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Trial registered on ANZCTR
Registration number
ACTRN12617000074392
Ethics application status
Approved
Date submitted
5/11/2016
Date registered
13/01/2017
Date last updated
14/06/2019
Date data sharing statement initially provided
14/06/2019
Date results provided
14/06/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Dry needling and exercise program in the treatment of patients with low back pain.
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Scientific title
Effectiveness of dry needling and a specific exercise program in gluteus medius as treatment of patients with nonspecific mechanical low back pain.
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Secondary ID [1]
290471
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Nonspecific mechanical low back pain
300838
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Condition category
Condition code
Physical Medicine / Rehabilitation
300664
300664
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0
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Physiotherapy
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Musculoskeletal
301032
301032
0
0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
In the first session, in addition of all we´ve explained, the physiotherapy group will valorate the patients according to their kind of low back pattern. In next lines, we will explain the main characteristics of each kind of patron:
- Flexion:
-Pain during flexion-rotation activities, sedestation (like driving), and in semiflexion and complete flexion activities.
-In standing position: loss of low lumbar lordosis, muscular tone of high lumbar back and low dorsal back raised, "flatted ass", high lumbar lordosis, central surcus and prominence of spinal erectors and hip in extenction and external rotation.
-Flexion-relajation phenomenon: patients flex their back and then the erector relaxes
-Sedestation with no pain except when patients make brusquely rotation.
-During prolonged sedestation there is an increase in flexion of low back and pelvis retroversion
-During low back flexion, patients use just 1/2 of the movement of the hip and appearance of great low back kyphosis. They don´t reach the floor with their fingers.
-Active extenction
-Central pain due to prolonged low back extenction and positions of extenction and rotation
-Pain get worst with different activities: running, jumping, swimming and activities that require upper limbs above head
-In standing position: pelvis posterior to thorax, great low lumbar lordosis with central surcus, very curved ass, muscular tone of low back raised, pelvis anteversion (posterosuperior iliac spine above anterosuperior iliac spine) and loss of high lumbar lordosis
-Psoas and spinal erector very active
-Low protruding abdomen
-Hip flexors developed (anterior quadriceps rectum, iliac, tensor fasciae latae…) which generates anterior convexity in the thigh.
-Presence of dimples on sacrum skin
-Inability to maintain semiflexion posture (patients support this by putting their hands on their knees)
-Pasive extenction
-Pain for loss of motor control in extenction
-Passive tendency to extend low back
-Presence of pain in extenction position and during movement or activities in extenction position. Joint pain in activities prolonged in time
-In standing position: Thorax posterior to pelvis, pelvis in retroversión, presence of kyphosis in high lumbar back, collapsed posture.
-Low muscle tone
-Little hip control
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Intervention code [1]
296323
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Rehabilitation
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Intervention code [2]
296608
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Treatment: Other
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Comparator / control treatment
the intervention in control group is the same than in the intervention group, except that, in the first session, instead of dry needling, physiotherapist will perform placebo dry needling by superficial dry needling (the patient will feel the prick but the needle won´t get to gluteus medium or any other muscle)
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Control group
Placebo
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Outcomes
Primary outcome [1]
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nonspecific low back mechanical pain, measured with 100 mm visual analogue scale.
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Assessment method [1]
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Timepoint [1]
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It will be assessed before and after the dry needling procedure in the first session of the intervention, and 1 month, 3 months after the first session of intervention.
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Secondary outcome [1]
328988
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disability caused by nonspecific low back mechanical pain, measured with the Roland Morris Questionnaire.
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Assessment method [1]
328988
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Timepoint [1]
328988
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It will be assessed before and after the dry needling procedure in the first session of the intervention, and 1 month, 3 months after the first session of intervention.
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Eligibility
Key inclusion criteria
- Nonspecific low back mechanical pain
- Adults between 18 and 65 years old.
