The study aims to compare the effects of core strengthening versus motor control training on pain, disability \& endurance in patients with low back pain
The study aims to compare the effects of core strengthening versus motor control training on pain, disability \& endurance in patients with low back pain. Comparing core strength and conditioning versus motor control for low back pain on physical and self-report outcomes lies in identifying the most effective treatment approach for this condition. This will help to determine which one yields better results in terms of improving physical function and reducing self-reported pain and disability associated with low back pain. This study can provide valuable insights for clinicians and patients in selecting the most appropriate treatment option.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
74
The Core Strengthening Program participants will have supervised gym-based sessions for 8 weeks. In the first 4 weeks , participants will attend two 1 hour training sessions, followed by self-selected one or two sessions per week. The session will begin with 20min of aerobic conditioning of walking or running on a treadmill, starting at 65% and moving to 85% of HR max. The 5 key elements of focus are i. Centering ii. Breathing iii. Head and neck placement iv. Shoulder placement v. Chest wall placement
Participants in Motor Control group will receive two physiotherapy sessions of 1hour / week in the first 4 weeks, during stage 1. i. Abdominal drawing-in maneuver (ADIM) : isometric contraction of the local stability muscles (e.g., lumbar multifidus, transversus abdominis) in minimally loading positions (supine lying, quadruped, sitting, and standing) by maintaining a neutral spine while maintaining normal breathing. During Phase 2, One 1 hour session / week in the second 4 weeks. Activation and facilitation of transversus abdominis, lumbar multifidus and pelvic floor motor control(36).Exercises target the transversus abdominis, multifidus and pelvic floor muscles plus postural correction to restore optimal motor control during non-weight-bearing activities. Exercises and progressions will follow previous protocols of motor control exercise.
Mediplex Health Care Center
Rawalpindi, Punjab Province, Pakistan
Goniometer
A goniometer will be used to measure ranges of motion of Trunk in Flexion, Extension, lateral Flexion and Rotation
Time frame: 8 weeks
Lower body strength
One-repetition maximum (1-RM) leg press at 70% 1-RM will be used to evaluate lower body strength.
Time frame: 8 weeks
Modified Oswestry disability index
The Oswestry Disability Index is considered one of the best accepted tools for assessment of low back pain. It is a patient-completed questionnaire which gives a subjective percentage score of level of function (disability) in activities of daily living in chronic low back pain. The ODI is made up of 10 items. Each item consist of 6 statements which are scored from 0 to 5. With 0 indicating the least disability and 5 the greatest then the total score is calculated as a percentage, with 0% indicating no disability and 100% indicating the highest level of disability. ODI = (Sum of items scored/Sum of sections answered) X 100
Time frame: 8 weeks
Tampa scale of kinesiophobia
The Tampa Scale of Kinesiophobia (TSK) was first developed in 1991 by R. Miller, S. Kopri, and D. Todd. A self-reported questionnaire that quantifies fear of movement, or (re)injury.It uses a 4-point Likert scale (Strongly Disagree-Disagree-Agree-Strongly Agree).The 17 item TSK total scores range from 17 to 68 where the lowest 17 means no or negligible kinesiophobia, and the higher scores indicate an increasing degree of kinesiophobia.Scores above 37 (17-item) are generally considered to indicate kinesiophobia.
Time frame: 8 weeks
Visual analog scale
The pain VAS is a uni dimensional measure of pain intensity, used to record patients' pain progression, or compare pain severity.Using a ruler, the score is determined by measuring the distance (mm) on the 10-cm line between the "no pain" anchor and the patient's mark, providing a range of scores from 0-100. A higher score indicates greater pain intensity.no pain (0-4 mm), mild pain(5-44 mm), moderate pain (45-74 mm), and severe pain (75-100 mm).Test-retest reliability has been shown to be good and moderate to good reliability for disability in patients with chronic musculoskeletal pain.
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Time frame: 8 weeks
Japanese orthopedic association back pain evaluation questionnaire
The JOABPEQ includes twenty-five questions that are subdivided into five sub scales: lower back pain, lumbar function, walking ability, social life function, and mental health. These questions are Intended to evaluate individuals with low back pain from five different perspectives.scores range from 0 to 100, with higher scores indicating a better patient condition. Both kappa and weighted kappa were more than 0.50 for all but one item, which was 0.48.
Time frame: 8 weeks