Low Back Pain Clinical Trial
Official title:
Immediate Effects of a Spinal Lumbar Manipulation on the Threshold Pressure Pain and the Postural Control in Subjects With Non-specific Low Back Pain
Non-specific low back pain is defined as a pain with no specific vertebral-related cause,
such as infectious disease, tumor, osteoporosis, fracture, structural abnormality,
inflammatory disease, radicular compressive syndrome or cauda equine syndrome. Non-specific
low back pain is a common disease in many countries. This musculoskeletal disorder is costly
to public health systems. Therefore, the use of manual therapies is important in the
treatment of this disease and studies show the effectiveness of this type of therapy.
Spinal manipulation is applied in manual therapies such as Osteopathy, Chiropractic and
Physical Therapy and is widely used for acute and chronic non-specific low-back pain. There
is moderate evidence that spinal manipulation is superior to sham spinal manipulation for
improving short-term pain and function in chronic and acute non-specific low back pain.
However the therapeutic mechanisms involved in this procedure are not well understood.
Furthermore, while the high velocity and low amplitude spinal therapy has been shown to be
effective in reducing pain and improving functional capacity in subjects with non-specific
low back pain, the effect on postural variables have not been investigated. Therefore, the
aim of this study is to evaluate the acute effect of lumbar manipulation on pain and
postural variables.
Twenty-four individuals with non-specific low back pain will be randomly allocated to two
groups. The intervention group will receive high velocity and low amplitude spinal therapy,
while the control group will receive sham manipulation. Immediately before and after the
respective manipulation protocol, both groups will be evaluated regarding pain level, using
a visual-analogue scale and algometer, and postural variables, using center of pressure
displacement measured with the aid of a force plate. While the patient and therapist
manipulator will be aware of the protocol applied in each case, the evaluator will be blind.
A statistical treatment will be used to compare the results.
Mean and standard deviation are calculated for each variable of postural control, as well as
the values obtained in the measurement of pain using the numeric pain rating scale and
algometry data.
t-test or Mann-Whitney test will be used to compare data before and after the manipulation
protocol.
Multiple One-Way ANOVAs will be used to compare the manipulation protocol, for each
dependent variable: effects of pain and center of pressure displacement.. Statistical
analysis will be conducted with a confidence interval of 95%, α value of 5%, p value of ≤
0.05.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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