Comparison of Electrotherapies for Chronic Low Back Pain
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Purpose
The intent of this project is to execute a high-quality double-blinded randomized controlled clinical trial that compares the H-Wave® device with a commonly used TENS device with a sub-therapeutic electrocurrent device. This study will provide a definable level of evidence for treatment efficacy, and provide a basis for evidence-based recommendation for or against utilization for these two modalities. The results for H-Wave® device, if positive, could significantly impact morbidity by providing a non-invasive, non-pharmacologic treatment for symptomatic relief, and reduce overall disability and health care costs associated with chronic low back pain.
| Condition | Intervention |
|---|---|
|
Non-specific Chronic Low Back Pain |
Device: H-Wave Device: Transcutaneous Electrical Nerve Stimulation (TENS) Device: Sham |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Electrical Stimulation for Chronic Non-specific Low Back Pain in a Working-Age Population: A 12-Week Double Blinded Randomized Controlled Trial |
- Change from baseline in Oswestry Disability Index at 1 week [ Time Frame: 1 week ] [ Designated as safety issue: No ]
- Change from baseline in Oswestry Disability Index at 4 weeks [ Time Frame: Week 4 ] [ Designated as safety issue: No ]
- Change from baseline in Oswestry Disability Index at 8 weeks [ Time Frame: Week 8 ] [ Designated as safety issue: No ]
- Change from baseline in Oswestry Disability Index at 12 weeks [ Time Frame: Week 12 ] [ Designated as safety issue: No ]
- Change from baseline in VAS Pain Score at 1 week [ Time Frame: Week 1 ] [ Designated as safety issue: No ]
- Change from baseline in VAS Pain Score at 4 weeks [ Time Frame: Week 4 ] [ Designated as safety issue: No ]
- Change from baseline in VAS Pain Score at 8 weeks [ Time Frame: Week 8 ] [ Designated as safety issue: No ]
- Change from baseline in VAS Pain Score at 12 weeks [ Time Frame: Week 12 ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 114 |
| Study Start Date: | July 2012 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: H-Wave Device
H-Wave Device with Usual Care
|
Device: H-Wave
Proprietary electrotherapy device using electrical stimulation of unique wave form and energy level that is delivered through transcutaneous electrodes to nerves and soft tissue for analgesic effect.
Other Name: H-Wave is the proprietary name of the device. There is only one model currently.
|
|
Active Comparator: TENS
Transcutaneous electrical nerve stimulation (TENS) Device with Usual Care
|
Device: Transcutaneous Electrical Nerve Stimulation (TENS)
Electrotherapy device that delivers current at different frequency, amplitude, and wave form through cutaneous electrodes placed near body parts with pain for temporary analgesic effect. The study device is installed inside the same housing as the H-Wave Device and Sham Device, so that all appear the same. There are no identifying marks on the case that participants will recognize in order to maintain blinding.
Other Name: Chattanooga Intellect TENS Device
|
|
Sham Comparator: Sham Electrotherapy
Sham Device plus Usual Care.
|
Device: Sham
The sham device is a TENS unit modified to have minimal electrical output. The device is installed in the same housing as the two active arms with equal weight, so that each device in the study appears identical.
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Detailed Description:
H-Wave® Device Stimulation (Intervention A) plus usual care, transcutaneous electrical nerve stimulation (TENS) (Intervention B) plus usual care, and sham electrotherapy plus usual care (control). Each treatment arm will have identical participants enrolled (n=38 per arm) of with the same number of visits and investigator contact time.
Eligible participants will be allocated through computerized randomization utilizing a stratified permuted-block randomization employing random block sizes. Allocation is concealed. Participants and assessors will be blinded. Participants will not be told what types of electrotherapy devices are being studied, only that there are different types, and that they may be randomized to receive a sham device.
Patients will be instructed on the use of the device they received to perform daily home therapy. Subjects will be assessed at week 1, 4, 8 and 12 for the primary and secondary outcomes measures. Compliance to treatment will be measured through an electronic meter on each of the devices, as well as by patient diary. Patients will be allowed to receive usual care from their own health care provider, with the exception of invasive procedures or surgery. Results will be analyzed by intention to treat methods.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Chronic Low Back Pain of at least 3 months duration
- ages 18-65
- Current VAS Pain Rating of 5 on 10 point scale
- No pain below the knee
- 75% of pain located in low back or buttock pain rather than lower extremity pain
- Proficient in English
- Able to complete and tolerate treatment for the study period.
Exclusion Criteria:
- Prior home use of H-Wave Device or TENS.
- Prior history of spinal fusion or failed spinal surgery syndrome.
- Laminectomy, laminotomy or discectomy within 12 months of enrollment.
- Diagnostic or interventional injections or any low back surgeries not mentioned above, including radiofrequency, neuroablation within 6 months of enrollment.
- Current implanted cardiac demand pacemakers, defibrillators, cardiac pumps, or other implanted electronic devices.
- Active psychiatric disorders will be excluded (e.g. use of antipsychotic medication, bipolar disorder, schizophrenia, uncontrolled depression or anxiety disorder).
- Patients currently or who become pregnant will be excluded.
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Matt Hughes, MD, MPH, Assistant Professor (clinical), University of Utah |
| ClinicalTrials.gov Identifier: | NCT01658735 History of Changes |
| Other Study ID Numbers: | IRB_00052918, IRB_00052918 |
| Study First Received: | July 30, 2012 |
| Last Updated: | August 2, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of Utah:
|
Chronic low back pain Electrotherapy H-Wave |
H wave TENS Trial |
Additional relevant MeSH terms:
|
Back Pain Low Back Pain Pain |
Neurologic Manifestations Nervous System Diseases Signs and Symptoms |
ClinicalTrials.gov processed this record on May 23, 2013