Effect of Spinal Manipulation on Sensorimotor Functions in Back Pain Patients: Study Protocol for a Randomised Controlled Trial

Overview

Journal Trials

Publisher Biomed Central

Specialties General Medicine
Pharmacology

Date 2011 Jun 29

PMID 21708042

Citations 12

Authors

David G Wilder

Robert D Vining

Katherine A Pohlman

William C Meeker

Ting Xia

James W DeVocht

R Maruti Gudavalli

Cynthia R Long

Edward F Owens

Christine M Goertz

Affiliations

Soon will be listed here.

Abstract

Background: Low back pain (LBP) is a recognized public health problem, impacting up to 80% of US adults at some point in their lives. Patients with LBP are utilizing integrative health care such as spinal manipulation (SM). SM is the therapeutic application of a load to specific body tissues or structures and can be divided into two broad categories: SM with a high-velocity low-amplitude load, or an impulse "thrust", (HVLA-SM) and SM with a low-velocity variable-amplitude load (LVVA-SM). There is evidence that sensorimotor function in people with LBP is altered. This study evaluates the sensorimotor function in the lumbopelvic region, as measured by postural sway, response to sudden load and repositioning accuracy, following SM to the lumbar and pelvic region when compared to a sham treatment.

Methods/design: A total of 219 participants with acute, subacute or chronic low back pain are being recruited from the Quad Cities area located in Iowa and Illinois. They are allocated through a minimization algorithm in a 1:1:1 ratio to receive either 13 HVLA-SM treatments over 6 weeks, 13 LVVA-SM treatments over 6 weeks or 2 weeks of a sham treatment followed by 4 weeks of full spine "doctor's choice" SM. Sensorimotor function tests are performed before and immediately after treatment at baseline, week 2 and week 6. Self-report outcome assessments are also collected. The primary aims of this study are to 1) determine immediate pre to post changes in sensorimotor function as measured by postural sway following delivery of a single HVLA-SM or LVVA-SM treatment when compared to a sham treatment and 2) to determine changes from baseline to 2 weeks (4 treatments) of HVLA-SM or LVVA-SM compared to a sham treatment. Secondary aims include changes in response to sudden loads and lumbar repositioning accuracy at these endpoints, estimating sensorimotor function in the SM groups after 6 weeks of treatment, and exploring if changes in sensorimotor function are associated with changes in self-report outcome assessments.

Discussion: This study may provide clues to the sensorimotor mechanisms that explain observed functional deficits associated with LBP, as well as the mechanism of action of SM.

Trial Registration: This trial is registered in ClinicalTrials.gov, with the ID number of NCT00830596, registered on January 27, 2009. The first participant was allocated on 30 January 2009 and the final participant was allocated on 17 March 2011.

Citing Articles

Myofascial Release for Chronic Low Back Pain: A Systematic Review and Meta-Analysis.

Wu Z, Wang Y, Ye X, Chen Z, Zhou R, Ye Z Front Med (Lausanne). 2021; 8:697986.

PMID: 34395477 PMC: 8355621. DOI: 10.3389/fmed.2021.697986.

Short-term increase in discs' apparent diffusion is associated with pain and mobility improvements after spinal mobilization for low back pain.

Thiry P, Reumont F, Brismee J, Dierick F Sci Rep. 2018; 8(1):8281.

PMID: 29844484 PMC: 5974269. DOI: 10.1038/s41598-018-26697-7.

Association of lumbar spine stiffness and flexion-relaxation phenomenon with patient-reported outcomes in adults with chronic low back pain - a single-arm clinical trial investigating the effects of thrust spinal manipulation.

Xia T, Long C, Vining R, Gudavalli M, DeVocht J, Kawchuk G BMC Complement Altern Med. 2017; 17(1):303.

PMID: 28599647 PMC: 5466774. DOI: 10.1186/s12906-017-1821-1.

Antinociceptive Effects of Spinal Manipulative Therapy on Nociceptive Behavior of Adult Rats during the Formalin Test.

Onifer S, Reed W, Sozio R, Long C Evid Based Complement Alternat Med. 2015; 2015:520454.

PMID: 26693243 PMC: 4674607. DOI: 10.1155/2015/520454.

Effects of spinal manipulation on sensorimotor function in low back pain patients--A randomised controlled trial.

Goertz C, Xia T, Long C, Vining R, Pohlman K, DeVocht J Man Ther. 2015; 21:183-90.

PMID: 26319101 PMC: 4713351. DOI: 10.1016/j.math.2015.08.001.

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