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Low Back PainLOMBATHERMNCT03910023

Non-pharmacological Treatment for Chronic Back Pain

A study testing Spa therapy in people with Low Back Pain, run by Association Francaise pour la Recherche Thermale at 1 site in France.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The working hypothesis is that spa therapy in addition to usual care including home exercises (UCHE) will result in greater improvements in pain reduction, associated disability and quality of life for chronic low back pain patients. It follows that health resource consumption and linked costs should also be reduced. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Low Back Pain
What is being tested?
Spa therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
358 participants
Where
1 siteFrance
Study dates
15 Jun 2019to 15 Jun 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult patient presenting with chronic low back pain: usual pain of the lumbar region lasting for more than 3 months. This pain may radiate to the buttocks, iliac crest, and does not go past the knee.
  • Patient presenting with a current pain intensity on a visual analogue scale (VAS) > or = 40 mm.
  • The patient has signed the informed consent
  • The patient is a beneficiary of a social security programme [national health insurance]

Who cannot join

  • Patients with secondary low back pain
  • Patients with severe depression, psychosis
  • Patients who have already had a spa treatment in the previous 6 months
  • Patients with a contraindication for spa treatment
  • Patients with a professional activity related to hydrotherapy (to avoid any conflict of interest)
  • Patients with sciatic pain beyond the knee (sciatica being a non-indication for spa treatment)
  • Other treatments that may interact according to the judgment of the investigator
  • Patients who live more than 30 km away from the spa

Trial locations and contacts

1 site in 1 country.

France1 site, 1 recruiting
  • Centre de recherche rhumatologique et thermal

    Aix-les-Bains, 73100

    Romain FORESTIER, Dr, 0479351487, romain.forestier@wanadoo.fr

    Recruiting

Other trials in France

About this study

Official title: Non-pharmacological Treatment for Chronic Back Pain: a Randomised, Controlled Trial

The working hypothesis is that spa therapy in addition to usual care including home exercises (UCHE) will result in greater improvements in pain reduction, associated disability and quality of life for chronic low back pain patients. It follows that health resource consumption and linked costs should also be reduced. The primary objective of this study is therefore to compare the therapeutic effect of UCHE alone versus spa therapy in addition to UCHE for chronic low back pain.

Read the detailed description

Secondarily, the study will also (i) evaluate the therapeutic effects specific to each spa-centre, (ii) specifically describe effects among subjects who are currently engaged in a professional activity, (iii) evaluate treatment tolerance as well as (iv) per-patient health resource use and associated costs.

Conditions
Low Back Pain
Being tested
Usual care comporting a home-exercise program (UCHE), Spa therapy
Keywords
Low back pain, Crenobalneotherapy, Spa therapy, Mud application, Water exercises, Underwater massages
Medical subject headings
Low Back Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Usual care comporting a home-exercise program (UCHE)Other

    The UCHE intervention will correspond to current practice (including the continuation of previous treatments, if applicable) as decided by the attending physician. The patient will also be provided with a practical guide on how to manage back pain (the "back book"), including a recommended home exercise program.

  • Spa therapyOther

    the spa-therapy intervention consists of 18 consecutive days of spa-therapy (excepting Sundays), that must occur with 60 days of randomisation. The latter will combine mineral water with physical and hydrotherapeutic treatments, including massages, heat and water exercises.

Study groups in NCT03910023
Study groupRoleWhat they receive
Control groupActive comparatorThe control group will perform home exercises alone
Receives: Other: Usual care comporting a home-exercise program (UCHE)
Spa groupExperimentalThe spa group will be proposed an additional spa treatment
Receives: Other: Usual care comporting a home-exercise program (UCHE); Other: Spa therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Presence/absence of a clinically relevant change in visual analogue scale (VAS) score for pain

    Presence/absence of a clinically relevant change in visual analogue scale (VAS) score for pain, defined by an improvement of at least 30%; cases where patients demonstrate a 30% improvement in VAS scores for pain but nevertheless require hospitalisation for back pain during the study follow-up period will be considered as treatment failures (absence of clinically relevant change).

