Elderly Back Pain: Comparing Chiropractic to Medical Care (HRSA4)

Study Description

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

The purpose of this study is to compare the clinical effectiveness of two types of chiropractic spinal manipulation to conservative medical care for patients at least 55 years old with sub-acute or chronic low back pain (LBP).

Condition or disease	Intervention/treatment	Phase
Subacute Low Back Pain; Chronic Low Back Pain	Other: HVLA-SM; Other: LVVA-SM; Drug: Usual medical care	Phase 2

Detailed Description:

Despite the high prevalence of LBP and the associated economic costs, disability, and lost productivity, and despite the development of several treatment guidelines, one of which recommends chiropractic spinal manipulation for some subgroups of patients with pack pain, the management of LBP remains controversial and highly variable across professions and geographic regions. Although one recent publication describes the design of chiropractic and exercise for seniors with low back or neck pain, no published studies to our knowledge, have assessed the effectiveness of chiropractic manipulation compared to medical care for older adults with sub-acute or chronic low back pain.

Study Design

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	240 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Single (Outcomes Assessor)
Primary Purpose:	Treatment
Official Title:	Elderly Back Pain: Comparing Chiropractic to Medical Care
Study Start Date :	July 2004
Actual Primary Completion Date :	October 2006
Actual Study Completion Date :	March 2007

Arms and Interventions

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Arm	Intervention/treatment
Experimental: HVLA-SM; High-velocity low amplitude spinal manipulation (HVLA-SM)	Other: HVLA-SM; High-velocity low amplitude spinal manipulation (HVLA-SM)
Experimental: LVVA-SM; Low-velocity variable amplitude spinal manipulation (LVVA-SM)	Other: LVVA-SM; Low-velocity variable amplitude spinal manipulation (LVVA-SM)
Active Comparator: Usual Medical Care; Usual medical care - (Celebrex, Aleve, Bextra, Naproxen)	Drug: Usual medical care; Celebrex: po, 200mg, qd, six weeks; Aleve: po, 220mg, bid, six weeks; Bextra: po, 10mg, qd, six weeks; Naproxen: po, 500mg, bid, six weeks.; Other Name: (Celebrex, Aleve, Bextra, Naproxen)

Outcome Measures

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Primary Outcome Measures :

1. Roland Morris Disability Questionnaire(RMDQ). [ Time Frame: 6 weeks ]

Secondary Outcome Measures :

1. Fear Avoidance Beliefs Questionnaire, physical subscale [ Time Frame: 6 weeks, 3 months, 6 months ]
2. Visual Analogue Scale for Pain [ Time Frame: 6 weeks ]
3. Postural Sway [ Time Frame: 6 weeks ]
4. SF-36, v1, Physical Function subscale [ Time Frame: 6 weeks ]
5. Posteroanterior Spinal Stiffness [ Time Frame: 6 weeks ]
6. Sit-to-Stand Maneuver [ Time Frame: 6 weeks ]
7. Spinal Manipulation [ Time Frame: 6 weeks ]

Eligibility Criteria

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Ages Eligible for Study:	55 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• Age 55 or older
• Idiopathic low back pain (LBP) of at least four weeks duration
• Meet the diagnostic classification of 1, 2, or 3 according to the Quebec Task Force on Spinal Disorders

Exclusion Criteria:

• Low back pain (LBP) not meeting Quebec Task Force Diagnostic Classifications 1, 2 or 3, especially LBP associated with: frank radiculopathy, altered lower extremity reflex, dermatomal sensory deficit, progressive unilateral muscle weakness or motor loss, symptoms of cauda equina compression, and CT or MRI evidence of anatomical pathology (e.g. abnormal disc, lateral or central stenosis.
• Co-morbid conditions or general poor health that could significantly complicate the prognosis of LBP, including pregnancy, bleeding disorders, extreme obesity, and clear evidence of narcotic or other drug abuse.
• Major clinical depression defined as scores greater that 29 on the Beck Depression Inventory - Second Edition
• Bone or joint pathology that contraindicate spinal manipulative therapy of joint pathology that contraindicate spinal manipulative therapy of the arthropathies and significant osteoporosis
• Pacemaker, because there are safety issues with equipment used to collect data in the biomechanical testing laboratory
• Current or pending litigation related to current episode of LBP.
• Receiving disability for any health-related condition
• Spinal Manipulative care for any reason within the past month
• Unwilling to postpone use of manual therapies for LBP except those provided in the study for the duration of the study period.
• Unable to read or verbally comprehend English.

Contacts and Locations

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Locations

United States, Iowa
Palmer Center for Chiropractic Research
Davenport, Iowa, United States, 52803
The University of Iowa
Iowa City, Iowa, United States, 52242

Sponsors and Collaborators

Palmer College of Chiropractic

Department of Health and Human Services

Investigators

Principal Investigator:	William C Meeker, DC, M.P.H.	Palmer College of Chiropractic
Study Director:	Maria A Hondras, DC, MPH	Palmer College of Chiropractic

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Publications of Results:

Hondras MA, Long CR, Cao Y, Rowell RM, Meeker WC. A randomized controlled trial comparing 2 types of spinal manipulation and minimal conservative medical care for adults 55 years and older with subacute or chronic low back pain. J Manipulative Physiol Ther. 2009 Jun;32(5):330-43. doi: 10.1016/j.jmpt.2009.04.012.

Hondras MA, Long CR, Haan AG, Spencer LB, Meeker WC. Recruitment and enrollment for the simultaneous conduct of 2 randomized controlled trials for patients with subacute and chronic low back pain at a CAM research center. J Altern Complement Med. 2008 Oct;14(8):983-92. doi: 10.1089/acm.2008.0066.

Responsible Party:	Palmer College of Chiropractic
ClinicalTrials.gov Identifier:	NCT00602901 History of Changes
Other Study ID Numbers:	R18HP01423
First Posted:	January 28, 2008
Last Update Posted:	April 6, 2017
Last Verified:	April 2017

Additional relevant MeSH terms:

Back Pain; Low Back Pain; Pain; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Naproxen; Celecoxib; Valdecoxib; Anti-Inflammatory Agents, Non-Steroidal; Analgesics, Non-Narcotic	Analgesics; Sensory System Agents; Peripheral Nervous System Agents; Physiological Effects of Drugs; Anti-Inflammatory Agents; Antirheumatic Agents; Gout Suppressants; Cyclooxygenase Inhibitors; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action; Cyclooxygenase 2 Inhibitors