The Effect of Body Awareness on Pain, Disability, Sensorimotor Acuity, Psychosocial and Central Sensitization Levels in Individuals With Non-Specific Chronic Low Back Pain

Condition(s) studied

Investigational drug(s) / intervention(s)

No intervention: No intervention applied, observational study.

Study summary

This study will be conducted to examine the levels of pain, pressure pain threshold, joint position sense, sensation, functionality, pain catastrophizing, central sensitization, and body awareness in individuals with non-specific chronic low back pain, and to compare these findings with those of healthy individuals. Additionally, the study will aim to objectively investigate the relationships between lumbar self-perception (FreBAQ) and tactile acuity (TPDT), pressure pain threshold (PPT), lumbar joint position sense (LJPS), as well as psychosocial (PCS) and central sensitization (CSI) indicators in individuals with non-specific chronic low back pain. Furthermore, the study will seek to evaluate the predictive effects of lumbar self-perception on pain (VAS) and disability (RMDQ), in conjunction with objectively assessed sensory and sensorimotor measures in individuals with non-specific chronic low back pain.

Eligibility

Primary outcome measure(s)

• Central sensitization levels — Baseline.
  Central Sensitization levels will be assessed using the Central Sensitization Inventory (CSI). The CSI consists of 25 items that evaluate somatic and emotional health-related symptoms commonly observed in conditions associated with central sensitization. Each item is rated on a 5-point temporal Likert scale with the following numerical options: Never (0), Rarely (1), Sometimes (2), Often (3), and Always (4). The total score ranges from 0 to 100. Higher scores indicate greater symptom severity (15).
• Body awareness levels — Baseline.
  Body awareness level will be assessed using the Fremantle Back Awareness Questionnaire (FBAQ). The FBAQ is a questionnaire that assesses body awareness related to the low back. The questionnaire consists of nine questions. Each item is scored from 0 to 4. The FBFQ total score ranges from 0 to 36. Higher scores indicate greater disruption in low back-specific body awareness.
• Tactile acuity of the lumbar region — Baseline.
  Tactile acuity of the lumbar region will be assessed using the Two-Point Discrimination Test (TPDT) with a mechanical esthesiometer. The TPDT consists of three ascending and three descending series for the right and left sides. The TPDT score is calculated as the average of three ascending and three descending thresholds for each side. The right and left TPTD values are then averaged, and the left ascending and left descending values are then averaged. The right and left TPDT values are then averaged to obtain a total TPDT score representing the overall tactile acuity of the lumbar spine.Lower values indicate better tactile acuity.
• Lumbar joint position sense — Baseline.
  Lumbar joint position sense (LJPS) will be measured using with digital electrogoniometer. LJPS errors will be recorded in degrees during lumbar flexion, extension, and left and right lateral flexion movements, and these values will be used as an estimate of lumbar proprioceptive accuracy. Each test will be repeated three times, and the average of the three trials was used for analysis. Repositioning errors will be calculated as the difference between the actual angle and the target angle in degrees.Greater absolute repositioning errors demonstrate poorer lumbar position sense.
• Pressure Pain Threshold (PPT) — Baseline.
  Pressure pain thresholds (i.e., the minimum pressure point that causes an unpleasant sensation) will be measured using a handheld pressure algometer with a 1 cm2 circular probe surface that allows measurement of pressure force up to 10 kg (Baseline®, 22 lbs × 1⁄4 lb and 10 kg ×). The measurement points will be bilaterally, 2 cm lateral to the L5 spinous process and the plantar side of the second toe. Three measurements will be taken at 30-second intervals for each area, and the average of these three measurements will be used for data analysis. Higher algometer values indicate an increased pressure pain threshold. Data will be recorded in kg/cm².
• Pain levels — Baseline.
  Participants pain levels will be measured using Visual Analog Scale (VAS). Participants will be asked to rate the intensity of pain they have experienced over the past week. A 10-cm continuous line will be presented, with one end labeled 'No pain at all' and the other end labeled 'Unbearable pain.' Participants will be asked to mark the level of their pain intensity on a 10-cm horizontal line with '0' at the beginning and '10' at the end. The marked location will then be measured using a ruler and recorded in centimeters. On the Visual Analog Scale (VAS), higher scores indicate greater pain intensity.
• Functionality — Baseline.
  The Roland Morris Disability Questionnaire (RMDQ) will be used to measure participants functional limitations. The RMDQ is a 24-item questionnaire that assesses normal activities of daily living. Participants will be asked to mark the items they found difficult to perform due to their chronic low back pain. Each response is scored as "no" (difficulty = 0 points) or "yes" (difficulty = 1 point). Total scores range from 0 to 24, with higher scores indicating more severe disability.
• Catastrophization levels — Baseline.
  The Pain Catastrophizing Scale (PCS) will be used to assess the catastrophizing levels of the participants. The PCS consists of 13 items that measure catastrophic thinking and maladaptive responses to pain, and includes three subscales assessing helplessness, magnification, and rumination. For each item, participants will be asked to choose one of the following options: none = 0, mild = 1, moderate = 2, considerable = 3, or always = 4. The PCS total score ranges from 0 to 52, with higher scores indicating more destructive thoughts and feelings related to pain.

Trial sites (1)

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