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Manual Therapy Dosage Factorial Study

22. září 2015 aktualizováno: McMaster University

This study will determine biological responses to different dosages of neck mobilization intervention in patients, providing opportunities to identify the optimal dosage, predictors of response, outcome measures as well as the longitudinal changes in biology.

Subjects with acute whiplash associated disorders (WAD) II and III with a symptom duration of less than 30 days (acute) or 30 to 90 days (subacute) will be randomly assigned to receive different doses of mobilization. The dosage treatment groups will differ in the number of sessions (1, 2 or 3 times per week) and the duration of treatment (duration of treatment intervention will be 3, 6, or 12 weeks). A zero treatment/week option is included to insure that the impact of any mobilization is included and because previous studies suggest a single mobilization may have a treatment effect.

All patient participants will receive a core standard treatment of education, advice to stay active, and neck/postural stretching and strengthening exercise. All patient participants will receive supervised exercise and advice for the full 12 weeks. All patients will be provided with an instructional CD and exercise brochure to reinforce the whole program.

Follow-up assessments will consist of quantitative sensory testing (vibration threshold; current perception threshold), the Neck Walk Index (NWI), the Upper Cyclical Reach and Grasp Task, muscle biology analyses (cytokine analyses), central breathing control tests (capnography), range of motion, head flexion endurance, and self-report symptoms and disability (Visual Analogue Scale; Neck Disability Index; Disabilities of the Arm, Shoulder, Hand; pain threshold and tolerance algometry; and perceived self-efficacy; SF-36).

Hypothesis: During recovery, patient are expected to transition from an acute painful state to one where they can resume normal activity and add intensive strengthening exercises.

Přehled studie

Postavení

Staženo

Intervence / Léčba

Typ studie

Intervenční

Fáze

  • Fáze 2
  • Fáze 3

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

    • Ontario
      • Hamilton, Ontario, Kanada, L8S 1C7
        • McMaster University

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

21 let až 60 let (Dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Všechno

Popis

Inclusion Criteria:

  • acute whiplash associated disorders (WAD) II and III (113) with a symptom duration of less than 30 days or subacute (30 to 90 days)
  • pain in the neck but may radiate to the shoulder region or upper extremities or have an associated headache
  • pain intensity must be at or above 30 mm on a 100 mm visual analogue scale
  • must be a new episode of pain with ,no other occurrences of neck pain requiring treatment in the previous 4 months.

Exclusion Criteria:

  • arthritis, neurological diseases, fractures, dislocation, rheumatoid arthritis, long tract signs and malignancy
  • conditions that make the provision of neck exercise unsafe

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Randomizované
  • Intervenční model: Faktorové přiřazení
  • Maskování: Dvojnásobek

