Multiple Sclerosis, Relapsing-Remitting Clinical Trial
Official title:
Effects of Chiropractic Care on Pro- and Anti-inflammatory Cytokine Levels in Multiple Sclerosis
Multiple sclerosis (MS) is an inflammatory autoimmune disease associated with an imbalance between pro- and anti-inflammatory markers (cytokines) resulting in a demyelinating and neurodegenerative disease. There is early evidence that spinal manipulation (chiropractic care) is better than control in influencing immune (cytokine) activity in asymptomatic participants, but few studies have been completed in participants with chronic inflammatory conditions, such as MS. The purpose of this project is to examine the immediate (after a single thoracic spinal manipulation treatment) and summative impact (after 8 thoracic spinal manipulation treatments occurring over 4 weeks) on pro-inflammatory (interleukin (IL) IL-1ß, IL-2, IL-6, Tumor necrosis factor-alpha) and anti-inflammatory (IL-4, IL-10) plasma cytokines 20 minutes and 2 hours after thoracic spinal manipulation in participants diagnosed with neuroinflammatory relapsing-remitting MS (RR-MS). Spinal manipulation treatment will be limited to the thoracic spine. Secondary outcomes will include determining the impact of 8 thoracic spinal manipulations on fatigue, cognitive processing speed, pain, depression, sleep, and motor function through questionnaires and performance of various in assessments such as the timed 25 foot walk test.
Status | Recruiting |
Enrollment | 24 |
Est. completion date | December 30, 2024 |
Est. primary completion date | December 30, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 55 Years |
Eligibility | Inclusion Criteria: - Age 18 to 55 years - Physician-confirmed diagnosis of MS within the last 5 years - Expanded Disability Status Scale (EDSS) score below 4 based on Neurostatus-certified examination - Relapse free in the last 30 days - No known cardiovascular, pulmonary, or metabolic disease - Currently on stable FDA-approved disease modifying therapy (eg, interferon beta-1a or beta-1b, natalizumab etc.) - Naïve to chiropractic care - No contraindications to spinal manipulation - Acceptance of informed consent. Exclusion criteria include: - Uncontrolled hypertension (systolic pressure >160 mmHg, diastolic blood pressure >95 mmHg) Any past spinal surgery or recent history of bone fractures - Pregnancy in the last 12 months - Unable to understand English or follow simple instruction. |
Country | Name | City | State |
---|---|---|---|
United States | University of Alabama at Birmingham | Birmingham | Alabama |
Lead Sponsor | Collaborator |
---|---|
University of Alabama at Birmingham |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Serum inflammatory cytokine levels | Determine changes in serum inflammatory cytokine levels from baseline | Week 1 (at baseline) | |
Primary | Serum inflammatory cytokine levels | Determine changes in serum inflammatory cytokine levels from baseline | Week 1 (after 1st treatment | |
Primary | Serum inflammatory cytokine levels | Determine changes in serum inflammatory cytokine levels from baseline | Week 4 (after 8th treatment) | |
Secondary | Fatigue Severity Scale | Determine changes in fatigue from baseline. It is a 9 item scale determining fatigue severity and its effect on a person's activities | Week 1 (at baseline) | |
Secondary | Fatigue Severity Scale | Determine changes in fatigue from baseline. It is a 9 item scale determining fatigue severity and its effect on a person's activities | Week 4 (after 8th treatment) | |
Secondary | Modified Fatigue Impact Scale | Determine changes in fatigue and tiredness from baseline. It is a 21 item scale that provides a more in-depth look at the impact of fatigue and lack of energy might have on mental alertness and daily activities. | Week 1 (at baseline) | |
Secondary | Modified Fatigue Impact Scale | Determine changes in fatigue and tiredness from baseline. It is a 21 item scale that provides a more in-depth look at the impact of fatigue and lack of energy might have on mental alertness and daily activities. | Week 4 (after 8th treatment) | |
Secondary | Cognitive Processing Speed | Determine changes in cognitive (rapid) processing speed from baseline. Assesses the time it takes to complete a mental task and is related to the speed at which a person can understand and react to a set of information that they receive. | Week 1 (at baseline) | |
Secondary | Cognitive Processing Speed | Determine changes in cognitive (rapid) processing speed from baseline. Assesses the time it takes to complete a mental task and is related to the speed at which a person can understand and react to a set of information that they receive. | Week 4 (after 8th treatment) | |
Secondary | Short-form McGill Pain Questionnaire | Determine changes in pain from baseline. There are 2 subscales with 11 words (sensory dimension) and 4 words (Affective dimension) with selections of none, mild, moderate and severe along with a visual analog scale and present pain intensity description. | Week 1 (at baseline) | |
Secondary | Short-form McGill Pain Questionnaire | Determine changes in pain from baseline. There are 2 subscales with 11 words (sensory dimension) and 4 words (Affective dimension) with selections of none, mild, moderate and severe along with a visual analog scale and present pain intensity description. | Week 4 (after 8th treatment) | |
Secondary | Hospital Anxiety Depression Scale | Determine changes in anxiety/depression from baseline. This is a 14 item instrument that you respond to inquires related about you have felt during the last week. | Week 1 (at baseline) | |
Secondary | Hospital Anxiety Depression Scale | Determine changes in anxiety/depression from baseline. This is a 14 item instrument that you respond to inquires related about you have felt during the last week. | Week 4 (after 8th treatment) | |
Secondary | Insomnia Severity Index | Determine changes in sleep quality from baseline. This is a 7 item instrument to assess components of nighttime and daytime insomnia | (Week 1 (at baseline) | |
Secondary | Insomnia Severity Index | Determine changes in sleep quality from baseline. This is a 7 item instrument to assess components of nighttime and daytime insomnia | Week 4 (after 8th treatment) | |
Secondary | Nine-Hole Peg Test | Determine changes in upper limb coordination from baseline. This is a standardized timed assessment to assess finger dexterity in which 9 wooden pegs are placed into predrilled holes in a block of wood. | Week 1 (at baseline) | |
Secondary | Nine-Hole Peg Test | Determine changes in upper limb coordination from baseline. This is a standardized timed assessment to assess finger dexterity in which 9 wooden pegs are placed into predrilled holes in a block of wood. | Week 4 (after 8th treatment) | |
Secondary | Timed 25 foot Walk Test | Determine changes in lower limb mobility from baseline. Evaluates leg function and quantitative mobility in a timed 25 foot walk. | Week 1 (at baseline) | |
Secondary | Timed 25 foot Walk Test | Determine changes in lower limb mobility from baseline. Evaluates leg function and quantitative mobility in a timed 25 foot walk. | Week 4 (after 8th treatment) |
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
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