Huber Proprioceptive Training and Alpha-Lipoic Acid: A New Approach in Optimizing Nerve Function in Patients With Chronic Low Back Pain

Background While there is evidence supporting the potential of alpha-lipoic acid (ALA) to improve nerve conduction parameters in certain neurological conditions, particularly diabetic neuropathy, its specific effects on nerve conduction in chronic low back pain (CLBP) patients have not been directly addressed in the current context. There is a connection between proprioceptive system deficits and movement control dysfunction in patients with chronic lower back pain, but the exact mechanism of this link is unknown. Aim To analyze the effectiveness of the proprioceptive rehabilitation method using the Huber system of exercises and to evaluate nerve conduction study findings in a patient with CLBP treated with ALA. Methods This prospective quasi-experimental clinical pilot study with a pre-test/post-test repeated-measures design included 15 patients treated at the Clinic for Physical Medicine and Rehabilitation, Clinical Center of the University of Sarajevo, during a three-week follow-up period. The study was conducted between January 1, 2025, and April 30, 2025. The patients were treated with 600 mg of ALA supplementation per day and participated in Huber proprioception training five days per week. Patients were followed for the next three weeks, with two study visits: one at baseline and one at the end of the study. The study visits included electromyography (EMG) and nerve conduction studies. A p-value of <0.05 was considered significant. Results Out of the total patients (n=15), 11 (73.3%) were male. The most commonly affected levels were L4/L5 (13, 87%), followed by L3/L4 (1, 6.5%) and L5/S1 (1, 6.5%). There was a statistically significant median increase after three weeks in both proximal (z=-3.298, p<0.001) and distal peroneal M wave amplitude (z=-3.415, p<0.001). A statistically significant median increase was also observed in proximal (z=-3.408, p<0.001) and distal tibial M wave amplitude (z=-3.409, p<0.001). Conclusion Future research with a larger sample size and longer follow-up periods is needed to evaluate the long-term effects of the sensoriomotor training program combined with ALA supplementation in patients with chronic low back pain.