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Manual Therapy Dosage Factorial Study

22 septembre 2015 mis à jour par: 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.

Aperçu de l'étude

Statut

Retiré

Intervention / Traitement

Type d'étude

Interventionnel

Phase

  • Phase 2
  • Phase 3

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

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

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

21 ans à 60 ans (Adulte)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

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

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation factorielle
  • Masquage: Double

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Aucune intervention: A
Zero treatment/3 weeks
Comparateur actif: 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.
Comparateur actif: 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.
Comparateur actif: 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.
Comparateur actif: 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.
Comparateur actif: 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.
Comparateur actif: 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.
Comparateur actif: 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.
Comparateur actif: 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.
Comparateur actif: 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.
Aucune intervention: E
Zero treatment/6 weeks
Aucune intervention: I
Zero treatment/12 weeks

Que mesure l'étude ?

Principaux critères de jugement

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

Mesures de résultats secondaires

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

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: Joy C MacDermid, PhD, McMaster University

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates d'inscription aux études

Première soumission

19 novembre 2007

Première soumission répondant aux critères de contrôle qualité

19 novembre 2007

Première publication (Estimation)

20 novembre 2007

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

23 septembre 2015

Dernière mise à jour soumise répondant aux critères de contrôle qualité

22 septembre 2015

Dernière vérification

1 septembre 2015

Plus d'information

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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