- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03063177
Evaluation of How Different Dosages of Spinal Manipulation Modulate Spinal Stiffness in Participants With Back Pain
September 7, 2018 updated by: Martin Descarreaux, Université du Québec à Trois-Rivières
Evaluation of the Associations Between Spinal Manipulative Therapy Dosage and the Related Spinal Stiffness Modulation in Participants With Chronic Thoracic Pain
This study evaluate the relationships between spinal manipulative therapy dosage (speed and peak force), the resulting modulation of thoracic spinal stiffness and changes in the clinical status in participants with chronic thoracic pain.
Participants will attend four sessions of one hour over 2 weeks.
During session 1 to 3, participants will receive one of three different spinal manipulative therapy dosages based on their group assignment and preceded and followed by the measurement of their thoracic spinal stiffness.
Session 4 will include spinal stiffness measurement and clinical status evaluation through questionnaires.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Spinal manipulative therapy (SMT) is based on the premise that clinicians can identify spine mechanical changes and accordingly determine the dosage of its biomechanical parameters: preload force, rate of force application and peak force.
In recent years, our research team showed, using an apparatus to deliver specific dosage SMTs, that SMT-related neurophysiological responses depend on the dosage of these parameters.
Beside determining the SMT dosage, clinicians have to select the spinal level to be treated which is partly done by applying a light pressure to each spinous process (spinal stiffness assessment).
This study consist of a randomized controlled trial including 75 participants with chronic thoracic pain who will be randomized in one of three groups.
Based on their group assignment, participants will receive a specific dosage SMT delivered at T7 three times over 2 weeks.
These SMT dosages are distinct regarding their speed and/or their peak force in order to generate either a high vertebral displacement or a high muscle reflex response.
T6, T7 and T8 spinal stiffness will be measured just before and after treatment and clinical status will be assessed at each session beginning through questionnaires.
Session four will include the questionnaires and the spinal stiffness measurement procedure.
Both SMT and spinal stiffness measurement will be performed using an apparatus aiming at simulating force-time profiles.
Surface electromyography electrodes and accelerometers will be positioned over the upper back skin in order to measure the muscle response and vertebral displacement during SMT and spinal stiffness measurement procedures.
Study Type
Interventional
Enrollment (Actual)
81
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
-
-
Quebec
-
Trois-Rivières, Quebec, Canada, G9A 5H7
- Université du Québec à Trois-Rivières
-
-
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 60 years (ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Adults aged between 18 and 60 years hold and presenting a constant or recurrent pain in the thoracic area for at least 12 weeks. Thoracic are is defined as the region boarded superiorly by T1 spinous process, inferiorly by T12 spinous process and laterally by the lateral border of the thoracic erector spinae muscles. The pain has to be of non organic origin.
Exclusion Criteria:
- Spinal arthritis, aortic aneurysm, collagenosis, advanced osteoporosis, spine surgery, neuromuscular disease, current cancer, uncontrolled hypertension, thoracic radiculopathy, thoracic herniated disc, current infection, thoracic scoliosis, current pregnancy, any contraindication to spinal manipulative therapy of the thoracic spine.
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
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: 1840Newtons/s(N/s);125ms;250 Newtons(N)
Participants will receive a spinal manipulative therapy of 20 Newtons (N) preload leading to a peak force of 250N over 125ms (rate of force application of 1840N/s).
|
A SMT will be delivered by contacting the transverse processes of T7 through our apparatus.
Each participant will receive one SMT per session for 3 sessions.
|
EXPERIMENTAL: 920N/s;125ms;135N
Participants will receive a spinal manipulative therapy of 20N preload leading to a peak force of 135N over 125ms (rate of force application of 920N/s).
|
A SMT will be delivered by contacting the transverse processes of T7 through our apparatus.
Each participant will receive one SMT per session for 3 sessions.
|
EXPERIMENTAL: 920N/s;250ms;250N
Participants will receive a spinal manipulative therapy of 20N preload leading to a peak force of 250N over 250ms (rate of force application of 920N/s).
|
A SMT will be delivered by contacting the transverse processes of T7 through our apparatus.
Each participant will receive one SMT per session for 3 sessions.
|
NO_INTERVENTION: control
Spinal stiffness will be assessed at each sesssion, however, participants won't receive any spinal manipulative therapy.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in spinal stiffness
Time Frame: 2 weeks
|
Changes in spinal stiffness between session four and the first session will be assessed at T6, T7 and T8.
Spinal stiffness is measured by applying a gradual load of 45 Newtons (N) (5 kg) through our apparatus and by recording the associated indenter displacement.
The resulting force-displacement data are used to calculate a spinal stiffness coefficient (N/mm) with lower value indicating more mobility at the spinal level.
The change in spinal stiffness will be calculated for each participant by subtracting the value obtained during the fourth session to the one during the first session.
A positive value will indicate a decrease in spinal stiffness (increase mobility) while a negative value will indicate an increase in spinal stiffness (decrease mobility) with higher value indicating more important changes.
|
2 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in pain intensity
Time Frame: 2 weeks
|
Changes in pain intensity between session four and the first session will be evaluated by subtracting the pain value (over a 0-100 point visual analogue rating scale) obtained at session four by the one at the first session.
Positive value indicates a decrease in pain with higher value indicating a more important decrease.
|
2 weeks
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in disability
Time Frame: 2 weeks
|
Changes in disability between session four and the first session will be evaluated by subtracting the Quebec Back Pain Disability scale score (0-100 score with higher score indicating higher disability) obtained at session four by the one at the first session.
Positive value indicates a decrease in disability with higher value indicating a more important decrease.
|
2 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Martin Descarreaux, Dc, Université du Québec à Trois-Rivières
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Descarreaux M, Nougarou F, Dugas C. Standardization of spinal manipulation therapy in humans: development of a novel device designed to measure dose-response. J Manipulative Physiol Ther. 2013 Feb;36(2):78-83. doi: 10.1016/j.jmpt.2012.12.007.
- Page I, Descarreaux M. Effects of spinal manipulative therapy biomechanical parameters on clinical and biomechanical outcomes of participants with chronic thoracic pain: a randomized controlled experimental trial. BMC Musculoskelet Disord. 2019 Jan 18;20(1):29. doi: 10.1186/s12891-019-2408-4.
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 (ACTUAL)
May 1, 2017
Primary Completion (ACTUAL)
December 22, 2017
Study Completion (ACTUAL)
December 22, 2017
Study Registration Dates
First Submitted
February 20, 2017
First Submitted That Met QC Criteria
February 23, 2017
First Posted (ACTUAL)
February 24, 2017
Study Record Updates
Last Update Posted (ACTUAL)
September 10, 2018
Last Update Submitted That Met QC Criteria
September 7, 2018
Last Verified
September 1, 2018
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- UQTR_2017_dose_stiffness
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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