Effect of Spinal Manipulation on Sensorimotor Functions in Back Pain Patients - Full Text View

Purpose

The long-term goal for this study is to understand the physiological mechanisms of various forms of spinal manipulation in order to refine and improve this therapy for appropriately selected patients. The objective of this study is to assess the effects of high-velocity low-amplitude spinal manipulation and low-velocity variable amplitude spinal manipulation on three types of sensorimotor abilities in patients with low back pain.

Condition	Intervention	Phase
Low Back Pain	Other: 1 Other: LVVA-SM Other: light effleurage followed by SMT	Phase 2


Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Outcomes Assessor) Primary Purpose: Treatment
Official Title:	Effect of Spinal Manipulation on Sensorimotor Functions in Back Pain Patients

Resource links provided by NLM:

MedlinePlus related topics: Back Pain Chiropractic

U.S. FDA Resources

Further study details as provided by Palmer College of Chiropractic:

Primary Outcome Measures:

Sensorimotor Functions [ Time Frame: 2 weeks, 6 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Roland Morris Disability Questionnaire (RMDQ) [ Time Frame: 2 weeks, 6 weeks ] [ Designated as safety issue: No ]


Enrollment:	221
Study Start Date:	July 2007
Study Completion Date:	July 2012
Primary Completion Date:	June 2012 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Active Comparator: 1 High velocity, low amplitude lumbo-pelvic manipulation	Other: 1 High velocity, low amplitude lumbo-pelvic manipulation
Active Comparator: 2 Low velocity, variable amplitude lumbo-pelvic manipulation	Other: LVVA-SM Low velocity, variable amplitude lumbo-pelvic manipulation
Placebo Comparator: 3 Light effleurage and a sham mechanically-assisted chiropractic treatment for 2 weeks followed by full spine manipulation for 4 weeks	Other: light effleurage followed by SMT 2 weeks of light effleurage and a sham mechanically-assisted chiropractic treatment followed by 4 weeks active care with full spine spinal manipulation

Detailed Description:

In collaboration with the University of Iowa, the Palmer Center for Chiropractic Research will pursue the following specific aims: 1) To determine the immediate pre-to-post changes from HVLA-SM and LVVA-SM to the lumbo-pelvic region, compared to a control group receiving light effleurage and a sham mechanically assisted adjustment, on sensorimotor function as measured by: lumbo-pelvic repositioning ability, standing postural sway, and response to sudden trunk loading; 2) To determine the effects of 2 weeks (4 applications @ 2 per week) of HVLA-SM and LVVA-SM to the lumbo-pelvic region, compared to a control group receiving light effleurage and a sham mechanically assisted adjustment, on sensorimotor function as measured by: lumbo-pelvic repositioning ability, standing postural sway and response to sudden trunk loading; 3) To determine the effects of 6 weeks (12 applications @ 2 per week) of HVLA-SM and LVVA-SM to the lumbo-pelvic region on sensorimotor function as measured by: Lumbo-pelvic repositioning ability, standing postural sway, and response to sudden truck loading; 4) To explore whether changes in sensorimotor function are associated with changes in self-reported back pain intensity, related disability, or health status at 2 weeks (after 4 SM Visits) and at 6 weeks (after 12 SM Visits); 5) To determine if sensorimotor function changes are greater in patients a priori clinically classified as being most appropriate for manipulation.; 6)Describe the sensorimotor and clinical effects of 4 weeks of full spine and extremity (clinician's choice) care following 2 weeks of receiving light effleurage and a sham mechanically assisted adjustment for participants with low back pain; and 7) To explore if there is an association between: a. DC characterization of the quality of the SM (as rated on a survey) and the biomechanics of the SM (as measured by the force-time profile, biomechanical assessments, and videotape), and b. DC and participant characterization of quality of the SM (as rated on surveys).

Eligibility


Ages Eligible for Study:	21 Years to 65 Years (Adult)
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

21 to 65 years old
Low back pain (LBP) score an 11 point numerical rating scale: (must be > 4 at the Phone Screening OR Baseline 1 Visit) AND (must be > 2 at the Phone Screen, Baseline 1 AND Baseline 2 Visits)
Acute (less than 7 days), sub-acute (7 days to 7 weeks), or chronic (more than 7 weeks) LBP matching classifications 1, 2, or 3 of the Quebec Task Force (QTF) Classification system - QTF 1: Pain without radiation, QTF 2: Pain + radiation to proximal extremity, QTF 3: Pain + radiation to distal extremity, QTF 7: Spinal stenosis
Written informed consent (ICD1, ICD2 and ICD3)

