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Manual Therapy Dosage Factorial Study

22. september 2015 oppdatert av: 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.

Studieoversikt

Status

Tilbaketrukket

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Fase

  • Fase 2
  • Fase 3

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

21 år til 60 år (Voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Faktoriell oppgave
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Ingen inngripen: A
Zero treatment/3 weeks
Aktiv komparator: 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.
Aktiv komparator: 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.
Aktiv komparator: 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.
Aktiv komparator: 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.
Aktiv komparator: 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.
Aktiv komparator: 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.
Aktiv komparator: 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.
Aktiv komparator: 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.
Aktiv komparator: 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.
Ingen inngripen: E
Zero treatment/6 weeks
Ingen inngripen: I
Zero treatment/12 weeks

Hva måler studien?

Primære resultatmål

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

Sekundære resultatmål

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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Samarbeidspartnere

Etterforskere

  • Hovedetterforsker: Joy C MacDermid, PhD, McMaster University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Datoer for studieregistrering

Først innsendt

19. november 2007

Først innsendt som oppfylte QC-kriteriene

19. november 2007

Først lagt ut (Anslag)

20. november 2007

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

23. september 2015

Siste oppdatering sendt inn som oppfylte QC-kriteriene

22. september 2015

Sist bekreftet

1. september 2015

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 1 R21 AT004263

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