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Completed

NCT Number: NCT00864422

Changes in Motor Cortex Following Exercises for Chronic Low Back Pain

The motor cortex of the brain changes following chronic pain and injury, and this is linked to pain-associated changes in motor behaviour. This study aimed to investigate whether therapeutic exercises in patients with chronic pain can induce reorganisation of the motor cortex and restore normal motor behaviour. The investigators hypothesised that motor training can induce reorganisation of the motor cortex and that these changes are related to improved motor behaviour.

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Key information

Conditions

Chronic Low Back Pain Back Pain Low Back Pain Neurologic Manifestations Pain Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

18 year–55 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Centre for Clinical Research Excellence in Spinal Pain, Injury and Health

Brisbane, Queensland, 4072, Australia

About this study

The sensory and motor systems can reorganize following injury and learning of new motor skills. Recently we observed adaptive changes in motor cortical organization in patients with chronic back pain, which are closely linked to changes in motor behavior. Although pain-related alterations in behavior can be trained and are associated with improved symptoms, it remains unclear whether these meaningful functional outcomes are related to motor cortical reorganization. Here we investigate the effects of two interventions in people with chronic back pain: skilled motor training and a control intervention of self-paced walking exercise. We measured motor cortical excitability (motor threshold (MT)) and organization (center of gravity (CoG) and map volume) of the deep abdominal muscle, transversus abdominis (TrA), using transcranial magnetic stimulation (TMS). In addition, motor behavior of TrA was assessed during single rapid arm movements. The study helps to elucidate the mechanisms of specific motor exercises in chronic back pain management.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Sustained or episodic non-specific low back pain lasting longer than 3 months

Exclusion criteria

  • Orthopaedic, neurological, circulatory or respiratory conditions
  • History or family history of epilepsy
  • Recent or current pregnancies
  • Previous surgery to the abdomen or back
  • Abdominal or back exercises in the preceding 12 months

Treatment and study plan

Skilled motor training

Behavioral

This involves training subjects to independently and cognitively activate the deep abdominal muscles, transversus abdominis, with minimal or no activity in other trunk muscles. The contraction is held for 10 seconds and subjects complete three blocks of ten contractions, twice per day for two weeks. This training protocol is commonly used clinically for people with chronic back pain.

Walking exercise

Behavioral

The control intervention involves walking exercises for ten minutes, twice per day. Subjects are advised to walk at their own pace with no instructions on activation of specific trunk muscles. The exercise is performed over two weeks.

Primary outcomes

  1. Motor cortical map and excitability from transcranial magnetic stimulation

    Time frame: Pre and 2 weeks post-intervention

Secondary outcomes

  1. Motor activation of the abdominal muscles during functional arm movement task

    Time frame: Pre and 2 weeks post-intervention

  2. Self-reported pain (VAS scale) and functional scale (patient-specific functional scale)

    Time frame: Pre and 2 weeks post-intervention

Sponsors and collaborators

Lead sponsor

The University of Queensland

Other

Registry information

Official study title

Driving Plasticity in the Motor Brain in Chronic Back Pain

Important dates

Study start
2006
Primary completion
2007
Study completion
2007
First posted
Mar 18, 2009
Registry last updated
Mar 18, 2009

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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