Immediate Effects Cervicothoracic Manipulation Versus Passive Upper Trapezius Stretch

September 16, 2015 updated by: Emilio J Puentedura, PT, DPT, PhD, University of Nevada, Las Vegas

Effects of Cervicothoracic Manipulation and Passive Stretching to the Upper Trapezius Muscle on Pressure Pain Thresholds and Cervical Range of Motion on Healthy Individuals

The proposed project seeks to evaluate the influence of cervicothoracic (CT) manipulation and passive stretching to the upper trapezius on pressure pain thresholds and range of motion (ROM) in individuals without recent complain of neck pain.

Study Overview

Detailed Description

Not needed

Study Type

Interventional

Enrollment (Actual)

90

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Nevada
      • Las Vegas, Nevada, United States, 89154
        • University of Nevada Las Vegas - Department of Physical Therapy

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

1. No current history or past history of neck pain; able to lie on back or stomach without difficulty

Exclusion Criteria:

  1. 'Red flag' items indicated in your Neck Medical Screening Questionnaire such as history of a tumor, bone fracture, metabolic diseases, Rheumatoid Arthritis, osteoporosis, severe atherosclerosis, prolonged history of steroid use, etc.
  2. History of neck whiplash injury
  3. Diagnosis from your physician of cervical spinal stenosis (narrowing of spinal canal) or presence of symptoms (pain, pins and needles, numbness) down both arms
  4. Presence of central nervous system involvement such as exaggerated reflexes, changes in sensation in the hands, muscle wasting in the hands, impaired sensation of the face, altered taste, and presence of abnormal reflexes
  5. Evidence of neurological signs consistent with nerve root entrapment (pinched nerve in the neck)
  6. Prior surgery to your neck or upper back
  7. A medical condition which may influence assessment of pain or pressure pain thresholds (i.e. taking analgesics, sedatives, history of substance abuse, or cognitive deficiency)
  8. Diagnosis from your physician of fibromyalgia syndrome
  9. Currently pregnant, or could be pregnant

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Cervicothoracic manipulation
Description of a Right C7/T1 manipulation. The subject will lie prone. The therapist will stand on the L side of the subject facing in a cephalic direction (towards the patient's head). The therapist's right hand makes contact with the thumb on the right side of the spinous process of the first thoracic vertebra. The therapist left hand supports the head making contact on the temporal bone. The hand/neck is gently laterally flexed to the right, until slight tension is palpated in the tissues. A high-velocity low-amplitude thrust will be applied towards the subjects left side. If cavitation does not occur (an audible pop) the subject will be repositioned and the manipulation attempted a second time. A maximum of 2 attempts will be performed for each side of the neck.
Manipulation to the cervicothoracic spine
Active Comparator: Upper trapezius stretch

The subjects will be in a supine position. A researcher will passively place the subject's head into flexion, side-bending away and rotation towards the side to be stretched until the muscle barrier is met. The researcher will depress the subject's shoulder with 100 Newtons of force measured with a Micro FET pressure dynamometer (Hoggan Health Industries, Salt Lake City, UT).) Once this pressure amount is achieved the stretch will be held for 30 seconds. This will be repeated two times on each side.

The subject will be asked to provide continuous feedback about the stretch felt and the degree of discomfort (if any) felt during the 30 second stretches.

Sustained stretch of upper trapezius muscle
Other: Control group
Subjects assigned to the control group will receive no intervention. They will stay behind the curtained research area for approximately 3 minutes in a seated position.
Wait

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cervical Range of Motion
Time Frame: Immediately after the intervention
Cervical Range of Motion in each cardinal plane (sagittal, coronal and transverse) will be measured in angular degrees using a CROM device
Immediately after the intervention

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Pressure Threshold
Time Frame: Two minutes and 5 Minutes after the intervention
Pain Pressure Threshold measured using a standard handheld algometer with 1 cm round tip
Two minutes and 5 Minutes after the intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Emilio J Puentedura, PT, DPT, PhD, UNLV

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2013

Primary Completion (Actual)

November 1, 2014

Study Completion (Actual)

November 1, 2014

Study Registration Dates

First Submitted

September 14, 2015

First Submitted That Met QC Criteria

September 16, 2015

First Posted (Estimate)

September 17, 2015

Study Record Updates

Last Update Posted (Estimate)

September 17, 2015

Last Update Submitted That Met QC Criteria

September 16, 2015

Last Verified

September 1, 2015

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 1303-4412

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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