Active clinical trials for "Low Back Pain"

The objective of the study will be to determine the effects of Sequential Core Stability Corrective Exercise Approach for Alignment and Muscle Function in Lower Crossed Syndrome.

to investigate the effect of pilat mat exercise versus MET on chronic non specific LBP:Randomized controlled trial

The main purpose of this study is to assess the clinical efficiency of an intervention including a short multidisciplinary program of education and rehabilitation and a personalized follow-up, in patients with subacute and chronic low back pain and no severe disability. The secondary objectives are: to assess the capacity of the program to modify and reduce the risk factors for evolution of patients towards a severe disability, to estimate the cost-utility ratio of the intervention.

IIn 2016, chronic low back pain (CLBP) was the leading cause of years lived with disability worldwide. This condition impacts social interactions, work life, and can lead to an altered quality of life for patients. For these patients, physical activity (PA) can reduce pain, improve function and the rate of return to work. According to the French National Authority for Health, it is the main treatment in the management of these patients. Nevertheless, the literature reports PA levels that are relatively comparable to those of the general population. Considering that a large proportion of adults struggle to meet these thresholds, we can infer that the same is true for CLBP patients. In addition to PA, the World Health Organization recommends that all adults should limit the amount of time spent in sedentary behaviors. Thus, CLBP patients should adopt an active lifestyle, characterized by regular PA and limited sedentary behaviors (SB). In view of these elements, it is essential to implement dedicated interventions. The literature reports mixed results with work focused on PA promotion. No study has focused on i) the reduction of CS, ii) the rehabilitation programs (RP) proposed in France. On the other hand, there is a need to better understand what determines engagement in such behaviors. Among these determinants are several psychological variables related to behavioral intentions. A recent line of research indicates that beyond these motivational dimensions, which are explicit in nature, certain implicit processes are significantly associated with the adoption or non-adoption of certain health-related behaviors. This result has been observed in the context of chronic disease (respiratory patients, metabolic patients) but remains unexplored in patients with chronic low back pain. The aim of this study is to simultaneously question these different aspects: the effects of a RP on changes in PA and CS, in relation to motivational changes in a population of CLBP patients.

The purpose of this study is to analyze the effects of an exercise program, based on the Pilates method, on the low back pain and muscle fatigue of Brazilian Air Force helicopter pilots.

The investigators will learn from the study whether actors playing the roles of patients (standardized patients) can help primary care and urgent care clinicians develop skill in offering watchful waiting to patients with acute low back pain as a means of averting low-value spinal imaging. Using patient and physician feedback, this study will refine and evaluate -- in a controlled experiment -- a simulated standardized patient intervention to enhance primary care physician use of watchful waiting when patients request low-value spinal imaging. The long-term goal of this study is to discover communication strategies primary care physicians can use to avert costly, potentially harmful testing while maintaining the patient-doctor relationship.

Over the last years a rising medical need for treatment of chronic pain was identified. Based on previous findings indicating the pain modulating effects of cannabinoids in chronic pain disorders, this clinical trial investigates the efficacy and tolerability of the THC-focused nano endocannabinoid system modulator AP707 in patients with chronic back pain disorders. Patients receive AP707 or placebo over the course of 14 weeks as an add-on to the standard of care. Changes in pain intensity, quality of life and sleep and others measures are monitored through different scales to assess the efficacy of AP707 in patients with chronic back pain.

When the thoracic kyphosis and lumbar lordosis are within a normal range of angular values back pain is less likely to occur. Angular modifications in the physiological curvatures of this sagittal plane have been shown to indicate spinal disorders. For instance, increasing lumbar lordosis and thoracic kyphosis result in higher intradiscal pressure, tension in the spine's passive parts, and creep in the lumbar viscoelastic structures. One of the most important factors of human biomechanics, spinal curvatures provide optimal energy expenditure and movement capacity. Abnormal adaptations in thoracic and lumbar spine biomechanics can cause low back and back pain. Multiple spinal segments are covered by the lumbar erector spinae muscle (LES), which is regarded as a superficial back muscle. LES consists of two muscles, the longissimus thoracis and iliocostalis lumborum. To move the lumbar spine, the lumbar erector spinae muscle (LES) is recruited in a manner that depends on the applied force. It was suggested that patients used LES to compensate for laxity in passive ligamentous structures in an attempt to reduce excessive force on the lumbar spine. Excessive lumbopelvic movements and altered muscle activation patterns are common in patients with low back pain. Researchers have investigated the timing of each muscle's onset and the activity of the LES, and found that patients with low back pain had higher LES activation compared to healthy people. Exercises for strengthening the LES muscle have been performed trunk extension during prone position. Strenghening LES and thoracic extansors may lead to decrease or prevent painful spinal disorders, improve thoracic excessive kyphosis and other complications. Prone trunk extension exercises is used to clinically exercise approcah to activate weak and susceptible to fatigue LES muscle in patients with nonspecific low back pain. This exercise lead to not only strentghening but also lengthening and streching these muscles. To fully understand the effects and underliying the mechanism of this exercise, biomechanical changes in lumbopelvic movement patterns of individuals with kyphotic posture should be examined. Based on current evidence, it is not clear the mechanism that the prone trunk extension exercises is effective on different spinal alignment postures as excessive thoracic khyposis and compansation mechanism on lumbal lordosis. Thus findings from this research may guide clinicians to examine the effects of different prone trunk extension exercises on LES muscles activation. Mitani et al showed that different upper extremity postures effects the lumbal multifudis activations during standing. Brown et al indicated that sit-stand workstations do not change muscle activations of lumbar muscles. Muyor et al concluded that spinal aligment of cyclists affects core muscle activity during cyling. Wattananon et al demonstrated that clinicians should focus on muscle activation patterns rather than the amount of lumbopelvic motion during prone hip extension. Based on the current studies, and to optimally address the underlying mechanism that the main objective was to investigate and show the effects of lumbal lordosis and thoracic kyphosis angles on muscle activations during different low back exercises.

This study relies on the use of a smartphone application (SOMA) that the investigators developed for tracking daily mood, pain, and activity status in acute pain, chronic pain, and healthy controls over four months.The primary goal of the study is to use fluctuations in daily self-reported symptoms to identify computational predictors of acute-chronic pain transition, pain recovery, and/or chronic pain maintenance or flareups. The general study will include anyone with current acute or chronic pain, while a smaller sub-study will use a subset of patients from the chronic pain group who have been diagnosed with chronic low back pain, failed back surgery syndrome, or fibromyalgia. These sub-study participants will first take part in one in-person EEG testing session while completing simple interoception and reinforcement learning tasks and then begin daily use of the SOMA app. Electrophysiologic and behavioral data from the EEG testing session will be used to determine predictors of treatment response in the sub-study.

The study aims to identify metabolites present in intervertebral discs colonized by C. acnes from patients with low back pain and degenerative disc disease, correlating them with their clinical, radiological and demographic profiles.