Low Back Pain (LBP) is one of the common causes of morbidity worldwide, with a one-month prevalence of 23.3 %. Number of people with LBP reached 577 million people in 2020. LBP has been the leading cause of years lived with disability from 1990 to 2017. The highest incidence of LBP is in people in their third decade of age. LBP is a complex disease difficult to treat as most of these cases (80 - 90 %) are classified as non-specific meaning that the pain cannot be attributed to any specific injury or pathology. Until now exercise therapy is commonly used as the treatment of choice in the rehab program of LBP. The aim of physical treatment is to improve function and prevent disability from getting worse. LumbaCure® is a robotic system driven by a proprietary movement algorithm to induce a specific and controlled mobilization of the low back in patient requiring treatment by physical exercises due to orthopedic disorder, especially low back pain. In Belgium, the standard back-school programme (rehabilitation programme) includes 35 rehabilitation sessions of 2 h delivered 2x/week at the investigator site (whom the first session is the inclusion visit, no therapy performed) and one session to tackle the psychological component of the condition (information on how to cope with pain). Participants are divided into two groups: the intervention group uses the LumbaCure® device (a seat that mobilizes the lower back for 15 minutes) in addition to the standard sessions (from session 2 to 27), while the control group follows the standard program with an extra 15 minutes of exercises. After session 27 (around 13 weeks), all participants continue their programme without the LumbaCure®, and their progress is assessed before the final 35th session.
Low Back Pain (LBP) is one of the most common causes of morbidity worldwide, with a one-month prevalence of 23.3%. In 2020, the number of people suffering from LBP reached 577 million. From 1990 to 2017, LBP remained the leading cause of years lived with disability. The highest incidence of LBP is observed in individuals in their third decade of life. LBP is a complex condition that is often difficult to treat, as 80-90% of cases are classified as non-specific, meaning the pain cannot be attributed to a specific injury or pathology. Exercise therapy is currently the most common treatment for LBP rehabilitation, aiming to improve function and prevent the worsening of disability. The study involves a standard rehabilitation program in Belgium consisting of 35 multidisciplinary sessions, each lasting 2 hours. Participants are divided into two groups: the intervention group and the control group. The intervention group follows the standard rehabilitation program but also uses the LumbaCure® device, a robotic system driven by a proprietary movement algorithm. The device is designed to induce controlled mobilization of the lower back, which is particularly beneficial for patients requiring physical treatment due to orthopedic disorders like low back pain. During each rehabilitation session, participants in the intervention group perform a 15-minute session on the LumbaCure® device under the supervision of a physiotherapist. Over the intervention period, participants in the intervention group are expected to complete 26 LumbaCure® sessions. In the control group, participants follow the same standard rehabilitation program with a frequency of ideally twice a week. To match the duration of the intervention group's additional LumbaCure® sessions, participants in the control group perform 15 minutes of additional exercises based on the standard care practices of their respective rehabilitation center. After session 27, which ideally take place over a period of 13 weeks, all participants continue with the remaining 8 sessions of the standard rehabilitation program. However, during this final phase, no LumbaCure® sessions are included for the intervention group. Participants' progress is monitored throughout the study, with a final evaluation taking place before the completion of the 35th session. This follow-up allows researchers to assess the overall effectiveness of the rehabilitation program, including the impact of the LumbaCure® device on patient outcomes compared to the standard care protocol.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
LumbaCure® is a robotic system that systematically moves the spine of affected patients with a complex proprietary algorithm.
Standard rehabilitation program
Jessa Ziekenhuis
Hasselt, Belgium
Jessa Ziekenhuis
Herk-de-Stad, Belgium
Disability
Comparison of the Oswestry Disability Index (ODI) evolution from baseline to session 26 (visit 4, end of intervention) between the two treatment arms.
Time frame: Around week 13 (intervention period)
Disability
\- Comparison of the difference in the ODI evolution from baseline to session 8 (visit2) session 18 (visit 3) and during the follow-up period (visit 5), between the two treatment arms.
Time frame: Around week 4, 9 (intervention period) and week 18 (follow-up)
Back pain
* Changes from baseline, in average back pain intensity over the last week, assessed on Numerical Pain Rating Scale (NPRS) from 0 to 10. Assessed at the different timepoints (visits 2 to 4). * Changes in average back pain intensity over the last week, assessed on Numerical Rating Scale from 0 to 10, during the follow-up period (V5).
Time frame: Around week 4, 9, 13, 18
Function
* Change in function score, assessed using the Patient Specific Functional Scale, between baseline, and the different time points (visits 2 to 4). The PSFS requires participants to identify three problematic activities and to rate these activities on a scale from 0 to 10. A high score indicates a greater ability to accomplish the task. * Change in function score during the follow-up period, assessed using the Pain Specific Functional Scale.
Time frame: Around week 4, 9, 13, 18
Kinesiophobia
* Change in fear of movements and attitudes and behaviour towards pain score, evaluated through the Tampa questionnaire (TSK-17) between baseline to the different timepoints (visits 2 to 4). The total score is calculated by adding up 17 sub-questions assessed using a 4-point Likert scale (from 1 to 4), with high scores indicating a greater degree of kinesiophobia. * Change in fear of movements and attitudes and behaviour towards pain score, evaluated through the Tampa questionnaire,during the follow-up period (V5)
Time frame: Around week 4, 9, 13, 18
Pain catastrophizing
Change in pain catastrophizing score, evaluated through the Pain catastrophizing scale (PCS), between baseline to the different timepoints (visits 2 to 4 and during follow-up : V5). The total score is calculated by adding up 13 sub-questions assessed using a 5-point Likert scale (from 0 to 4), with high score indicating a greater degree of pain catastrophising.
Time frame: Around week 4, 9, 13, 18
Flexibility
The ability of the patient to flex the lower back via fingertips to floor distance. It will be performed at each visit for both groups.
Time frame: Around week 4, 9, 13, 18
Disability
\- Disability Responding rate: Number and percentage of patients presenting a clinically significant improvement in the ODI at the different timepoints versus baseline in the two treatment arms
Time frame: Around week 4, 9 (intervention period) and week 18 (follow-up)
Back pain
\- Pain responding rate : Number and percentage of patients presenting a clinically significant improvement in the NPRS at the different timepoints versus baseline in the two treatment arms
Time frame: Around week 4, 9, 13, 18
Function
Function responding rate : Number and percentage of patients presenting a clinically significant improvement in the pain specific function scale at the different timepoints versus baseline in the two treatment arms.
Time frame: Around week 4, 9, 13, 18
Kinesiophobia
Responding Rate kinesiophobia : Number and percentage of patients presenting a clinically significant improvement in Tampa scale (TSK-17) at the different timepoints versus baseline in the two treatment arms.
Time frame: Around week 4, 9, 13, 18
Pain catastrophizing
Responding Rate pain catastrophization : Number and percentage of patients presenting a clinically significant improvement in Pain catastrophizing scale (PCS) at the different timepoints versus baseline, in the two-treatment arms.
Time frame: Around week 4, 9, 13, 18
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