CClinicalTrials.gg
CompletedNCT04266366Updated Nov 30, 2022

Cost- Effectiveness of a Face-to-Face Rehabilitation Program vs an Telemedicine Program in Chronic Low Back Pain

An interventional study of Face-to-Face Rehabilitation program and Telemedicine program in Low Back Pain, sponsored by Universidad de Almeria. Completed at 1 site in Spain. Open to participants aged 30 Years to 67 Years. Per ClinicalTrials.gov, last updated 2022-11-30.

Sponsored by Universidad de Almeria · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
540
Allocation
Randomized
Ages
30 Years to 67 Years
Sex
All
01

Study summary

Perform a cost-utility analysis in patients with chronic low back pain through electroanalgesia treatment and exercises administered by telemedicine program versus face-to-face program

Read the detailed description

A double blind clinical trial will be developed in a sample of 80 subjects with chronic low back pain. Patients will receive 3 weekly sessions of electroanalgesia and an exercise program for 8 weeks, for a total of 24 sessions. The aim is to analyze the cost- effectiveness of a face-to- face rehabilitation program vs a telemedicine program on disability, pain, fear of movement, quality of life, resistance of the trunk flexors, lumbar mobility in flexion and muscular electrical activity.

02

Conditions studied

  • Low Back Pain

Keywords

  • Low back pain
  • Electroanalgesia
  • McKenzie Method
  • Telemedicine
  • Study protocol for a Randomized clinical trial
03

In context

Back Pain

2,373 studies on the registry are indexed under Back Pain; 284 are open to participants now.

This study's enrollment of 540 is above the median of 60 across 1,941 interventional studies indexed under Back Pain.

Browse Back Pain studies →

Lead sponsor

Universidad de Almeria is the lead sponsor of 71 studies on the registry; 11 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
30 Years to 67 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Low back pain ≥ 3 months.
  • Age between 30 and 67 years old.
  • Not being receiving physical therapy.

Exclusion criteria

Exclusion Criteria:

  • Presence of lumbar stenosis.
  • Diagnosis of spondylolisthesis.
  • Diagnosis of fibromyalgia.
  • Treatment with corticosteroids or oral medication in recent weeks.
  • History of spine surgery.
  • Contraindication of analgesic electrical therapy.
  • Have previously received a treatment of electrical analgesia or exercise.
  • Central or peripheral nervous system disease.
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
540 participants (actual)

Study arms

  • Active comparator
    Face-to Face rehabilitation program

    Electroanalgesia therapy and the McKenzie exercise protocol will be applied by six therapists with more than 10 years of experience. This program will be developed in the rehabilitation service of the study health centers. Patients will perform the treatment 3 times per week, for 4 weeks, with a total of 24 sessions

    Other: Face-to-Face Rehabilitation program

  • Experimental
    Telemedicine Program

    It consists in a support system for the treatment of chronic low back pain based on web technologies. The system can register a subject and provide a treatment of electroanalgesia and exercise through the Mckenzie method. Video applications of electroanalgesia and exercises will be shown to patients who use their computer or mobile device to access the platform through the Internet. The treatments will be recommended by the system based on the database that is configured to accommodate the application of electroanalgesia and McKenzie exercises based on the diagnosis according to the McKenzie method.patients will perform the treatment 3 times per week, for 8 weeks, with a total of 24 sessions

    Other: Telemedicine program

Interventions

  • OtherFace-to-Face Rehabilitation program

    In each hospital, two trained therapists will carry out a face-to-face rehabilitation program consisting of electroanalgesia and an exercise program that follows the Mckenzie method. The physiotherapists place the electrodes in the patients, for this they use 5x9 cm electrodes, which they place at the bilateral paravertebral level, in the patients who present with radicular pain, the electrodes will be placed in the path of the affected nerve. The duration will be sufficient to carry out the Mckenzie protocol. Mckenzie exercises are designed to make changes in the internal periarticular components of the spine.

  • OtherTelemedicine program

    It consists in an e-Health rehabilitation program through a web platform performing electroanalgesia and an exercise program following the Mckenzie method. Patients will be instructed in the use of the TENS device using 5x9cm electrodes at the bilateral paravertebral level, the patients that present radicular pain, the electrodes will be placed in the path of the affected nerve. The realization of exercises will be through the application of an Mckezie protocol. The duration will be the same as that used to carry out the Mckenzie protocol. Mckenzie exercises are designed to make changes in the internal components periarticular of the spine.