    Measured: 6 months

Secondary outcomes (46)
  1. Huskinsson's VAS for pain.

    Measured: Baseline (day 0)

  2. Huskinsson's VAS for pain.

    Measured: 1 month

  3. Huskinsson's VAS for pain.

    Measured: 6 months

  4. Huskinsson's VAS for pain.

    Measured: 12 months

  5. The EIFEL scale

    The EIFEL scale: the validated French version of a disability rating scale by Rolland and Morris. This 24-question scale (with scores ranging from 0 (no impact) to 24 (maximum impact) quantifies the impact of low back pain on daily life.

    Measured: Baseline (day 0)

  6. The EIFEL scale

    The EIFEL scale: the validated French version of a disability rating scale by Rolland and Morris. This 24-question scale (with scores ranging from 0 (no impact) to 24 (maximum impact) quantifies the impact of low back pain on daily life.

    Measured: 1 month

  7. The EIFEL scale

    The EIFEL scale: the validated French version of a disability rating scale by Rolland and Morris. This 24-question scale (with scores ranging from 0 (no impact) to 24 (maximum impact) quantifies the impact of low back pain on daily life.

    Measured: 6 months

  8. The EIFEL scale

    The EIFEL scale: the validated French version of a disability rating scale by Rolland and Morris. This 24-question scale (with scores ranging from 0 (no impact) to 24 (maximum impact) quantifies the impact of low back pain on daily life.

    Measured: 12 months

  9. The Fear Avoidance and Belief Questionnaire (FABQ)

    The Fear Avoidance and Belief Questionnaire (FABQ) assess inappropriate fears and beliefs concerning back pain; the validated French version will be used.

    Measured: Baseline (day 0)

  10. The Fear Avoidance and Belief Questionnaire (FABQ)

    The Fear Avoidance and Belief Questionnaire (FABQ) assess inappropriate fears and beliefs concerning back pain; the validated French version will be used.

    Measured: 1 month

  11. The Fear Avoidance and Belief Questionnaire (FABQ)

    The Fear Avoidance and Belief Questionnaire (FABQ) assess inappropriate fears and beliefs concerning back pain; the validated French version will be used.

    Measured: 6 months

  12. The Fear Avoidance and Belief Questionnaire (FABQ)

    The Fear Avoidance and Belief Questionnaire (FABQ) assess inappropriate fears and beliefs concerning back pain; the validated French version will be used.

    Measured: 12 months

  13. The EQ-5D-5L questionnaire

    The EQ-5D-5L questionnaire will be used to track changes in quality of life. This self-administered questionnaire consists of two pages: the first contains the EQ-5D descriptive system and the second a visual analogue scale. The descriptive system has five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), each described by five levels of intensity ("no problems", "slight problems", "moderate problems", "severe problems" and "extreme problems or complete inability"). The respondent must indicate one intensity level for each dimension.

    Measured: Baseline (day 0)

  14. The EQ-5D-5L questionnaire

    The EQ-5D-5L questionnaire will be used to track changes in quality of life. This self-administered questionnaire consists of two pages: the first contains the EQ-5D descriptive system and the second a visual analogue scale. The descriptive system has five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), each described by five levels of intensity ("no problems", "slight problems", "moderate problems", "severe problems" and "extreme problems or complete inability"). The respondent must indicate one intensity level for each dimension.

    Measured: 1 month

  15. The EQ-5D-5L questionnaire

    The EQ-5D-5L questionnaire will be used to track changes in quality of life. This self-administered questionnaire consists of two pages: the first contains the EQ-5D descriptive system and the second a visual analogue scale. The descriptive system has five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), each described by five levels of intensity ("no problems", "slight problems", "moderate problems", "severe problems" and "extreme problems or complete inability"). The respondent must indicate one intensity level for each dimension.

    Measured: 6 months

  16. The EQ-5D-5L questionnaire

    The EQ-5D-5L questionnaire will be used to track changes in quality of life. This self-administered questionnaire consists of two pages: the first contains the EQ-5D descriptive system and the second a visual analogue scale. The descriptive system has five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), each described by five levels of intensity ("no problems", "slight problems", "moderate problems", "severe problems" and "extreme problems or complete inability"). The respondent must indicate one intensity level for each dimension.