Exclusion Criteria:

Ongoing treatment for low back pain by other health care providers - unwillingness to postpone use of all other types of manual treatment for LBP except those provided in the study (including chiropractic and osteopathic SM, physical therapy and massage) for the duration of the study period.
Co-morbidities Bleeding Disorders Bone and Joint Pathology Cauda Equina Syndrome Contra-indication to spinal manipulation, in general Current or Pending Litigation General Poor Health Inflammatory or Destructive tissue changes to the spine Neuromuscular Diseases Obesity Osteoporosis Peripheral Neuropathies Spinal Surgery Suspicion of drug or alcohol abuse Uncontrolled hypertension Vascular claudication
Quebec Task Force (QTF) on Spinal Disorders QTF 4: Pain + radiation to upper/lower limb with neurologic signs QTF 5: Presumptive compression of a spinal nerve root on a simple roentgenogram QTF 6: Compression of a spinal nerve root confirmed by specific imaging techniques QTF 8: Postsurgical status, 1-6 months after intervention QTF 9: Postsurgical status, >6 months after intervention 9.1: Asymptomatic 9.2: Symptomatic QTF 10: Chronic pain syndrome QTF 11: Other diagnoses
Pregnant or nursing women
Pacemaker
Inability to read or verbally comprehend English
Any Joint Replacement
Use of spinal manipulation within the past 4 weeks. If participants are willing to delay study enrollment until four weeks post spinal manipulative therapy, then we will schedule accordingly until this criterion is met
Sensitivity to tape used during the biomechanical assessments
If the Study Clinician believes that diagnostic procedures other than x-rays or dipstick urinalysis are necessary to diagnose a participant's condition, then the participant will be excluded
Beck Depression Inventory-II greater than or equal to 29
Retention of legal advice and an open or pending case for a health-related condition

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00830596

Locations


United States, Iowa
Palmer College of Chiropractic
Davenport, Iowa, United States, 52803

Sponsors and Collaborators

Palmer College of Chiropractic

National Center for Complementary and Integrative Health (NCCIH)

Investigators


Principal Investigator:	Christine G Choate, DC, PhD	Palmer College of Chiropractic

More Information

Publications:

Goertz CM, Xia T, Long CR, Vining RD, Pohlman KA, DeVocht JW, Gudavalli MR, Owens EF Jr, Meeker WC, Wilder DG. Effects of spinal manipulation on sensorimotor function in low back pain patients--A randomised controlled trial. Man Ther. 2016 Feb;21:183-90. doi: 10.1016/j.math.2015.08.001. Epub 2015 Aug 8.

Vining RD, Potocki E, McLean I, Seidman M, Morgenthal AP, Boysen J, Goertz C. Prevalence of radiographic findings in individuals with chronic low back pain screened for a randomized controlled trial: secondary analysis and clinical implications. J Manipulative Physiol Ther. 2014 Nov-Dec;37(9):678-87. doi: 10.1016/j.jmpt.2014.10.003. Epub 2014 Nov 1.

Wilder DG, Vining RD, Pohlman KA, Meeker WC, Xia T, Devocht JW, Gudavalli RM, Long CR, Owens EF, Goertz CM. Effect of spinal manipulation on sensorimotor functions in back pain patients: study protocol for a randomised controlled trial. Trials. 2011 Jun 28;12:161. doi: 10.1186/1745-6215-12-161.

Vining RD, Salsbury SA, Pohlman KA. Eligibility determination for clinical trials: development of a case review process at a chiropractic research center. Trials. 2014 Oct 24;15:406. doi: 10.1186/1745-6215-15-406.

Vining R, Potocki E, Seidman M, Morgenthal AP. An evidence-based diagnostic classification system for low back pain. J Can Chiropr Assoc. 2013 Sep;57(3):189-204.


Responsible Party:	Palmer College of Chiropractic
ClinicalTrials.gov Identifier:	NCT00830596 History of Changes
Other Study ID Numbers:	D2P3 U19AT004137
Study First Received:	January 27, 2009
Last Updated:	September 4, 2015
Health Authority:	United States: Institutional Review Board

Additional relevant MeSH terms:


Back Pain Low Back Pain Pain	Neurologic Manifestations Nervous System Diseases Signs and Symptoms

ClinicalTrials.gov processed this record on September 29, 2016

Effect of Spinal Manipulation on Sensorimotor Functions in Back Pain Patients (D2P3)