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Low Back PainNCT03879031

Responsiveness of the Bridge Tests in Non-specific Low Back Pain

An observational study of Low Back Pain, run by University of Bologna at 1 site in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This observational study aims to investigate the internal responsiveness and external responsiveness of the Bridge Tests (supine bridge test, prone bridge test, and side bridge test) in relation to pain and disability, in subjects with subacute and chronic non-specific low back pain submitted to a physical therapy… Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Low Back Pain
What is being tested?
Cluster of Clinical tests to measure lumbar stability
How many people
139 participants
Where
1 siteItaly
Study dates
20 Mar 2019to 30 Nov 2019
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • Adult, Older adult

Study population: All outpatients entering the conservative physical therapy treatment for subacute or chronic non-specific low back pain in a Occupational Medicine Unit are considered eligible.

Who may be able to join

  • Non-specific subacute or chronic low back pain (low back pain from 1 month or more, not related to specific pathologies);
  • Low back pain, with or without irradiation to the lower limb, noted as ≥2 on a scale of 0-10;
  • Good comprehension of written and spoken Italian Language;
  • Informed consent.

Who cannot join

  • Acute low back pain;
  • Specific causes of low back pain (truma, herniated disc, vertebral deformity, fractures, dislocations);
  • Central or peripheral neurologic signs;
  • Systemic pathologies;
  • Rheumatic disorders;
  • Neuromuscular pathologies;
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  • Tumors;
  • Cognitive deficits;
  • Surgical interventions in the last six months prior to the study;
  • Osteoporosis.

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • Policlinico S.Orsola-Malpighi

    Bologna, Emilia-Romagna, 40138

Other trials in Italy

About this study

Official title: Evaluation of the Responsiveness of the Bridge Tests in Subjects With Non-specific Subacute or Chronic Low Back Pain

This observational study aims to investigate the internal responsiveness and external responsiveness of the Bridge Tests (supine bridge test, prone bridge test, and side bridge test) in relation to pain and disability, in subjects with subacute and chronic non-specific low back pain submitted to a physical therapy program.

Read the detailed description

Time 0 (first session of the physical therapy treatment program)

The physical therapist will explain to each patient the purpose of the study and request informed consent and data processing consent. In the informed consent form will be specified that the study will concern some diagnostic tests and the study protocol will not influence the physical therapy treatment strategy in any way. Only those who give their consent will be included in the study and will fill in a booklet containing:

  • socio-demographical, anthropometric and pain data;
  • the Italian version of the Oswestry Disability Index (ODI-I);
  • the Italian version of the 0-100 Numerical Rating Scale (NRS). Once completed, the questionnaires will be placed in a sealed envelope and delivered to the examiner.

The physical therapist will perform the following tests, without being aware of the results collected during the initial clinical evaluation and will record the tests results on a pre-printed sheet, which will then be inserted in the same envelope as well.

The tests performed are (in order of execution):

  • Aberrant Movements (AM) Test,
  • Active Straight Leg Raise (ASLR) Test,
  • Supine Bridge Test (SuBT),
  • Right Side Bridge Test (RBT),
  • Left Side Bridge Test (LBT),
  • Prone Bridge Test (PrBT),
  • Passive Lumbar Extension (PLE) Test,
  • Prone Instability Test (PIT).

The envelope containing the patient's data and the results of the tests will be sent to an independent subject, who will take care of the data collection and their insertion into the electronic database, assigning to each patient a numerical code as the only identification element.

The patients will be submitted to a physical therapy treatment for eight 30-minutes sessions, once a week.

Time 1 (at the end of the last session of the physical therapy treatment)

Those who have completed the physical therapy treatment will receive a final booklet containing the Italian version of the Oswestry Disability Index (ODI-I), the Numerical Rating Scale (NRS) and the Global Perceived Effect (GPE) Questionnaire. Once completed, these questionnaires will be placed in a sealed envelope and delivered to the examiner.

Without being aware of the outcome of the questionnaires contained in the final booklet, the same tests will be repeated:

  • Aberrant Movements (AM) Test,
  • Active Straight Leg Raise (ASLR) Test,
  • Supine Bridge Test (SuBT),
  • Right Side Bridge Test (RBT),
  • Left Side Bridge Test (LBT),
  • Prone Bridge Test (PrBT),
  • Passive Lumbar Extension (PLE) Test,
  • Prone Instability Test (PIT).

