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Lumbar surgery is the most common treatment for chronic disabling low back pain with degenerative disc disease. There are few elements to objectively evaluate the improvement of the motor control after surgery and the motor adaptation capacities of the patients.
The impact of lumbar surgery on complexity in this painful context has never been studied. Theoretically, the restriction of mobility imposed by lumbar surgery should limit the subject's adaptive capacities (of one or more lumbar segments) and thus reduce complexity. Nevertheless, improvement in pain intensity levels could allow the patient to find better motor adaptation capacities, necessary for a positive evolution in the long-term.
The aim of this study was to investigate the evolution of gait complexity in chronic low back pain patients pre- and post-surgery. If surgery improves the adaptability of walking through an antalgic benefit exceeding the induced stiffness, the complexity of walking should be superior after surgery.
This is a proof-of-concept study in which the study investigators hypothesize that measuring complexity by fractal analysis during a walking task will show the increase in gait complexity induced by lumbar surgery at 3 and 6 months after surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with Low Back Pain |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Walking task | Other | Treadmill walking task with study of fractal variability (complexity) for 10 minutes. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Gait complexity | fractal analysis of gait variability: value normally between 0.5 (degraded structure) to 1 (optimal structure) | 10 days before surgery +/- 3 days |
| Gait complexity | fractal analysis of gait variability: value normally between 0.5 (degraded structure) to 1 (optimal structure) | Month 3 |
| Gait complexity | fractal analysis of gait variability: value normally between 0.5 (degraded structure) to 1 (optimal structure) | Month 6 |
| Measure | Description | Time Frame |
|---|---|---|
| Patient reported pain | Visual analog scale (0-100) | 10 days before surgery +/- 3 days |
| Patient reported pain | Visual analog scale (0-100) |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with chronic low back pain requiring prosthesis or arthrodesis surgery for their lumbar pathology (surgery on one or two levels) followed at the Nîmes University Hospital or at the Grand Sud Polyclinic.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Alexis Homs | Contact | 04.66.68.34.59 | alexis.homs@chu-nimes.fr |
| Name | Affiliation | Role |
|---|---|---|
| Alexis Homs | CHU Nimes | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Nîmes | Recruiting | Nîmes | France |
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| Month 3 |
| Patient reported pain | Visual analog scale (0-100) | Month 6 |
| Apprehension of pain of movement | Tampa Scale of Kinesiophobia. Score ranging from 17-68. Higher scores denote greater level of kinesiophobia (a score >40 is considered significant kinesiophobia) | 10 days before surgery +/- 3 days |
| Apprehension of pain of movement | Tampa Scale of Kinesiophobia. Score ranging from 17-68. Higher scores denote greater level of kinesiophobia (a score >40 is considered significant kinesiophobia) | Month 3 |
| Apprehension of pain of movement | Tampa Scale of Kinesiophobia. Score ranging from 17-68. Higher scores denote greater level of kinesiophobia (a score >40 is considered significant kinesiophobia) | Month 6 |
| Patient reported quality of life | EuroQol-5 Dimension questionnaire: results generated as 5 digit number corresponding to different aspects of quality of life | 10 days before surgery +/- 3 days |
| Patient reported quality of life | EuroQol-5 Dimension questionnaire: results generated as 5 digit number corresponding to different aspects of quality of life | Month 3 |
| Patient reported quality of life | EuroQol-5 Dimension questionnaire: results generated as 5 digit number corresponding to different aspects of quality of life | Month 6 |
| Correlation between type of surgery and gait variability | Classified as either arthrodesis or prosthesis | 10 days before surgery +/- 3 days |
| Correlation between type of surgery and gait variability | Classified as either arthrodesis or prosthesis | Month 3 |
| Correlation between type of surgery and gait variability | Classified as either arthrodesis or prosthesis | Month 6 |
| Polyclinique Grand Sud | Not yet recruiting | Nîmes | France |
|
| D013568 |
| Pathological Conditions, Signs and Symptoms |