06

What researchers measure

Primary outcomes

  1. Change from baseline in Roland Morris Disability Questionnaire (RMDQ).

    This is a self-reported questionnaire consisting in 24 items reflecting limitations in different activities of daily living attributed to low back pain including walking, vending over, sitting, lying down, dressing, sleeping, self-care and daily activities.Ranging from 0 points- better to 24 points- worse disability

    Time frame: At baseline, at 8 weeks and at 6 months

Secondary outcomes

  1. Change from baseline in disability. Oswestry Low Back Pain Disability Idex.

    It has 10 items associated to activities of daily living, each ítem has a puntuation fron 0 to 5 points.The higher scores mean a worse outcome.

    Time frame: At baseline, at 8 weeks and at 6 months.

  2. Change from baseline in pain intensity. Visual analogue scale.

    A 10-point Numerical Pain Scale (0: no pain, 10: maximum pain) assesses the intensity of pain. Range from no pain 0 to maximum pain 10 points

    Time frame: At baseline, at 8 weeks and at 6 months

  3. Change from baseline in Fear of Movement. Tampa Scale of kinesiophobia.

    Is a 17-item questionnaire that measures the fear of movement and (re)injury.Patient rate beliefs about their kinesiophobia on a 4-point scale ranging from strongly disagree to strongly agree.

    Time frame: At baseline, at 8 weeks and at 6 months

  4. Change from baseline on Quality of Life. SF-36 Health questionnaire.

    SF-36 Health questionnaire scores range from 0 to 100% and indicate the self-perceived health-related quality of life.

    Time frame: At baseline, at 8 weeks and at 6 months

  5. Change from Mcquade Test

    It measures the isometric endurance of trunk flexion muscles.

    Time frame: At baseline, at 8 weeks and at 6 months

  6. Change from baseline in lumbar mobility flexion.

    For the quantification of lumbar flexion an angular inclinometer is used (Fleximeter UM 8320-3 RJ Code Research Institute, Brazil).

    Time frame: At baseline, at 8 weeks and at 6 months

  7. Changes from baseline in Lumbar electromyography.

    The degree of electromyographic activation of the lumbar paravertebral musculature will be carried out by using a set of electrodes of 3x7 dimensions that will be applied uniformly in the lumbar region from the spinal level from L2 to L5.

    Time frame: At baseline, at 8 weeks and at 6 months

  8. Change from baselina in range of motion

    This variable is quantified using the SpinalMouse ® device (Phisiotech, Spain). It is an electronic computer-aided measuring device that measures sagittal spinal amplitude of movement (ROM) and intersegmental angles in a non-invasive way.

    Time frame: At baseline, at 8 weeks and at 6 months

  9. Change from baselina in lumbar segmental mobility

    This variable is quantified using the SpinalMouse ® device (Phisiotech, Spain). It is an electronic computer-aided measuring device that measures sagittal spinal amplitude of movement (ROM) and intersegmental angles in a non-invasive way.

    Time frame: At baseline, at 8 weeks and at 6 months

  10. Change from baseline in indirect non-medical costs

    sick leave days due to low back pain and labor absenteeism costs in terms of workdays lost due to illness at salary level.

    Time frame: At baseline, at 8 weeks and at 6 months

  11. Change from baseline in direct medical costs

    costs of visits to primary care, emergency visits, home help received as a result of disability related to LBP, diagnostic tests and pharmaceutical products

