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Trial registered on ANZCTR
Registration number
ACTRN12622001195741
Ethics application status
Approved
Date submitted
1/08/2022
Date registered
6/09/2022
Date last updated
7/07/2023
Date data sharing statement initially provided
6/09/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Development of accurate assessment methods to complement existing Clinical Pilates assessment method among adults with chronic low back pain
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Scientific title
Development of objective outcome measures for Clinical Pilates assessment for chronic low back pain
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Secondary ID [1]
307690
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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:
Chronic low back pain
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Condition category
Condition code
Musculoskeletal
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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
Participants will be prescribed exercises according to Dance Medicine Australia (DMA) Clinical Pilates method (supported by Australian Physiotherapy Association). A physiotherapist will be supervising the session, one-on-one. This is a single session intervention of 30 minutes (inclusive of directional preference assessment). The mat-based exercises prescribed will be specific for each participant based on his/her movement directional preference to achieve physical performance improvements. The exercises will be of low to moderate exercise intensity, measured with RPE 10-point scale.
Examples of flexion preference exercises include cat stretch, bug legs and scissors, while examples of extension preference exercises include bridging, prone single leg kick and quadruped (leg). Lateral flexion preference exercises include mermaid and side lunges. Rotation preference exercises include bug roll (flexion) and attitude rotation (extension).
The new assessment method involves the use of portable force plate to quantify the postural sway of a person between left and right leg single-leg squat performance (5 times on each side). This could help to assist in more accurate (objective) identification of side impairment as compared to traditional observations made by a clinician/assessor that is dependent on years of clinical experience (subjective). This would also allow the understanding of the clinical pilates method of side impairment identification which at times can be different from routine interpretation, for example better performance of single-leg squat on the left than the right may not always mean that the left is not the side with impairments.
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Intervention code [1]
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Rehabilitation
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Centre of pressure postural sway parameters for 5 repetitions of single-leg squat, assessed using force plate.
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Assessment method [1]
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Timepoint [1]
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Single session, assessed pre- and post-implementation of prescribed exercises.
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Primary outcome [2]
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Modified-modified schober test for lumbar spine flexion flexibility (range of motion).
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Assessment method [2]
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Timepoint [2]
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Single session, assessed pre- and post-implementation of prescribed exercises.
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Primary outcome [3]
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Hamstrings muscle length test (90-90) using handheld goniometer to quantify knee flexion angle.
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Assessment method [3]
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Timepoint [3]
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Single session, assessed pre- and post-implementation of prescribed exercises.
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Secondary outcome [1]
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Pain visual numeric scale (VNS) score
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Assessment method [1]
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Timepoint [1]
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Single session, assessed pre- and post-implementation of prescribed exercises.
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Eligibility
Key inclusion criteria
- Pain in the lower back with and without lower limb symptoms on most days of the week;
- Pain in the lower back for >3 months (chronic);
- Average pain in the past week greater than or equal to 4 points rated on the 11-point pain numeric rating scale (0 = no pain); and
- Understands written and spoken English.
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Minimum age
21
Years
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Maximum age
40
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
- Recent spinal surgery (past 6 months);
- On-going fever or infection;
- Unexplained weight loss (>5% body weight) or loss of appetite;
- Malignant cancer or received cancer intervention in the past 6 months;
- Cauda equina lesion, complete loss of bladder or bowel control, or saddle paresthesia;
- Known pregnancy at point of screening;
- Recent spinal fractures (past 3 months);
- Spinal inflammatory disease such as ankylosing spondylitis and rheumatoid arthritis; or
- Recent exercise intervention for managing low back pain (past 6 months).
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
Correlation: Relationship between primary outcome measures with Clinical Pilates physical performance ratings (0 to 5).
Qualitative analyses: To explore musculoskeletal case complexity classification.
Paired sample t-test: To determine effect size of DMA Clinical Pilates intervention when intervention is individualised.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
31/10/2022
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Actual
19/11/2022
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Date of last participant enrolment
Anticipated
28/02/2023
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Actual
15/06/2023
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Date of last data collection
Anticipated
3/03/2023
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Actual
15/06/2023
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Sample size
Target
44
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Accrual to date
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Final
40
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Recruitment outside Australia
Country [1]
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Singapore
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State/province [1]
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Singapore
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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None
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Address [1]
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None
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Country [1]
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Primary sponsor type
University
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Name
National Institute of Education
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Address
1 Nanyang Walk Singapore 637616
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Country
Singapore
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
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None
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Country [1]
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Other collaborator category [1]
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University
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Name [1]
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Singapore Institute of Technology
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Address [1]
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10 Dover Dr Singapore 138683
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Country [1]
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Singapore
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Nanyang Technological University - Institutional Review Board
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Ethics committee address [1]
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Research Integrity and Ethics Office (RIEO) 62 Nanyang Drive Blk N1.2, B1-02A Singapore 637459
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Ethics committee country [1]
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Singapore
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Date submitted for ethics approval [1]
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02/09/2022
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Approval date [1]
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12/10/2022
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Ethics approval number [1]
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IRB-2022-492
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Summary
Brief summary
The key to the Clinical Pilates framework is to correctly identify a patient’s directional preference such that specific exercises can be prescribed. The current methods used by physiotherapist to assess directional preference rely on medical history, observation and clinical assessment. These approaches can be subjective and challenging for junior physiotherapists who have less clinical experience. To complement the current practice which requires strong clinical expertise, this study aims to develop objective methods to identify the directional preference of individual patients. In specific, we will evaluate the postural control using biomechanical instrumentation to quantify the quality of movement. It is hypothesized that the postural sway parameters during single-leg squats will correspond well with clinical ratings and assessment of directional preference.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Kong Pui Wah (Veni)
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Address
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National Institute of Education
Nanyang Technological University
1 Nanyang Walk Singapore 637616
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Country
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Singapore
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Phone
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+6562196213
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Kwok Boon Chong
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Address
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Singapore Institute of Technology
10 Dover Dr Singapore 138683
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Country
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Singapore
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Phone
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+6562053794
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Kwok Boon Chong
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Address
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Singapore Institute of Technology
10 Dover Dr Singapore 138683
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Country
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Singapore
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Phone
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+6562053794
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Fax
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Email
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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)?
No
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No/undecided IPD sharing reason/comment
Requirements of personal data protection act in Singapore
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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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