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Žádný zásah: A
Zero treatment/3 weeks
Aktivní komparátor: B
Frequency of Mobilization:1/week Duration of Mobilization Treatment: 3 weeks
Mobilizations are passive movements performed in such a manner that the patient can volitionally prevent the movement. Types of mobilization include: a) passive oscillatory movements (2-3 Hz) of small or large amplitude, applied anywhere in a range of movement, typically for anything between 30 seconds and several minutes depending on the response and desired effects, and b) sustained stretching (glides) with or without tiny amplitude oscillations at the limit of the range.
Aktivní komparátor: C
Frequency of Mobilization: 1/week Duration of Mobilization Treatment: 6 weeks
Mobilizations are passive movements performed in such a manner that the patient can volitionally prevent the movement. Types of mobilization include: a) passive oscillatory movements (2-3 Hz) of small or large amplitude, applied anywhere in a range of movement, typically for anything between 30 seconds and several minutes depending on the response and desired effects, and b) sustained stretching (glides) with or without tiny amplitude oscillations at the limit of the range.
Aktivní komparátor: D
Frequency of Mobilization: 1/week Duration of Mobilization Treatment: 12 weeks
Mobilizations are passive movements performed in such a manner that the patient can volitionally prevent the movement. Types of mobilization include: a) passive oscillatory movements (2-3 Hz) of small or large amplitude, applied anywhere in a range of movement, typically for anything between 30 seconds and several minutes depending on the response and desired effects, and b) sustained stretching (glides) with or without tiny amplitude oscillations at the limit of the range.
Aktivní komparátor: F
Frequency of Mobilization: 2/week Duration of Mobilization Treatment: 3 weeks
Mobilizations are passive movements performed in such a manner that the patient can volitionally prevent the movement. Types of mobilization include: a) passive oscillatory movements (2-3 Hz) of small or large amplitude, applied anywhere in a range of movement, typically for anything between 30 seconds and several minutes depending on the response and desired effects, and b) sustained stretching (glides) with or without tiny amplitude oscillations at the limit of the range.
Aktivní komparátor: G
Frequency of Mobilization: 2/week Duration of Mobilization Treatment:6 weeks
Mobilizations are passive movements performed in such a manner that the patient can volitionally prevent the movement. Types of mobilization include: a) passive oscillatory movements (2-3 Hz) of small or large amplitude, applied anywhere in a range of movement, typically for anything between 30 seconds and several minutes depending on the response and desired effects, and b) sustained stretching (glides) with or without tiny amplitude oscillations at the limit of the range.
Aktivní komparátor: H
Frequency of Mobilization: 2/week Duration of Mobilization Treatment: 12 weeks
Mobilizations are passive movements performed in such a manner that the patient can volitionally prevent the movement. Types of mobilization include: a) passive oscillatory movements (2-3 Hz) of small or large amplitude, applied anywhere in a range of movement, typically for anything between 30 seconds and several minutes depending on the response and desired effects, and b) sustained stretching (glides) with or without tiny amplitude oscillations at the limit of the range.
Aktivní komparátor: J
Frequency of Mobilization: 3/week Duration of Mobilization Treatment: 3 weeks
Mobilizations are passive movements performed in such a manner that the patient can volitionally prevent the movement. Types of mobilization include: a) passive oscillatory movements (2-3 Hz) of small or large amplitude, applied anywhere in a range of movement, typically for anything between 30 seconds and several minutes depending on the response and desired effects, and b) sustained stretching (glides) with or without tiny amplitude oscillations at the limit of the range.
Aktivní komparátor: K
Frequency of Mobilization: 3/week Duration of Mobilization Treatment:6 weeks
Mobilizations are passive movements performed in such a manner that the patient can volitionally prevent the movement. Types of mobilization include: a) passive oscillatory movements (2-3 Hz) of small or large amplitude, applied anywhere in a range of movement, typically for anything between 30 seconds and several minutes depending on the response and desired effects, and b) sustained stretching (glides) with or without tiny amplitude oscillations at the limit of the range.
Aktivní komparátor: L
Frequency of Mobilization: 3/week Duration of Mobilization Treatment:12 weeks
Mobilizations are passive movements performed in such a manner that the patient can volitionally prevent the movement. Types of mobilization include: a) passive oscillatory movements (2-3 Hz) of small or large amplitude, applied anywhere in a range of movement, typically for anything between 30 seconds and several minutes depending on the response and desired effects, and b) sustained stretching (glides) with or without tiny amplitude oscillations at the limit of the range.
Žádný zásah: E
Zero treatment/6 weeks
Žádný zásah: I
Zero treatment/12 weeks

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Časové okno
Quantitative Sensory Testing (QST)
Časové okno: Within 24 weeks
Within 24 weeks
Current Perception Threshold (CPT)
Časové okno: Within 24 weeks
Within 24 weeks
Neck Walk Index (NWI)
Časové okno: Within 24 weeks
Within 24 weeks
Cyclical Reach and Grasp Test (CRGT)
Časové okno: Within 24 weeks
Within 24 weeks
Muscle Biology (cytokine analyses)
Časové okno: Within 24 weeks
Within 24 weeks
Central Breathing Control Test
Časové okno: Within 24 weeks
Within 24 weeks
Neck Disability Index
Časové okno: Within 24 weeks
Within 24 weeks
Pain Intensity - Visual Analogue Scale (VAS)
Časové okno: Within 24 weeks
Within 24 weeks

Sekundární výstupní opatření

Měření výsledku
Časové okno
Global Perceived Effect (GPE)
Časové okno: Within 24 weeks
Within 24 weeks
Disabilities of the Arm, Shoulder, and Hand (DASH)
Časové okno: Within 24 weeks
Within 24 weeks
Pain Threshold and Pain Tolerance Algometry
Časové okno: Within 24 weeks
Within 24 weeks
Head Flexion Endurance
Časové okno: Within 24 weeks
Within 24 weeks
Range of Motion
Časové okno: Within 24 weeks
Within 24 weeks
Quality of Life (SF-36v2)
Časové okno: within 24 weeks
within 24 weeks

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Vyšetřovatelé

  • Vrchní vyšetřovatel: Joy C MacDermid, PhD, McMaster University

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Termíny zápisu do studia

První předloženo

19. listopadu 2007

První předloženo, které splnilo kritéria kontroly kvality

19. listopadu 2007

První zveřejněno (Odhad)

20. listopadu 2007

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Odhad)

23. září 2015

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

22. září 2015

Naposledy ověřeno

1. září 2015

Více informací

Termíny související s touto studií

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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