    Measured: 12 months

  17. Patient Acceptable Symptom State (PASS)

    Patient Acceptable Symptom State (PASS): Yes/no response to the following question: "If you take into account all the activities you have in your daily life, the importance of your pain and your disability, do you consider your condition as satisfactory?"

    Measured: Baseline (day 0)

  18. Patient Acceptable Symptom State (PASS)

    Patient Acceptable Symptom State (PASS): Yes/no response to the following question: "If you take into account all the activities you have in your daily life, the importance of your pain and your disability, do you consider your condition as satisfactory?"

    Measured: 1 month

  19. Patient Acceptable Symptom State (PASS)

    Patient Acceptable Symptom State (PASS): Yes/no response to the following question: "If you take into account all the activities you have in your daily life, the importance of your pain and your disability, do you consider your condition as satisfactory?"

    Measured: 6 months

  20. Patient Acceptable Symptom State (PASS)

    Patient Acceptable Symptom State (PASS): Yes/no response to the following question: "If you take into account all the activities you have in your daily life, the importance of your pain and your disability, do you consider your condition as satisfactory?"

    Measured: 12 months

  21. Overall opinion of the patient on his/her state of health (5-point Likert scale)

    Overall opinion of the patient on his/her state of health (5-point Likert scale)

    Measured: Baseline (day 0)

  22. Overall opinion of the patient on his/her state of health (5-point Likert scale)

    Overall opinion of the patient on his/her state of health (5-point Likert scale)

    Measured: 1 month

  23. Overall opinion of the patient on his/her state of health (5-point Likert scale)

    Overall opinion of the patient on his/her state of health (5-point Likert scale)

    Measured: 6 months

  24. Overall opinion of the patient on his/her state of health (5-point Likert scale)

    Overall opinion of the patient on his/her state of health (5-point Likert scale)

    Measured: 12 months

  25. Overall opinion of the evaluating physician on the patient's state of health (5-point Likert scale)

    Overall opinion of the evaluating physician on the patient's state of health (5-point Likert scale)

    Measured: Baseline (day 0)

  26. Overall opinion of the evaluating physician on the patient's state of health (5-point Likert scale)

    Overall opinion of the evaluating physician on the patient's state of health (5-point Likert scale)

    Measured: 1 month

  27. Overall opinion of the evaluating physician on the patient's state of health (5-point Likert scale)

    Overall opinion of the evaluating physician on the patient's state of health (5-point Likert scale)

    Measured: 6 months

  28. Overall opinion of the evaluating physician on the patient's state of health (5-point Likert scale)

    Overall opinion of the evaluating physician on the patient's state of health (5-point Likert scale)

    Measured: 12 months

  29. Daily drug consumption over the past 72 hours: Analgesics

    Daily drug consumption over the past 72 hours: Analgesics (in mg of paracetamol and morphine equivalents).

    Measured: Baseline (day 0)

  30. Daily drug consumption over the past 72 hours: Analgesics

    Daily drug consumption over the past 72 hours: Analgesics (in mg of paracetamol and morphine equivalents).

    Measured: 1 month

  31. Daily drug consumption over the past 72 hours: Analgesics

    Daily drug consumption over the past 72 hours: Analgesics (in mg of paracetamol and morphine equivalents).

    Measured: 6 months

  32. Daily drug consumption over the past 72 hours: Analgesics

    Daily drug consumption over the past 72 hours: Analgesics (in mg of paracetamol and morphine equivalents).