    Time frame: At baseline, at 8 weeks and at 6 months

  12. Change from baseline direct non-medical costs

    The patient expenses in transportation

    Time frame: At baseline, at 8 weeks and at 6 months

07

Study locations

1 site
  • Universidad de Almería
    Almería, Andalucía 04120, Spain
08

References and documents

Publications

  • Von Korff M, Moore JC. Stepped care for back pain: activating approaches for primary care. Ann Intern Med. 2001 May 1;134(9 Pt 2):911-7. doi: 10.7326/0003-4819-134-9_part_2-200105011-00016. PubMed 11346328 ↗
  • Schaafsma FG, Whelan K, van der Beek AJ, van der Es-Lambeek LC, Ojajarvi A, Verbeek JH. Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with back pain. Cochrane Database Syst Rev. 2013 Aug 30;2013(8):CD001822. doi: 10.1002/14651858.CD001822.pub3. PubMed 23990391 ↗
  • Becker A, Held H, Redaelli M, Strauch K, Chenot JF, Leonhardt C, Keller S, Baum E, Pfingsten M, Hildebrandt J, Basler HD, Kochen MM, Donner-Banzhoff N. Low back pain in primary care: costs of care and prediction of future health care utilization. Spine (Phila Pa 1976). 2010 Aug 15;35(18):1714-20. doi: 10.1097/brs.0b013e3181cd656f. PubMed 21374895 ↗
  • Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 2008 Jan-Feb;8(1):8-20. doi: 10.1016/j.spinee.2007.10.005. PubMed 18164449 ↗
  • GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053):1545-1602. doi: 10.1016/S0140-6736(16)31678-6. Erratum In: Lancet. 2017 Jan 7;389(10064):e1. doi: 10.1016/S0140-6736(16)32606-X. PubMed 27733282 ↗
  • Froud R, Patterson S, Eldridge S, Seale C, Pincus T, Rajendran D, Fossum C, Underwood M. A systematic review and meta-synthesis of the impact of low back pain on people's lives. BMC Musculoskelet Disord. 2014 Feb 21;15:50. doi: 10.1186/1471-2474-15-50. PubMed 24559519 ↗
  • Palacin-Marin F, Esteban-Moreno B, Olea N, Herrera-Viedma E, Arroyo-Morales M. Agreement between telerehabilitation and face-to-face clinical outcome assessments for low back pain in primary care. Spine (Phila Pa 1976). 2013 May 15;38(11):947-52. doi: 10.1097/BRS.0b013e318281a36c. PubMed 23238489 ↗
  • Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G; COST B13 Working Group on Guidelines for Chronic Low Back Pain. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006 Mar;15 Suppl 2(Suppl 2):S192-300. doi: 10.1007/s00586-006-1072-1. No abstract available. PubMed 16550448 ↗
  • Jensen CE, Riis A, Petersen KD, Jensen MB, Pedersen KM. Economic evaluation of an implementation strategy for the management of low back pain in general practice. Pain. 2017 May;158(5):891-899. doi: 10.1097/j.pain.0000000000000851. PubMed 28114182 ↗
  • Petersen T, Kryger P, Ekdahl C, Olsen S, Jacobsen S. The effect of McKenzie therapy as compared with that of intensive strengthening training for the treatment of patients with subacute or chronic low back pain: A randomized controlled trial. Spine (Phila Pa 1976). 2002 Aug 15;27(16):1702-9. doi: 10.1097/00007632-200208150-00004. PubMed 12195058 ↗
  • Khadilkar A, Milne S, Brosseau L, Robinson V, Saginur M, Shea B, Tugwell P, Wells G. Transcutaneous electrical nerve stimulation (TENS) for chronic low-back pain. Cochrane Database Syst Rev. 2005 Jul 20;(3):CD003008. doi: 10.1002/14651858.CD003008.pub2. PubMed 16034883 ↗
  • Castro-Sanchez AM, Mataran-Penarrocha GA, Gomez-Garcia S, Garcia-Lopez H, Andronis L, Albornoz-Cabello M, Lara Palomo IC. Study protocol randomised controlled trial comparison of cost-utility and cost-effectiveness of a face-to-face rehabilitation programme versus a telemedicine programme in the treatment of patients with chronic low back pain. BMJ Open. 2020 Dec 12;10(12):e040633. doi: 10.1136/bmjopen-2020-040633. PubMed 33310802 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 30, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04266366
Lead sponsor
Universidad de Almeria
Collaborators
Funding: Junta de Andalucía
Responsible party
Adelaida María Castro-Sánchez (Principal Investigator, Universidad de Almeria) — Principal investigator
First posted
Feb 12, 2020
Start date
Mar 1, 2020
Primary completion
Mar 1, 2022
Completion
Oct 1, 2022
Last update
Nov 30, 2022

Study contacts

Adelaida María Castro-Sánchez, PhD
principal investigator · Almería University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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