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Randomized Controlled Trial
. 2018 Sep 26;15(1):85.
doi: 10.1186/s12984-018-0423-6.

Sensor-based Postural Feedback Is More Effective Than Conventional Feedback to Improve Lumbopelvic Movement Control in Patients With Chronic Low Back Pain: A Randomised Controlled Trial

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Free PMC article
Randomized Controlled Trial

Sensor-based Postural Feedback Is More Effective Than Conventional Feedback to Improve Lumbopelvic Movement Control in Patients With Chronic Low Back Pain: A Randomised Controlled Trial

Thomas Matheve et al. J Neuroeng Rehabil. .
Free PMC article

Abstract

Background: Improving movement control can be an important treatment goal for patients with chronic low back pain (CLBP). Although external feedback is essential when learning new movement skills, many aspects of feedback provision in patients with CLBP remain currently unexplored. New rehabilitation technologies, such as movement sensors, are able to provide reliable and accurate feedback. As such, they might be more effective than conventional feedback for improving movement control. The aims of this study were (1) to assess whether sensor-based feedback is more effective to improve lumbopelvic movement control compared to feedback from a mirror or no feedback in patients with chronic low back pain (CLBP), and (2) to evaluate whether patients with CLBP are equally capable of improving lumbopelvic movement control compared to healthy persons.

Methods: Fifty-four healthy participants and 54 patients with chronic non-specific LBP were recruited. Both participant groups were randomised into three subgroups. During a single exercise session, subgroups practised a lumbopelvic movement control task while receiving a different type of feedback, i.e. feedback from movement sensors, from a mirror or no feedback (=control group). Kinematic measurements of the lumbar spine and hip were obtained at baseline, during and immediately after the intervention to evaluate the improvements in movement control on the practised task (assessment of performance) and on a transfer task (assessment of motor learning).

Results: Sensor-based feedback was more effective than feedback from a mirror (p < 0.0001) and no feedback (p < 0.0001) to improve lumbopelvic movement control performance (Sensor vs. Mirror estimated difference 9.9° (95% CI 6.1°-13.7°), Sensor vs. Control estimated difference 10.6° (95% CI 6.8°-14.3°)) and motor learning (Sensor vs. Mirror estimated difference 7.2° (95% CI 3.8°-10.6°), Sensor vs. Control estimated difference 6.9° (95% CI 3.5°-10.2°)). Patients with CLBP were equally capable of improving lumbopelvic movement control compared to healthy persons.

Conclusions: Sensor-based feedback is an effective means to improve lumbopelvic movement control in patients with CLBP. Future research should focus on the long-term retention effects of sensor-based feedback.

Trial registration: clinicaltrials.gov NCT02773160 , (retrospectively registered on May 16th, 2016).

Keywords: Feedback; Low back pain; Motor learning; Movement control; Sensors; Technology.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by The Ethics Committees of Hasselt University and Jessa Hospital, Belgium (B243201423040). All participants provided written informed consent before being included in the study.

Consent for publication

Written consent for publication was obtained from the person in the pictures.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Movement control tasks. a Lifting task. b Waiter’s bow
Fig. 2
Fig. 2
Sensor-feedback with an avatar. a The green rectangle is kept on the upper body of the avatar, indicating that the lumbar curvature is maintained. b The green rectangle moves anteriorly to the avatar’s upper body, indicating a lumbar flexion
Fig. 3
Fig. 3
Design and flow of participants through the trial. FB = feedback. a Participants were excluded after the trial, based on their performance on the baseline movement control tasks (exclusion criterion set a priori). Because the performance on the baseline kinematic measurements was calculated after trial completion, all participants were measured post-intervention, but only 44 participants in the low back pain group and 47 participants in the healthy group were included in the final analysis
Fig. 4
Fig. 4
Evolution of the performance on the waiter’s bow in the Sensor groups throughout the intervention. On the Y-axis, the range of motion (ROM) in the lumbar spine is shown in proportion to the baseline ROM. A decrease in ROM indicates an improvement in movement control

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