The Effects of Open/Closed Kinetic Chain Exercises in Water on the Electrical Activity of Selected Lumbar Muscles, Lumbopelvic Control, Ground Reaction Force, and Psychological Factors in Men with Chronic Non-Specific Low Back Pain: A Study Protocol for a Randomized Crossover Clinical Trial

Abstract

Abstract Background Chronic non-specific low back pain (CNSLBP) has been documented among the top causes of absenteeism at work, coupled with the use of health insurance and healthcare services. Considering little research on the consequences of open/closed kinetic chain (O/CKC) exercises in water on the CNSLBP improvement, the present study is to investigate the effects of such interventions on the electrical activity of selected lumbar muscles, pain, lumbopelvic control (LPC), ground reaction force (GRF) for balance analysis, and psychological factors in men with CNSLBP. Methods In this randomized crossover clinical trial, 60 adult male participants with CNLBP, at the age range of 40–60, will be assigned to one of the following three groups through the block randomization method, viz., open kinetic chain (OKC) exercises, closed kinetic chain (CKC) exercises, and controls. The primary outcomes of the electrical activity of the multifidus (MF), transversus abdominis (TrA), gluteus medius (GM), and quadratus lumborum (QL) muscles will be then measured by an electromyography (EMG) device. As well, the pressure biofeedback (BFB) device and the visual analogue scale (VAS) will be utilized to assess LPC and pain intensity, respectively. The secondary outcomes of the GRF along with foot pressure and kinesiophobia will be subsequently measured by the Tampa Scale of Kinesiophobia (TSK). Conclusion The study results develop a comprehensive treatment protocol with much emphasis on maintaining its effectiveness and practicality in daily living activities, such as walking, going up and down the stairs, sitting on and getting up from chairs and couches, and sleeping pain-free, and provides a therapeutic solution for physiotherapists and sports therapists. Trial registration This trial was approved by the ethics committee for human research of BuAliSina University (reference number: IR.BASU.REC.1402.011) and IRCT CODE (20190129042534N1).