Efficacy of a multidimensional versus usual care physiotherapy on pain and electroencephalography (EEG) spectrum in chronic nonspecific low back pain: study protocol for a randomized controlled trial

Abstract

Background Non-specific chronic low back pain (NSCLBP) is a major public health and global socioeconomic burden associated with a complex interplay of biopsychosocial factors. Despite scientific signs of progress, treatment of NSCLBP often tends to stick to a biomechanical model, without targeting psychological and social factors. To enhance the clinical efficacy of usual physiotherapy for NSCLBP, the development of clinical strategies is to be pursued. This study aims to assess the effectiveness of multidimensional physiotherapy based on a biopsychosocial approach compared to usual care physiotherapy, on clinical findings and electroencephalography spectrum in non-specific chronic low back pain. Methods This study is a triple-blind, two-arm (1:1) randomized controlled trial with a 4 months follow-up. Seventy NSCLBP patients will be randomly allocated to either the experimental (multidimensional physiotherapy) or the active control group (usual physiotherapy); each group will receive 6 weeks of physiotherapy. The main outcome is pain and secondary outcomes are brain function, quality of life, disability, lumbar flexion range of motion, and psychosocial correlates. Assessment will be performed at baseline, post-treatment, and at 1 and 4 months follow-up. Discussion Findings may provide evidence on the effectiveness of multidimensional physiotherapy on clinical findings and brain characteristics and might provide evidence towards showing the role of brain and biopsychosocial factors on chronic pain. Trial registration ClinicalTrials.gov NCT04270422, Registered on 17 February 2020, IRCT Identifier: IRCT20140810018754N11

Pain intensity and Disability of chronic low back pain patients receiving physiotherapy in Cameroon: A call for patients’ awareness to focus on physiotherapy treatment

“…This result corroborates that by Atemkeng et al (15) in Douala Cameroon, who observed a signi cant improvement in pain and mobility of the low back pain patients after 6 weeks of physiotherapy follow-up. Similarly, studies (18) in India and Iran (19) reported signi cant improvement in pain and disability after receiving conventional physiotherapy treatment. However, this result is in contrary to that reported by a systematic review on the effects of physical therapy rehabilitation on chronic non-speci c low back pain.…”

Effect of multidimensional physiotherapy on non-specific chronic low back pain: a randomized controlled trial

“…This study was a 22-week, outcome assessor-blind, randomized, controlled, parallel trial from April 2020 to February 2022. The study protocol has been published previously [39] (Additional le 1). The ethical committee of the Iran University of Medical Sciences (IUMS) approved this study (IR.IUMS.REC.1398.1041).…”

“…EEG signals were recorded under two conditions: three minutes of an eyes-open resting state and 20 seconds of active lumbar forward exion. The absolute and relative (percentage of total EEG power) EEG power spectra analyses of the following frequency domains were calculated: delta (1-3.8 Hz), theta (4.0-7.8 Hz), alpha (8.0-13.8 Hz), beta (14.0-34.8 Hz), and gamma (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50).…”