- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02375386
Feasibility Assessment of Neurophysiological Measurement in Veterans With LBP
CENTRAL MECHANISMS OF BODY BASED INTERVENTION FOR MUSCULOSKELETAL LOW BACK PAIN: Feasibility Assessment of Neurophysiological Measurement in Veterans With Low Back Pain
Study Overview
Status
Conditions
Detailed Description
Participants will be enrolled from VA pain clinical at the North Florida/South George VA Medical Center.
The investigators will collect functional magnetic resonance imaging data of resting state and pain-related events (i.i. during thermal pain sensitivity testing, as well as psychophysical data to determine pain sensitivity. Pain sensitivity will be measured using thermal and mechanical stimuli. These data will be collected before and after the interventions, in addition to two follow-up sessions after intervention.
In addition, clinical measures of pain intensity in the low back, as well as trunk range of motion and strength will also be collected.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Florida
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Gainesville, Florida, United States, 32610-0154
- University of Florida
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- complaints of current back pain that they rate at least 40 on a 101-point numeric rating scale
- Participants must able to understand written and spoken English
Exclusion Criteria:
- currently receiving treatment for LBP or have received SMT for LBP in the past year
- Quebec Task Force on Spinal Disorders (QTFSD) to identify patients with pre-existing nerve root compression, spinal stenosis, or post-surgery
- any chronic medical conditions that may affect pain perception (e.g., diabetes, high blood pressure, fibromyalgia, headaches)
- any contraindication to MRI
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Spinal manipulation
Participants will receive a lumbar SMT technique previously described in the literature and commonly utilized for the treatment of low back pain .
The SMT will be performed four times (two times on each side) in a 5-minute period.
In addition, the following will be performed: Functional MRI (fMRI), Behavioral: Pain Sensitivity Testing, Questionnaires,Behavioral: Physical Impairment.
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Participants will receive a lumbar SMT technique previously described in the literature and commonly utilized for the treatment of low back pain .
The SMT will be performed four times (two times on each side) in a 5-minute period.
In addition, the following will be performed: Functional MRI, Behavioral: Pain Sensitivity Testing, Questionnaires,Behavioral: Physical Impairment.
Both groups will receive an fMRI.
Other Names:
Both groups will receive an Pain Sensitivity Testing
Both groups will receive Questionnaires
Both groups will receive testing on physical impairment.
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Sham Comparator: Therapeutic touch
Participants in this group will lie prone.
The therapist will place both hands in contact with the participants' pelvis across the top of the posterior aspect of the sacrum and ilia and apply a downward force to keep the pelvis in contact with the table.
This group accounts for effects of time and personal contact.
The amount of "hands-on" contact will be equivalent between groups.
Both groups will be given the same verbal instructions regarding the techniques performed.
In addition, the following will be performed: Functional MRI (fMRI), Behavioral: Pain Sensitivity Testing, Questionnaires,Behavioral: Physical Impairment.
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Both groups will receive an fMRI.
Other Names:
Both groups will receive an Pain Sensitivity Testing
Both groups will receive Questionnaires
Both groups will receive testing on physical impairment.
Participants in this group will lie prone.
The therapist will place both hands in contact with the participants' pelvis across the top of the posterior aspect of the sacrum and ilia and apply a downward force to keep the pelvis in contact with the table.
This group accounts for effects of time and personal contact.
The amount of "hands-on" contact will be equivalent between groups.
Both groups will be given the same verbal instructions regarding the techniques performed.
In addition, the following will be performed: Functional MRI, Behavioral: Pain Sensitivity Testing, Questionnaires,Behavioral: Physical Impairment.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
fMRI during testing of pain changes from approximately Day 3 and Day 5
Time Frame: Change from approximately Day 3 and Day 5
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Change from approximately Day 3 and Day 5
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fMRI during quite rest changes from approximately Day 3 and Day 5
Time Frame: Change from approximately Day 3 and Day 5
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Change from approximately Day 3 and Day 5
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Pain Sensitivity Testing changes from Day 3, Day 4 and Day 5
Time Frame: Change from Day 3, Day 4 and Day 5
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This measure thermal threshold and tolerance using continuous heat stimulus delivered to the participants' dominant arm.
The stimulus will start at 35°C and will be increased at a rate of 0.5°C with participants terminating the stimulus when the temperature reached pain threshold ("when the sensation first transitions from heat to pain") and tolerance ("when the sensation becomes so strong you want to remove it from your skin").
Threshold and tolerance measures will also be collected using mechanical pressure applied using a Fischer Dolorimeter.
During Dolorimeter testing, force is slowly increased until the subject indicates that the sensation changes from pressure to pain.
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Change from Day 3, Day 4 and Day 5
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pain Intensity
Time Frame: Change from Day 3, Day 4 and Day 5
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Pain visual analog scale is a 10cm long line.
The line is anchored at one end with 'none' or 'not bad at all' and at the other with 'worst imaginable.' Participants are asked to rate their pain at rest by placing a mark along the 10cm line.
Participants will also rate pain during active trunk range of motion using the same scale.
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Change from Day 3, Day 4 and Day 5
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McGill Pain Questionnaire-2
Time Frame: Change from Day 3, Day 4 and Day 5
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This is 22-item questionnaire that asks participants to describe the intensity of varies qualities of the pain that he or she is experiencing; for example, throbbing or itching.
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Change from Day 3, Day 4 and Day 5
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Physical Impairment
Time Frame: Change from Day 3, Day 4 and Day 5
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A physical impairment scale consists of 7 different examination procedures that assess lumbar and hip range of motion, muscle performance of trunk musculature, and response to palpation.
Scores is 0 - 8, Range is 0 is no impairment and 8 is completely impaired.
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Change from Day 3, Day 4 and Day 5
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Oswestry Disability Questionnaire (ODQ)
Time Frame: Change from Day 3, Day 4 and Day 5
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The ODQ has a range of 0 (no disability due to back pain) to 100 (completely disabled due to back pain), so higher scores indicate higher disability from LBP.
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Change from Day 3, Day 4 and Day 5
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Mark D Bishop, PhD, University of Florida
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB201300827-N
- 3R01AT006334-02S1 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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