Test results will be recorded on a pre-printed sheet, which will then be inserted in the same envelope and send to the independent subject who is responsible for data collection.

Conditions
Low Back Pain
Being tested
Cluster of Clinical tests to measure lumbar stability
Keywords
lumbar, physical endurance, pain, disability, assessment
Medical subject headings
Low Back Pain, Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cluster of Clinical tests to measure lumbar stabilityDiagnostic test

    All subjects will be submitted to a cluster of clinical test before the starting of the first session, and at the ending of the last session of the physical therapy program. This cluster will include:

    • Aberrant Movements (AM) Test,
    • Active Straight Leg Raise Test (ASLR) Test,
    • Supine Bridge Test (SuBT),
    • Right Side Bridge Test (RBT),
    • Left Side Bridge Test (LBT),
    • Prone Bridge Test (PrBT),
    • Passive Lumbar Extension (PLE) Test,
    • Prone Instability Test (PIT).
Study groups in NCT03879031
Study groupRoleWhat they receive
Outpatients with low back painAll outpatients with non-specific subacute or chronic low back pain will be submitted to a physical therapy program including: * information on pain mechanisms and the favorable nature of non-specific low back pain; * advice on positions, movements and activities recommended or advised against in people with low back pain, both at work and during leisure time; * active postural correction exercises, overactive muscles lengthening and weak musculature strengthening; * passive manual techniques, aimed at muscle relaxation and recovery of lumbar joint mobility. A cluster of Clinical tests to measure lumbar stability will be administrated before the starting of the first session and at the ending of the last session of the physical therapy program.
Receives: Diagnostic Test: Cluster of Clinical tests to measure lumbar stability

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes in low back pain over time

    0-100 Numerical Rating Scale (NRS) for low back pain. This scale is arranged to measure the amount of perceived lumbar pain, from 0 (= no pain) to 100 (=maximum pain).

    Measured: Time zero: at baseline - Time one: at the end of the last session of physical therapy treatment (8 weeks after Time zero)

  2. Changes in lumbar disability over time

    Oswestry Disability Index - Italian version (ODI-I). This questionnaire measures disability related to low back pain in 10 different domains (Pain Intensity, Personal Care, Lifting, Walking, Sitting, Standing, Sleeping, Sex Life, Social Life, and Traveling). The patients are asked to identify which of six statements in each domain applies to them at the time of evaluation. The sentences are arranged from no impairment (0) to maximum impairment (5). The scores for each domain are added together (range from 0 to 50) and multiplied by 2 which yields a Disability Index Score percent. If not all items are completed, the score is prorated by averaging the items completed and then multiplying it by 10. A Disability Index Score of 0% to 20% corresponds to minimal disability, 21% to 40% to moderate disability, 41% to 60% to severe disability, 61% to 80% crippled, and 81% to 100% indicates a patient that is either bed-bound or exaggerating their symptoms.

    Measured: Time zero: at baseline - Time one: at the end of the last session of physical therapy treatment (8 weeks after Time zero)

Secondary outcomes (1)
  1. Changes in Global Perceived Effect (GPS) questionnaire (Italian version) over time

    The GPE is composed of one question on a 7-point Likert-type scale, evaluating the subjective self-reported improvement or deterioration after the intervention, from "fully improved" (score 1) to "fully worsened" (score 7). More specificaly, 1=fully improved; 2=much improved; 3=a little improved; 4=no change; 5= a little deterioration; 6=much deterioration; 7=fully worsened. GPE is widely used in the physical therapy literature.

    Measured: At the end of the last session of physical therapy treatment (8 weeks after Time zero)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Mar 2019
  2. Study start20 Mar 2019
  3. Primary completion30 Nov 2019
  4. Study completion30 Nov 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
139 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03879031
Sponsor's protocol ID
1/Bridge
Status last verified
Dec 2019
First submitted
8 Mar 2019
Last updated
19 Dec 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Abbott JH, McCane B, Herbison P, Moginie G, Chapple C, Hogarty T. Lumbar segmental instability: a criterion-related validity study of manual therapy assessment. BMC Musculoskelet Disord. 2005 Nov 7;6:56. doi: 10.1186/1471-2474-6-56.

    PubMed 16274487
  • Alqarni AM, Schneiders AG, Hendrick PA. Clinical tests to diagnose lumbar segmental instability: a systematic review. J Orthop Sports Phys Ther. 2011 Mar;41(3):130-40. doi: 10.2519/jospt.2011.3457. Epub 2011 Feb 2.

