector spinae muscles at t= 0 weeks (only for healthy controls) (At t= 0 weeks)
  Muscle volume and quality will be measured with 3D freehand ultrasound, muscle cross-sectional area and thickness will be evaluated with 2D ultrasound.
• Macroscopic characteristiscs of the lumbar multifidus and erector spinae muscles at baseline 2 (t= 8 weeks) (only for patients) (At baseline 2 (t= 8w, 2nd baseline))
  Muscle volume and quality will be measured with 3D freehand ultrasound, muscle cross-sectional area and thickness will be evaluated with 2D ultrasound.
• Macroscopic characteristics of the lumbar multifidus and erector spinae muscles after 16 weeks of training (t= 24 weeks) (only for patients) (After 16 weeks of training (t= 24 weeks))
  Muscle volume and quality will be measured with 3D freehand ultrasound, muscle cross-sectional area and thickness will be evaluated with 2D ultrasound.
• Macroscopic characteristisc of the lumbar multifidus and erector spinae muscles 16 weeks after the end of training (t= 40 weeks) (only for patients) (16 weeks after the end of training (t= 40 weeks))
  Muscle volume and quality will be measured with 3D freehand ultrasound, muscle cross-sectional area and thickness will be evaluated with 2D ultrasound.
• Microscopic muscle characteristics of the lumbar multifidus and erector spinae muscles at t= 0 weeks (only for healthy controls) (At t= 0 weeks)
  Fine-needle biopsies of the lumbar multifidus and erector spinae muscles will be acquired.
• Microscopic muscle characteristics of the lumbar multifidus and erector spinae muscles at baseline 2 (t= 8 weeks) (only for patients) (At baseline 2 (t= 8 weeks))
  Fine-needle biopsies of the lumbar multifidus and erector spinae muscles will be acquired.
• Microscopic muscle characteristics of the lumbar multifidus and erector spinae muscles after 16 weeks of training (t= 24 weeks) (only for patients) (After 16 weeks of training (t= 24 weeks))
  Fine-needle biopsies of the lumbar multifidus and erector spinae muscles will be acquired.
• Microscopic muscle characteristics of the lumbar multifidus and erector spinae muscles 16 weeks after the end of training (t= 40 weeks) (only for patients) (16 weeks after the end of training (t= 40 weeks))
  Fine-needle biopsies of the lumbar multifidus and erector spinae muscles will be acquired.
• Hemodynamic muscle characteristics of the lumbar multifidus and erector spinae muscles at baseline 1 (t= 0 weeks) (At baseline 1 (t= 0 weeks))
  The Tissue Oxygenation Index will be recorded continuously with near-infrared spectroscopy during different functional postures (prone lying, usual sitting, usual standing, standing with the trunk bent 25° forward).
• Hemodynamic muscle characteristics of the lumbar multifidus and erector spinae muscles at baseline 2 (t= 8 weeks) (only for patients) (At baseline 2 (t= 8 weeks))
  The Tissue Oxygenation Index will be recorded continuously with near-infrared spectroscopy during different functional postures (prone lying, usual sitting, usual standing, standing with the trunk bent 25° forward).
• Hemodynamic muscle characteristics of the lumbar multifidus and erector spinae muscles after 8 weeks of training (t= 16 weeks) (only for patients) (After 8 weeks of training (t= 16 weeks))
  The Tissue Oxygenation Index will be recorded continuously with near-infrared spectroscopy during different functional postures (prone lying, usual sitting, usual standing, standing with the trunk bent 25° forward).
• Hemodynamic muscle characteristics of the lumbar multifidus and erector spinae muscles after 16 weeks of training (t= 24 weeks) (only for patients) (After 16 weeks of training (t= 24 weeks))
  The Tissue Oxygenation Index will be recorded continuously with near-infrared spectroscopy during different functional postures (prone lying, usual sitting, usual standing, standing with the trunk bent 25° forward).
• Hemodynamic muscle characteristics of the lumbar multifidus and erector spinae muscles 16 weeks after the end of training (t= 40 weeks) (only for patients) (16 weeks after the end of training (t= 40 weeks))
  The Tissue Oxygenation Index will be recorded continuously with near-infrared spectroscopy during different functional postures (prone lying, usual sitting, usual standing, standing with the trunk bent 25° forward).
• Electrophysiological muscle characteristics of the lumbar multifidus and erector spinae at baseline 1 (t= 0 weeks) (At baseline 1 (t= 0 weeks))
  Muscle activitation levels and patterns will be measured with surface electromyography during different functional postures (prone lying, usual sitting, usual standing, standing with the trunk bent 25° forward).
• Electrophysiological muscle characteristics of the lumbar multifidus and erector spinae at baseline 2 (t= 8 weeks) (only for patients) (At baseline 2 (t= 8 weeks))
  Muscle activitation levels and patterns will be measured with surface electromyography during different functional postures (prone lying, usual sitting, usual standing, standing with the trunk bent 25° forward).
• Electrophysiological muscle characteristics of the lumbar multifidus and erector spinae after 8 weeks of training (t= 16 weeks) (only for patients) (After 8 weeks of training (t= 16 weeks))
  Muscle activitation levels and patterns will be measured with surface electromyography during different functional postures (prone lying, usual sitting, usual standing, standing with the trunk bent 25° forward).
• Electrophysiological muscle characteristics of the lumbar multifidus and erector spinae after 16 weeks of training (t= 24 weeks) (only for patients) (After 16 weeks of training (t= 24 weeks))
  Muscle activitation levels and patterns will be measured with surface electromyography during different functional postures (prone lying, usual sitting, usual standing, standing with the trunk bent 25° forward).
• Electrophysiological muscle characteristics of the lumbar multifidus and erector spinae 16 weeks after the end of training (t= 40 weeks) (only for patients) (16 weeks after the end of training (t= 40 weeks))
  Muscle activitation levels and patterns will be measured with surface electromyography during different functional postures (prone lying, usual sitting, usual standing, standing with the trunk bent 25° forward).

Countries

Belgium

Locations and Investigators

• REVAL Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium (Recruiting)
  • Lotte Janssens, PhD
  • Nina Goossens, PhD
  • Lotte Janssens, PhD (Principal Investigator)
  • Nina Goossens, PhD
  • Frank Vandenabeele, PhD
  • Anouk Agten, PhD
• Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium (Recruiting)
  • Simon Brumagne, PhD
  • Vasiliki Karagiannopoulou, MSc
  • Simon Brumagne, PhD (Principal Investigator)
  • Lieven Moke, PhD
  • Kaat Desloovere, PhD
  • Zafeiris Louvaris, PhD
  • Vasiliki Karagiannopoulou, MSc

Study Officials

• Lotte Janssens, PhD (Principal Investigator) — Hasselt University