    Measured: 12 months

  33. Daily drug consumption over the past 72 hours: NSAIDs

    Daily drug consumption over the past 72 hours: NSAIDs (reported in mg and as a percentage of the maximum dose)

    Measured: Baseline (day 0)

  34. Daily drug consumption over the past 72 hours: NSAIDs

    Daily drug consumption over the past 72 hours: NSAIDs (reported in mg and as a percentage of the maximum dose)

    Measured: 1 month

  35. Daily drug consumption over the past 72 hours: NSAIDs

    Daily drug consumption over the past 72 hours: NSAIDs (reported in mg and as a percentage of the maximum dose)

    Measured: 6 months

  36. Daily drug consumption over the past 72 hours: NSAIDs

    Daily drug consumption over the past 72 hours: NSAIDs (reported in mg and as a percentage of the maximum dose)

    Measured: 12 months

  37. Daily drug consumption over the past 72 hours: Corticosteroids

    Daily drug consumption over the past 72 hours: Corticosteroids (in mg equivalent prednisone)

    Measured: Baseline (day 0)

  38. Daily drug consumption over the past 72 hours: Corticosteroids

    Daily drug consumption over the past 72 hours: Corticosteroids (in mg equivalent prednisone)

    Measured: 1 month

  39. Daily drug consumption over the past 72 hours: Corticosteroids

    Daily drug consumption over the past 72 hours: Corticosteroids (in mg equivalent prednisone)

    Measured: 6 months

  40. Daily drug consumption over the past 72 hours: Corticosteroids

    Daily drug consumption over the past 72 hours: Corticosteroids (in mg equivalent prednisone)

    Measured: 12 months

  41. Daily drug consumption over the past 72 hours: Benzodiazepine muscle relaxants:

    Daily drug consumption over the past 72 hours: Benzodiazepine muscle relaxants: % of maximum dose

    Measured: Baseline (day 0)

  42. Daily drug consumption over the past 72 hours: Benzodiazepine muscle relaxants:

    Daily drug consumption over the past 72 hours: Benzodiazepine muscle relaxants: % of maximum dose

    Measured: 1 month

  43. Daily drug consumption over the past 72 hours: Benzodiazepine muscle relaxants:

    Daily drug consumption over the past 72 hours: Benzodiazepine muscle relaxants: % of maximum dose

    Measured: 6 months

  44. Daily drug consumption over the past 72 hours: Benzodiazepine muscle relaxants:

    Daily drug consumption over the past 72 hours: Benzodiazepine muscle relaxants: % of maximum dose

    Measured: 12 months

  45. Number of infiltrations

    Measured: 12 months

  46. Estimated per-patient cost for one year of care

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Apr 2019
  2. Study start15 Jun 2019
  3. Primary completion15 Dec 2021 (estimated)
  4. Study completion15 Jun 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
In this prospective, evaluator-blinded, multi-centre, 2-parallel-arm, Zelen randomized (1:1), controlled trial, UCHE alone will be compared to spa therapy in addition to UCHE for the treatment of chronic low back pain.
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
358 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03910023
Sponsor's protocol ID
2018-A02801-54
Acronym
LOMBATHERM
Status last verified
Jun 2019
First submitted
12 Mar 2019
Last updated
7 Nov 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The general goal is to, in as much as possible, make the study data available to interested researchers as well as to provide proof of transparency for the study. Data (and an accompanying data dictionary) will be de-identified and potentially further cleaned or aggregated as the investigators deem necessary to protect participant anonymity. Due to conditions imposed by French law, data will be made available to the public upon request to the AFRETH scientific committee (Association Française pour la Recherche Thermale, 1 rue Cels 75014 Paris, France; http://www.afreth.org).

Publications

  • Forestier R, Suehs C, Francon A, Marty M, Genevay S, Sellam J, Chauveton C, Erol Forestier FB, Molinari N. Usual care including home exercise with versus without spa therapy for chronic low back pain: protocol for the LOMBATHERM' study, a multicentric randomised controlled trial. Trials. 2020 May 11;21(1):392. doi: 10.1186/s13063-020-04271-9.

    PubMed 32393320

Questions about this trial

What is this clinical trial studying?

A study testing Spa therapy in people with Low Back Pain, run by Association Francaise pour la Recherche Thermale at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 7 Nov 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Romain FORESTIER, MD (00334 79 35 14 87, romain.forestier@wanadoo.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Presence/absence of a clinically relevant change in visual analogue scale (VAS) score for pain (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03910023, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Nov 2019.

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