    PubMed 21289452
  • Delitto A, George SZ, Van Dillen L, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ; Orthopaedic Section of the American Physical Therapy Association. Low back pain. J Orthop Sports Phys Ther. 2012 Apr;42(4):A1-57. doi: 10.2519/jospt.2012.42.4.A1. Epub 2012 Mar 30.

    PubMed 22466247
  • Durall CJ, Greene PF, Kernozek TW. A comparison of two isometric tests of trunk flexor endurance. J Strength Cond Res. 2012 Jul;26(7):1939-44. doi: 10.1519/JSC.0b013e318237ea1c.

    PubMed 22728944
  • Ferrari S, Manni T, Bonetti F, Villafane JH, Vanti C. A literature review of clinical tests for lumbar instability in low back pain: validity and applicability in clinical practice. Chiropr Man Therap. 2015 Apr 8;23:14. doi: 10.1186/s12998-015-0058-7. eCollection 2015.

    PubMed 25866618
  • Fritz JM, Whitman JM, Childs JD. Lumbar spine segmental mobility assessment: an examination of validity for determining intervention strategies in patients with low back pain. Arch Phys Med Rehabil. 2005 Sep;86(9):1745-52. doi: 10.1016/j.apmr.2005.03.028.

    PubMed 16181937
  • Frymoyer JW, Selby DK. Segmental instability. Rationale for treatment. Spine (Phila Pa 1976). 1985 Apr;10(3):280-6. doi: 10.1097/00007632-198504000-00017.

    PubMed 3992349
  • Habets B, van Cingel RE, Ostelo RW. Reproducibility of a battery of commonly used clinical tests to evaluate lumbopelvic motor control. Phys Ther Sport. 2015 Nov;16(4):331-9. doi: 10.1016/j.ptsp.2015.02.004. Epub 2015 Mar 7.

    PubMed 26254503
  • Hicks GE, Fritz JM, Delitto A, McGill SM. Preliminary development of a clinical prediction rule for determining which patients with low back pain will respond to a stabilization exercise program. Arch Phys Med Rehabil. 2005 Sep;86(9):1753-62. doi: 10.1016/j.apmr.2005.03.033.

    PubMed 16181938
  • Kasai Y, Morishita K, Kawakita E, Kondo T, Uchida A. A new evaluation method for lumbar spinal instability: passive lumbar extension test. Phys Ther. 2006 Dec;86(12):1661-7. doi: 10.2522/ptj.20050281. Epub 2006 Oct 10.

    PubMed 17033040
  • McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehabil. 1999 Aug;80(8):941-4. doi: 10.1016/s0003-9993(99)90087-4.

    PubMed 10453772
  • Mens JM, Huis In 't Veld YH, Pool-Goudzwaard A. The Active Straight Leg Raise test in lumbopelvic pain during pregnancy. Man Ther. 2012 Aug;17(4):364-8. doi: 10.1016/j.math.2012.01.007. Epub 2012 Feb 22.

    PubMed 22365484
  • Ozcan Kahraman B, Salik Sengul Y, Kahraman T, Kalemci O. Developing a Reliable Core Stability Assessment Battery for Patients with Nonspecific Low Back Pain. Spine (Phila Pa 1976). 2016 Jul 15;41(14):E844-E850. doi: 10.1097/BRS.0000000000001403.

    PubMed 26679886
  • Rabin A, Shashua A, Pizem K, Dar G. The interrater reliability of physical examination tests that may predict the outcome or suggest the need for lumbar stabilization exercises. J Orthop Sports Phys Ther. 2013 Feb;43(2):83-90. doi: 10.2519/jospt.2013.4310. Epub 2013 Jan 14.

    PubMed 23321848
  • Schellenberg KL, Lang JM, Chan KM, Burnham RS. A clinical tool for office assessment of lumbar spine stabilization endurance: prone and supine bridge maneuvers. Am J Phys Med Rehabil. 2007 May;86(5):380-386. doi: 10.1097/PHM.0b013e318032156a.

    PubMed 17303961

Questions about this trial

What is this clinical trial studying?

An observational study of Low Back Pain, run by University of Bologna at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Dec 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in low back pain over time (time frame: Time zero: at baseline - Time one: at the end of the last session of physical therapy treatment (8 weeks after Time zero)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03879031, which also lists 19 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Dec 2019.

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