Impact of Combined CST, BFR, and Tai Chi on Muscle Physiology and Functional Characteristics Among Adults With LBP

Summary

Background:

Low back pain (LBP) is highly prevalent globally, affecting people of all ages(Wu et al., 2020). In China, LBP is a leading cause of disease burden(Wu et al., 2019). Exercise therapy such as core stability training(CST), Tai Chi(TC) and education are commonly recommended treatments, but research on optimal protocols has been limited. Blood flow restriction(BFR) is beneficial for inducing muscle hypertrophy and promoting muscle strength (Hughes et al., 2019). Combined approaches using multiple modalities may provide added benefits but are understudied.

Research objectives:

1. To determine the effects of combined CST, BFR and Tai Chi on muscle physiology (muscle activation, muscle fatigue, back extensor strength, and transverses abdominus control) among working adults with LBP.
2. To determine the effects of combined CST+ BFR+Tai Chi on functional performance (gait speed, balance, proprioception, and postural sway) among working adults with LBP.
3. To determine the effects of combined CST+BFR+Tai Chi on pain intensity among working adults with LBP.
4. To determine the effects of combined CST+BFR+Tai Chi on fear among working adults with LBP.

Location of research:

Qianxinan Wutong Orthopedic Hospital, Guizhou Province, China

Instrumentations:

1. Demographic Data
2. Surface Electromyography (S-EMG)
3. Pressure Biofeedback Unit (PBU)
4. Back Extensor Strength Test (BEST)
5. Joint Repositioning Error(JRE)
6. APECS app
7. Y-Balance Test(YBT)

8.10-Meter Walk Test(10MWT)

9.Visual Analogue Scale (VAS)

10.Chinese version of the Fear-Avoidance Beliefs Questionnaire(FABQ-CHI)

Interventions:

Group A: CST+BFR+Tai Chi+Education;

Group B: CST+BFR+Education;

Group C: Tai Chi +BFR+Education;

Group D: CST+Education.

Sample size:

Considering 30% drop out. 52 participants. 13 participants in each group

Statistical analysis:

Data were processed using SPSS version 25.0 and Microsoft Excel 2010 software.

1. Demographic data = descriptive analytics.
2. All objectives = repeated measure ANCOVA (within-between interactions) for all variables.
3. The significant level is P \< 0.05.

Conditions

• Low Back Pain

Interventions

OTHER

CST+BFR+Tai Chi+Education

1. Core Stability Training: It includes core activation exercises (feed-forward control)(Libenson,2006). Each set will consist of 10 repetitions of this exercise with a 10-second hold. There will be a 30-second rest between repetitions and a 60-second rest after each set. 2. Tai Chi: The first 10 Tai Chi movements from the 24-simplified Tai Chi form. Three qualified teachers will lead the training sessions. 3. Blood Flow Restriction: The professional physical therapist puts on the cuff pneumatic tourniquet system(Kaastu Master) on the proximal end of the left lower limb of the subjects and gives a certain pressure through the Kaastu Master. The pressure needs to ensure that the venous return of the particapants is restricted to perfect ground, while the artery still has some blood flow. 4. Education: After enrollment, patients will receive face-to-face education sessions at baseline, 30-45 min each time. Guided education by the same experienced professional physiotherapist.

OTHER

CST+BFR+Education

1. Core Stability Training: It includes core activation exercises (feed-forward control)(Libenson,2006). Each set will consist of 10 repetitions of this exercise with a 10-second hold. There will be a 30-second rest between repetitions and a 60-second rest after each set. 2. Blood Flow Restriction: The professional physical therapist puts on the cuff pneumatic tourniquet system(Kaastu Master) on the proximal end of the left lower limb of the subjects and gives a certain pressure through the Kaastu Master. The pressure needs to ensure that the venous return of the particapants is restricted to perfect ground, while the artery still has some blood flow. 3. Education: After enrollment, patients will receive face-to-face education sessions at baseline, 30-45 min each time. Guided education by the same experienced professional physiotherapist.

OTHER

Tai Chi +BFR+Education

1. Tai Chi: The first 10 Tai Chi movements from the 24-simplified Tai Chi form. Three qualified teachers will lead the training sessions. 2. Blood Flow Restriction: The professional physical therapist puts on the cuff pneumatic tourniquet system(Kaastu Master) on the proximal end of the left lower limb of the subjects and gives a certain pressure through the Kaastu Master. The pressure needs to ensure that the venous return of the particapants is restricted to perfect ground, while the artery still has some blood flow. 3. Education: After enrollment, patients will receive face-to-face education sessions at baseline, 30-45 min each time. Guided education by the same experienced professional physiotherapist.

OTHER

CST+Education

1. Core Stability Training: It includes core activation exercises (feed-forward control)(Libenson,2006). Each set will consist of 10 repetitions of this exercise with a 10-second hold. There will be a 30-second rest between repetitions and a 60-second rest after each set. 2. Education: After enrollment, patients will receive face-to-face education sessions at baseline, 30-45 min each time. Guided education by the same experienced professional physiotherapist.

Sponsors & Collaborators

• Universiti Teknologi Mara

  lead OTHER

Principal Investigators

• Zarina Zahari, Doctor · Centre of Physiotherapy, Faculty of Health Sciences, Universiti Teknologi MARA, Malaysia

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-10-08

Primary Completion

2025-05-08

Completion

2025-07-31