- Presence of nonspecific low back mechanical pain in the last year
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Patients who underwent surgery in the lumbopelvic or hip región
- Patients who are following a physiotherapist treatment to solve their low back pain.
- Diabetic patients
- Pregnant patients
- Anticoagulated patients
- Patients with belenofobia
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
sealed opaques envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
it was calculated 36 patients at least for participating in the study (18 per group), having in count the stadistic power of 0,95 and an alfa level of 0,05. It will be used the Gpower 3.0.18 software.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
20/11/2018
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Actual
25/05/2017
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Date of last participant enrolment
Anticipated
20/12/2018
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Actual
26/09/2017
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Date of last data collection
Anticipated
20/03/2019
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Actual
21/12/2017
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Sample size
Target
36
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Accrual to date
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Final
47
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Recruitment outside Australia
Country [1]
8374
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Spain
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State/province [1]
8374
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Comunidad de Madrid
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Funding & Sponsors
Funding source category [1]
294885
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University
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Name [1]
294885
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Universidad de Alcala
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Address [1]
294885
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Facultad de Medicina y Ciencias de la Salud – Campus externo Universidad de Alcala, Carretera Madrid-Barcelona Km 33,600, Alcala de Henares (Madrid), Spain.
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Country [1]
294885
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Spain
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Primary sponsor type
Individual
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Name
Daniel Pecos Martin
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Address
Facultad de Medicina y Ciencias de la Salud – Campus externo Universidad de Alcala, Carretera Madrid-Barcelona Km 33,600, Alcala de Henares (Madrid), Spain.
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Country
Spain
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Secondary sponsor category [1]
293722
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None
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Name [1]
293722
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Address [1]
293722
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Country [1]
293722
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296262
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Comite de etica de la investigacion y de experimentacion animal de la Universidad de Alcala
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Ethics committee address [1]
296262
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Colegio de San Ildefonso, Plaza de San Diego s/n 28801, Alcala de Henares (Madrid)
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Ethics committee country [1]
296262
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Spain
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Date submitted for ethics approval [1]
296262
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19/09/2016
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Approval date [1]
296262
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26/09/2016
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Ethics approval number [1]
296262
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CEIM/HU/2016/14
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Summary
Brief summary
The purpose of the study is to demonstrate that the treatment of the gluteus medius reduces nonspecific mechanical low back pain, specially if dry needling and an exercise program are performed instead of just exercise. We hypothesize that the weakness and the presence of trigger points is relationed directly with the low back pain of the patient, so the treatment focused on this muscle should reduce the low back pain level and also the disability. Two randomized groups, of at least 18 patients with low back pain per group, will participate in the study. In the first session, the intervention group will be performed dry needling in gluteus medium, while the control group will be performed placebo dry needling. Both groups will learn an exercise program focused on gluteus medium which must perform for 8 weeks (2 days per week). Outcomes have in count will be level of pain and disability, measured before the first session, after finishing the first session, and 1, 3 and 6 months after the first session.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
1224
1224
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0
/AnzctrAttachments/371782-Comite etica.pdf
(Ethics approval)
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Contacts
Principal investigator
Name
70186
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Mr Jose Enrique Mendez Mera
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Address
70186
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C/Francisco del Pino n32, C.P. 28021 Madrid, Spain.
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Country
70186
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Spain
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Phone
70186
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+34677058261
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Fax
70186
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Email
70186
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[email protected]
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Contact person for public queries
Name
70187
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Jose Enrique Mendez Mera
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Address
70187
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C/Francisco del Pino n32, C.P. 28021 Madrid, Spain.
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Country
70187
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Spain
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Phone
70187
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+34677058261
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Fax
70187
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-
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Email
70187
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[email protected]
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Contact person for scientific queries
Name
70188
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Jose Enrique Mendez Mera
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Address
70188
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C/Francisco del Pino n32, C.P. 28021 Madrid, Spain.
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Country
70188
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Spain
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Phone
70188
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+34677058261
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Fax
70188
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-
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Email
70188
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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