Manual Therapy as a Form of Sensory Discrimination in Chronic Low Back Pain

A Randomized Controlled Trial of Manual Therapy as a Form of Sensory Discrimination in Chronic Low Back Pain

This study evaluates whether different explanations given to patients with long lasting back pain influence a physical therapy treatment technique. Half of the patients will receive an explanation of the proposed treatment technique focusing on how their joints are moving and not moving. The second half of the group will receive the same treatment technique as the first group, but their explanation of the technique's purpose will focus on how their brain interprets the information. The study aims to determine if patients have a different response to the treatment based on the words chosen to explain the technique.

Study Overview

• Status: Completed
• Conditions: Low Back Pain
• Intervention / Treatment: Procedure: Neuroplasticity Explanation (Experimental); Procedure: Biomechanical Explanation (Control)

Detailed Description

Traditional treatment provided by physical therapists to patients with chronic low back pain focuses on the biomechanical or anatomical impact to local tissues. Recent research has shown that treatment effects may be more related to the understanding of the structural and functional changes in the brain of someone suffering from chronic low back pain. This research implicates that the patients understanding and interpretation of input to the brain may change the patient's perceived representation and interpretation of output of pain within the brain.

• Study Type: Interventional
• Enrollment (Actual): 62
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Illinois
    • Moline, Illinois, United States, 61265
      • Rock Valley Physical Therapy
    • Silvis, Illinois, United States, 61282-4700
      • Rock Valley Physical Therapy
    • Woodridge, Illinois, United States, 60517
      • Edward Health & Fitness Center & Spa at Seven Bridges
  • Iowa
    • Davenport, Iowa, United States, 52806
      • Rock Valley Physical Therapy
    • Davenport, Iowa, United States, 52807
      • Genesis Physical Therapy and Sports Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Adults over the age of 18
• Presenting at Physical Therapy with a primary complaint of Low Back Pain
• Low Back Pain being present for 6 months or more
• Fluent in English and willing to participate in the study.

Exclusion Criteria:

• Medical precautions to the use of manual therapy (metal, skin lesions, etc.)
• Prior spine surgery
• Unable to lay prone for the treatment.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Neuroplasticity Education Group; Patients who receive manual physical therapy treatment with a neuroplasticity explanation of the basis for the technique	Procedure: Neuroplasticity Explanation (Experimental); Patients were given an explanation of how the brain uses the information from a manual therapy technique to help it remain sharp in identifying where this input is coming from.
Active Comparator: Biomechanical Education Group; Patients who receive manual physical therapy treatment with a traditional, biomechanical explanation of the basis for the technique	Procedure: Biomechanical Explanation (Control); Patients were given an explanation of how the manual therapy technique affects the anatomy and physiology of the back.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Low back pain rating change	Change, measured within a single, one hour session, of baseline measurements taken, followed immediately by the education / treatment, followed immediately by post-education / treatment measurement of the patient's pain in low back on a numeric pain rating scale of 0 to 10	Within a single, one hour session
Leg pain rating	Change, measured within a single, one hour session, of baseline measurements taken, followed immediately by the education / treatment, followed immediately by post-education / treatment measurement, level of patient's leg pain on a numeric pain rating scale of 0 to 10.	Within a single, one hour session
Active trunk forward flexion	Change, measured within a single, one hour session, of baseline measurements taken, followed immediately by the education / treatment, followed immediately by post-education / treatment measurement of distance from longest finger to the floor when patient bends forward (in cm).	Within a single, one hour session
Straight Leg Raise	Change, measured within a single, one hour session, of baseline measurements taken, followed immediately by the education / treatment, followed immediately by post-education / treatment measurement of angle to which the patient's most affected leg can be lifted (measured in degrees using an inclinometer).	Within a single, one hour session

Collaborators and Investigators

• Sponsor: Kevin Farrell
• Investigators: Principal Investigator: Adriaan Louw, PT, PhD, International Spine Pain Institute

Study record dates

Study Major Dates

• Study Start: May 1, 2015
• Primary Completion (Actual): September 1, 2015
• Study Completion (Actual): September 1, 2015

Study Registration Dates

• First Submitted: April 12, 2016
• First Submitted That Met QC Criteria: April 27, 2016
• First Posted (Estimate): May 2, 2016

Study Record Updates

• Last Update Posted (Estimate): May 2, 2016
• Last Update Submitted That Met QC Criteria: April 27, 2016
• Last Verified: April 1, 2016

More Information

Terms related to this study

• Keywords: Pain; Brain; Education; Plasticity; Manual Therapy; Straight Leg Raise; Remapping
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Back Pain; Low Back Pain
• Other Study ID Numbers: StAmbroseU

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No