Low back pain (LBP) is the leading cause of disability worldwide. Impaired postural control is a key factor in the development and maintenance of LBP. Moreover, the prevalence of LBP is associated with impairments in diaphragm function, symptoms of dyspnea, and dysfunctional breathing. However, the association between LBP (and more specifically postural control) and hyperventilation remains unknown. The main objective of this project is to investigate whether the presence of recurrent non-specific LBP is related to the presence of hyperventilation, when classified either objectively by decreased carbon dioxide values (demonstrating hypocapnia) or by symptoms while showing normal carbon dioxide values. Moreover, the investigators will explore whether psychosocial factors play a role in this relation. Subsequently, the investigators will examine whether hyperventilation in LBP patients is related to impaired postural control, and more specifically to a decreased postural contribution of the diaphragm.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
90
assessment of hyperventilation, postural control and psychological behavior
Hasselt University
Hasselt, Belgium
RECRUITINGNijmegen questionnaire
Questionnaire evaluating hyperventilation symptoms, 16 items, total score range 0-64
Time frame: Day 1
Nijmegen questionnaire
Questionnaire evaluating hyperventilation symptoms, 16 items, total score range 0-64
Time frame: Day 4
PetCO2
End-tidal carbon dioxide pressure measured with a capnograph
Time frame: Day 1
Postural control
upright standing balance measured by center of pressure by force plate
Time frame: Day 1
Breathing frequency
amount of breaths per minute, inspiratory and expiratory time
Time frame: Day 1
Breathing pattern (abominal and thoracic)
abdominal or thoracic contribution to one breath measured by respiratory inductance plethysmography
Time frame: Day 1
Numerical Rating Scale for low back pain (NRS)
11 point Likert scale evaluating severity/intensity of back pain, ranging from 0 (no pain) to 11 (worst pain imaginable)
Time frame: Day 1
Oswestry Disability Index version 2.1a (ODI-2.1a)
Questionnaire evaluating disability. 10 items Total score range from 0-100
Time frame: Day 1
12-item Short form Health Survey (SF-12)
Questionnaire evaluating physical and mental components of health related quality of life. 12 items. Total score range 12-56.
Time frame: Day 1
Fear Avoidance Component Scale (FACS)
Questionnaire evaluating fear-avoidance related to pain. 20 items Total score range from 0-100
Time frame: Day 1
Tampa Scale for Kinesiophobia (TSK)
Questionnaire evaluating kinesiophobia related to pain. 17 items. Total score range from 17-68
Time frame: Day 1
Pain Catastrophizing Scale (PCS)
Questionnaire evaluating catastrophizing. 13 items, 5 point Likert scale. Total score 0-52
Time frame: Day 1
Need for Controllability and Predictability Questionnaire (NCP-Q)
Questionnaire evaluating the need for being able to control and predict situations. 15 items, 5 point Likert scale. Total score range 15 - 75
Time frame: Day 1
Positive And Negative Affect Schedule (PANAS)
Questionnaire evaluating positive and negative affect. 10 items positive affect, 10 items negative affect, 5 point Likert scale. Total score range per affect: 10 - 50
Time frame: Day 1
Pain Solutions Questionnaire (PaSoL)
Questionnaire evaluating assimilative and accommodative responses to problems associated with pain. 14 items, 7 point Likert scale. Total score range 0 - 84
Time frame: Day 1
Toronto Alexithymia Scale 20 (TAS-20)
Questionnaire evaluating characteristics linked to alexithymia. 20 items, 3 factors. Total score range 20 - 100
Time frame: Day 1
Interoceptive Awareness Questionnaire (IAQ)
Questionnaire evaluating adaptive and maladaptive body awareness. 19 items, 5 point Likert scale.
Time frame: Day 1
Fremantle Back Awareness Questionnaire (FreBAQ)
Questionnaire evaluating back specific perceptual awareness. 9 items, 5 point Likert scale. Total score range 0-36
Time frame: Day 1
Vragenlijst belastende ervaringen (VBE) - short version
Questionnaire evaluating aversive experiences in adult life. 11 items should be scored with yes or no. If yes a score on a 5 point Likert scale should be given.
Time frame: Day 1
Multidimensional Perfectionism Scale (MPS)
Questionnaire evaluating adaptive and maladaptive perfectionism. 35 items, 5 point Likert scale. Total score range 35 - 175
Time frame: Day 1
International Physical Activity Questionnaire - Short Form (IPAQ-SF)
Questionnaire evaluating subjective level of physical activity. 7 questions regarding amount of time spent on certain activities.
Time frame: Day 1
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