title: Effects of postural specific sensorimotor training in patients with chronic low back pain: study protocol for randomised controlled trial.
abstract: BACKGROUND
  Sensorimotor training (SMT) is popularly applied as a preventive or rehabilitative exercise method in various sports and rehabilitation settings. Yet, there is only low-quality evidence on its effect on pain and function. This randomised controlled trial will investigate the effects of a theory-based SMT in rehabilitation of chronic (>3 months) non-specific low back pain (CNLBP) patients.
  
  
  METHODS
  A pilot study with a parallel, single-blinded, randomised controlled design. Twenty adult patients referred to the clinic for CNLBP treatment will be included, randomised, and allocated to one of two groups. Each group will receive 9 x 30 minutes of standard physiotherapy (PT) treatment. The experimental group will receive an added 15 minutes of SMT. For SMT, proprioceptive postural exercises are performed on a labile platform with adjustable oscillation to provoke training effects on different entry levels. The active comparator group will perform 15 minutes of added sub-effective low-intensity endurance training. Outcomes are assessed on 4 time-points by a treatment blinded tester: eligibility assessment at baseline (BL) 2-4 days prior to intervention, pre-intervention assessment (T0), post-intervention assessment (T1), and at 4 weeks follow-up (FU). At BL, an additional healthy control group (n = 20) will be assessed to allow cross-sectional comparison with symptom-free participants. The main outcomes are self-reported pain (Visual Analogue Scale) and functional status (Oswestry Disability Index). For secondary analysis, postural control variables after an externally perturbed stance on a labile platform are analysed using a video-based marker tracking system and a pressure plate (sagittal joint-angle variability and centre of pressure confidence ellipse). Proprioception is measured as relative cervical joint repositioning error during a head-rotation task. Effect sizes and mixed-model MANOVA (2 groups × 4 measurements for 5 dependent variables) will be calculated.
  
  
  CONCLUSIONS
  This is the first attempt to systematically investigate effects of a theory-based sensorimotor training in patients with CNLBP. It will provide analysis of several postural segments during a dynamic task for quantitative analysis of quality and change of the task performance in relation to changes in pain and functional status.
  
  
  BACKGROUND
  Trial registry number on cliniclatrials.gov is NCT02304120 , first registered on 17 November 2014.
authors.affiliation: Department of Health Sciences and Technology, Institute of Human Movement Sciences, ETH Zurich, Wolfgang-Pauli-Strasse 27, Zurich, 8093, Switzerland. m.mccaskey@reha-rhf.ch.|Reha Rheinfelden, Research Department, Salinenstrasse 98, Rheinfelden, 4310, Switzerland. m.mccaskey@reha-rhf.ch.
authors.forename: Michael A
authors.initials: MA
authors.lastname: McCaskey
authors.affiliation: Reha Rheinfelden, Research Department, Salinenstrasse 98, Rheinfelden, 4310, Switzerland. c.schuster@reha-rhf.ch.|Institute of Rehabilitation and Performance Technology, Bern University of Applied Sciences, Pestalozzistrasse 20, Burgdorf, 3400, Switzerland. c.schuster@reha-rhf.ch.
authors.forename: Corina
authors.initials: C
authors.lastname: Schuster-Amft
authors.affiliation: Balgrist University Hospital, Forchstrasse 340, Zurich, 8008, Switzerland. brigitte.wirth@balgrist.ch.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Wirth
authors.affiliation: Department of Health Sciences and Technology, Institute of Human Movement Sciences, ETH Zurich, Wolfgang-Pauli-Strasse 27, Zurich, 8093, Switzerland. eling.debruin@hest.ethz.ch.|Department of Epidemiology, CAPHRI School for Public Health and primary Care, PO Box 616, Maastricht, 6200, Netherlands. eling.debruin@hest.ethz.ch.|Maastricht University, Centre for Evidence Based Physiotherapy, PO Box 616, Maastricht, 6200, Netherlands. eling.debruin@hest.ethz.ch.
authors.forename: Eling D
authors.initials: ED
authors.lastname: de Bruin
mesh_terms: D059350:Chronic Pain / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D002985:Clinical Protocols; D004185:Disability Evaluation; D056228:Feedback, Sensory; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D010147:Pain Measurement; D017288:Pain Threshold; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D011187:Posture; D011434:Proprioception; D012107:Research Design; D057566:Self Report; D016037:Single-Blind Method; D013557:Switzerland; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording