Effects of a Thoracic Manipulation on Hip Adductor, Extensor, and Latissimus Dorsi Force in Those With Adductor Weakness

July 30, 2024 updated by: Michael Lawrence, University of New England

Effects of a High Velocity Low Amplitude Mid-Thoracic Spinal Segment Manipulation on the Force Output of the Hip Adductors and Extensors and the Latissimus Dorsi in Healthy Individuals With Unilateral Hip Adductor Weakness

The goal of this trial was to determine if a mid-thoracic high velocity low amplitude spinal manipulation improves force output in those with unilateral hip adductor weakness. The main aims were to determine if the intervention:

Improved hip adductor force and muscle activation immediately and 48 h post manipulation compared to a control group.

Improved gluteus maximus and latissimus dorsi force and muscle activation immediately and 48 h post manipulation compared to a control group.

Strength and muscle activation of the hip adductors, hip extensors (gluteus maximus), and shoulder extensors (latissimus dorsi) were measured prior to, immediate after, and 48 hours after receiving a high velocity low amplitude manipulation to the thoracic spine. The manipulation was performed by a licensed chiropractor.

A control group received a validated sham manipulation to the thoracic spine. Participants were blinded to group assignment.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

40

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

  • United States
    • Maine
      • Portland, Maine, United States, 04103
        • University of New England

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Unilateral hip adductor weakness, as assessed by manual muscle testing
  • Pain free hip motion
  • No contraindications to high velocity thoracic spine manipulation including:

Any known active cancer/ Metastatic Bone Cancer Osteoporosis or other metabolic bone disorders Signs of spinal cord compression Nerve root compression with increasing neurologic deficit Signs of Vertebrobasilar insufficiency/ cervical artery abnormalities Bleeding Diatheses Angina pectoris

Exclusion Criteria:

  • Current pain in the adductor muscle group
  • Past history of hip surgery
  • Past history of hip fracture
  • History of spine or rib fractures
  • Psoas muscle group (hip flexor) weakness as determined by manual muscle testing
  • Received a chiropractic manipulation in past week

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Manipulation
Those in the intervention group received a high velocity low amplitude manipulation to the mid-thoracic spine provided by a licensed chiropractor.
Procedure: High velocity low amplitude thoracic spine manipulation
Participants were supine on a treatment table. The chiropractor determined levels of apparent spinal dysfunction by means of static palpation. Participants were then asked to curl forward and bring their knees to their chest as the chiropractor placed a fist just inferior to the targeted level, anywhere between the T4 - T10 vertebrae. The participant was instructed to inhale and then exhale, at which point the chiropractor lowered the participant's torso back to the table and delivered a thrust using his body into his fist.
Sham Comparator: Sham
Those in the control group received a validated sham manipulation to the mid-thoracic spine. The sham manipulation was done so that there was minimal downward force applied to the spine.
Procedure: Sham
A previously validated physiologically inert manual procedure to the thoracic spine

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Hip adductor force (weak limb)
Time Frame: Pre intervention, immediatly post intervention, 48 hours post intervention
Isometric force produced by the hip adductors in the weaker limb. Measured with a force transducer and reported in Newtons.
Pre intervention, immediatly post intervention, 48 hours post intervention
Hip adductor muscle activity (weak limb)
Time Frame: Pre intervention, immediatly post intervention
Mean muscle activity during isometric contraction. Measured with surface electrode and reported as a percentage of maximum activation.
Pre intervention, immediatly post intervention

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Hip extension force (strong limb)
Time Frame: Pre intervention, immediatly post intervention, 48 hours post intervention
Isometric force produced by the hip extensors in the strong limb. Measured with a force transducer and reported in Newtons.
Pre intervention, immediatly post intervention, 48 hours post intervention
Gluteus maximus muscle activity (strong limb)
Time Frame: Pre intervention, immediatly post intervention
Mean muscle activity during isometric contraction. Measured with surface electrode and reported as a percentage of maximum activation.
Pre intervention, immediatly post intervention
Hip extension force (weak limb)
Time Frame: Pre intervention, immediatly post intervention, 48 hours post intervention
Isometric force produced by the hip extensors in the weak limb. Measured with a force transducer and reported in Newtons.
Pre intervention, immediatly post intervention, 48 hours post intervention
Gluteus maximus muscle activity (weak limb)
Time Frame: Pre intervention, immediatly post intervention
Mean muscle activity during isometric contraction. Measured with surface electrode and reported as a percentage of maximum activation.
Pre intervention, immediatly post intervention
Shoulder extension force (weak limb)
Time Frame: Pre intervention, immediatly post intervention, 48 hours post intervention
Isometric force produced by the shoulder extensors in the weak limb. Measured with a force transducer and reported in Newtons.
Pre intervention, immediatly post intervention, 48 hours post intervention
Latissimus dorsi muscle activity (weak limb)
Time Frame: Pre intervention, immediatly post intervention
Mean muscle activity during isometric contraction. Measured with surface electrode and reported as a percentage of maximum activation.
Pre intervention, immediatly post intervention
Shoulder extension force (strong limb)
Time Frame: Pre intervention, immediatly post intervention, 48 hours post intervention
Isometric force produced by the shoulder extensors in the strong limb. Measured with a force transducer and reported in Newtons.
Pre intervention, immediatly post intervention, 48 hours post intervention
Latissimus dorsi muscle activity (strong limb)
Time Frame: Pre intervention, immediatly post intervention
Mean muscle activity during isometric contraction. Measured with surface electrode and reported as a percentage of maximum activation.
Pre intervention, immediatly post intervention
Hip adductor muscle activity (strong limb)
Time Frame: Pre intervention, immediatly post intervention
Mean muscle activity during isometric contraction. Measured with a force transducer and reported in Newtons.
Pre intervention, immediatly post intervention
Hip adductor force (strong limb)
Time Frame: Pre intervention, immediatly post intervention, 48 hours post intervention
Isometric force produced by the hip adductors in the strong limb. Measured with a force transducer and reported in Newtons.
Pre intervention, immediatly post intervention, 48 hours post intervention

Collaborators and Investigators

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

Sponsor

University of New England

Collaborators

Raymond Chiropractic

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

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)

November 8, 2021

Primary Completion (Actual)

December 13, 2023

Study Completion (Actual)

December 13, 2023

Study Registration Dates

First Submitted

July 30, 2024

First Submitted That Met QC Criteria

July 30, 2024

First Posted (Actual)

August 2, 2024

Study Record Updates

Last Update Posted (Actual)

August 2, 2024

Last Update Submitted That Met QC Criteria

July 30, 2024

Last Verified

July 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ThoracicManip

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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