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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
Matheve T, Brumagne S, Demoulin C, Timmermans A
Journal of NeuroEngineering & Rehabilitation 2018 Sep 26;15(85):Epub
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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, ie, 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 versus mirror estimated difference 9.9 degrees (95% CI 6.1 degrees to 13.7 degrees), sensor versus control estimated difference 10.6 degrees (95% CI 6.8 degrees to 14.3 degrees) and motor learning (sensor versus mirror estimated difference 7.2 degrees (95% CI 3.8 degrees to 10.6 degrees), sensor versus control estimated difference 6.9 degrees (95% CI 3.5 degrees to 10.2 degrees). 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).

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