Effects of GPR on Non-Specific Chronic Low Back Pain
ConditionLow Back Pain
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-55
SponsorFederal University of Bahia
About this trial
Introduction: Low back pain affects approximately 18.5% of the Brazilian population in adulthood, significantly impacting the quality of life and generating substantial costs for the health system. The Global Postural Reeducation Method (GPR) is a promising therapeutic alternative due to its multidimensional approach, capable of improving postural control and reducing pain. Objectives: to evaluate the Efficacy of the RPG method compared to simulated RPG (SHAM) in treating patients with chronic nonspecific low back pain. Methods: Randomized sham-controlled clinical trial. Forty-two adult individuals with chronic nonspecific low back pain will be recruited and distributed into two groups: the Experimental Group (EG), which will receive GPR sessions, and the Control Group (CG), which will receive RPG-SHAM sessions. Both groups will be treated for 30 minutes once a week for 8 weeks. Descriptive analysis will be performed, continuous variables will be summarized to the mean, and standard deviation and categorical variables will be summarized as absolute and relative frequencies. To assess the effects of the intervention over team, analysis of variance (ANOVA) with repeated measures will be used, with a significance level of 5% (p \< 0.05). Expected Results: This study is expected to provide robust evidence on the effectiveness of RPG in treating patients with low back pain, contributing to a better understanding of this complex health condition. The results will potentially positively impact the clinical practice of Orthopedic Physiotherapy, offering an exercise-based and accessible approach for treating patients with low back pain.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Adults aged between 18 and 55 years with chronic non-specific low back pain,
Participants who voluntarily agree to participate and sign the Free and Informed Consent Form,
Participants who have never done any treatment with the GPR method, and
Participants who have not been undergoing physiotherapy treatment for at least 2 months.
Disqualifiers
Patients with pain lumbar acute, or it is, with symptoms gifts there is less of dose weeks, what carried out blocking medicinal in the column us last six months;
Patients with hernia of disk of type extruded and/or kidnapped;
Patients in possess or be in investigation of any kind of neoplasia;
Patients who have undergone any type of surgery with placement of any type of prosthesis in the spine;
Trial design
Design model
Parallel
Treatments tested in this trial
Global Postural Reeducation
Procedure/SurgeryGlobal Postural Reeducation, better known as GPR, was developed by Philippe Souchard in the 1980s and involves a sequence of postures or treatment positions, including the main ones: frog on the ground with arms open; frog on the ground with arms closed; frog in the air with arms open; frog in the air with arms closed; standing against the wall; standing at the center; anterior tilt sitting; anterior tilt standing. GPR is based on the concept of proprioception and inhibition. Souchard (2016) describes RPG as a proprioceptive method of inhibition, where proprioception refers to the body's ability to perceive its position in space, and inhibition refers to the muscle relaxation induced after intense contraction. This principle is applied through the postures and techniques used in treatment, aiming to correct postural deviations, promote one bigger conscious body, and relieve pain.
Global Postural Reeducation Sham
Procedure/SurgeryGlobal Postural Reeducation Sham is the comparator group.
Treatment groups
42 Participants
are divided into 2 treatment groupsGroup A: Experimental Group (EG) - GPRExperimental treatment 2 interventions
Group B: Control Group (CG) - GPR-SHAMSham comparator 2 interventions
Trial outcomes
Primary outcomes
1
Pain Gradiation
Pain will be assessed three times: at rest, after a short walk, and during stem flexion using the Scale Visual Analog (EVE). This scale consists of a graduated horizontal line from 0 to 10, where 0 (zero) represents absence of pain and 10 (ten) represents maximum unbearable pain. Higher scores mean greater pain intensity.
Time frame
pre and post eight weeks of intervention.Secondary outcomes
1
Range of motion (ROM) of the spine (Adams test)
The Adams test will be used to assess the range of motion during the spine flexion. The physiotherapist will ask the patient to stand barefoot, with feet hip-width apart and knees extended. Then, the physiotherapist will request one flexion before the stem, keeping the legs extended and avoiding compensations while the head and your shoulders remain relaxed. If the patient cannot touch the floor with their hands, the distance from the middle finger to the floor will be measured and recorded using a standard tape measure. Greater ranges of motion mean greater mobility of the evaluated segment.
Time frame
pre and post eight weeks of intervention.2
Range of motion (ROM) of the spine (Inclinometer)
This instrument measures the inclination of a body segment relative to gravity, providing accurate data on joint mobility. To measure trunk rotation, the physical therapist will place the inclinometer on the patient's sternum, asking them to rotate the trunk as much as possible to both sides while the pelvis remains fixed. In the assessment of trunk flexion, the inclinometer will be placed on the upper part of the sacrum, and the patient will be instructed to lean forward as much as possible, keeping the knees extended. The inclinometer will remain in the same position for spine extension, and the patient will be requested to lean back as much as possible. The readings of the angles in each one of these positions will be recorded and compared to assess a range of motion and identify potential limitations or asymmetries. Greater ranges of motion mean greater mobility of the evaluated segment.
Time frame
pre and post eight weeks of intervention.3
Postural Organization (photogrammetry)
The photos will be registered in the views front anterior and posterior, right and left lateral, following specific anatomical references. To meet the research objectives, additional markings will be added to the vertebrae with a circular sticker of 19mm in diameter in the colors green, lemon, or pink: seventh cervical, first and seventh thoracic, fourth and fifth lumbar.
Time frame
pre and post eight weeks of intervention.4
Activity and participation assessment - World Health Organization Disability Assessment Schedule (WHODAS 2.0)
Assessment Schedule (WHODAS 2.0) will be used to assess patients' activities and participation. This tool consists of 36 items grouped into six main domains: cognition, self-care, interpersonal relationships, daily living activities, and social participation (CASTRO et al., 2019). Scores range from 0 to 100, with higher scores indicating greater functional limitation. The WHODAS 2.0 score ranges from 0 to 40, where higher values indicate greater disability.
Time frame
pre and post eight weeks of intervention.Other outcomes
1
The perceived overall effect - Likert Scale
To assess the perceived overall effect, the physiotherapist will ask the following question: "Compared to the beginning of the treatment, how would the participant describe your lower back today?" The patient will respond using the Likert Scale. Higher scores indicate greater satisfaction.
Time frame
post eight weeks of intervention.Sponsors and contacts
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Source ClinicalTrials.gov