Effects of Lumbopelvic Manipulation on Neuromuscular Activity of Back & Hip Muscles in Adults With Chronic Low Back Pain

Texas Woman's University

Status: Completed

Conditions: Chronic Low Back Pain

Treatments: Other: Lumbopelvic Manipulation; Other: Sham manipulation

Study type: Interventional

Funder types: Other

Identifiers

NCT01861418

TexasWU

Details and patient eligibility

About

The purposes of this study are:

1. To examine the within-day and between-day test-retest reliability of a testing protocol measuring the back and hip muscles fatigability using EMG median frequency
2. To examine the immediate and the carry-over effects of the lumbopelvic manipulation on the EMG median frequency of the lumbar multifidus (MULT), gluteus medius (GMED) and gluteus maximus (GMAX) muscles in patients with chronic low back pain (CLBP)
3. To compare the fatigability levels of the MULT, GMED and GMAX muscles by measuring the EMG median frequency between the participants who will receive lumbopelvic manipulation.

The research hypotheses are:

1. The testing protocol using EMG median frequency as a fatigue indicator for MULT,GMED and GMAX muscles will have good (ICC ≥ 0.80) within-day and between-day test-retest reliability.
2. The fatigability level of the MULT, GMED and GMAX muscles will significantly decrease immediately after the lumbopelvic manipulation and will be maintained over two to four days following the manipulation.
3. The fatigability of the MULT, GMED and GMAX muscles will significantly decrease after the intervention in the manipulation group while no change will occur in the placebo group.

Enrollment: 52 patients

Sex: All

Ages: 20 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Healthy subjects or the reliability phase:

Inclusion Criteria:

• Subjects without any history of back problems
• Subjects without any known pathology.

Exclusion Criteria:

• Any serious spinal condition such as tumor, fracture, or infection,
• Signs of nerve root compression (i.e. straight leg- raise ≤ 45° or diminished reflexes, sensation or lower extremity strength),
• Structural deformity,
• Spondylolithesis ,
• Ankylosing spondylitis
• Spinal stenosis,
• Osteoporosis,
• Previous surgery to the back or the hip, and
• Current pregnancy.

Subjects with Chronic low back pain for both the reliability and the manipulation phases:

Inclusion Criteria:

• Participants should be between the age of 20 to 60 years.
• Have had complaints of chronic low back pain for at least three months.

Exclusion Criteria:

• Any serious spinal condition such as tumor, fracture, or infection,
• Signs of nerve root compression (i.e. straight leg- raise ≤ 45° or diminished reflexes, sensation or lower extremity strength),
• Structural deformity,
• Spondylolithesis ,
• Ankylosing spondylitis
• Spinal stenosis,
• Osteoporosis,
• Previous surgery to the back or the hip, and
• Current pregnancy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

52 participants in 2 patient groups, including a placebo group

Sham manipulation

Placebo Comparator group

Description:

Each participant will lie in a supine position. The treating investigator (TI) will stand on the opposite side of the low back pain. Then, the participant will be asked to clasp his/her hand behind the neck. The TI will side bend the participant's spine towards the non-painful side, reach through the participant's hands and perform a spinal rotation away from the painful side. The TIs other hand will be placed over the anterior superior iliac spine (ASIS) of the painful side. Lastly, the TI will take up the slack and maintain the pressure on the ASIS for 5-10 seconds and ask the participant whether he/she can tolerate the pressure. If the participant can tolerate the pressure for at least 5 seconds. Then, the subjects will be re-positioned to the starting position.

Treatment:

Other: Sham manipulation

Lumbopelvic Manipulation, Chicago

Experimental group

Description:

Each participant will lie in supine position. The treating investigator (TI) will stand opposite of the low back pain. Participant will clasp his/her hand behind the neck. TI will side bend the participant's spine toward non-painful side, reach through participant's hands and perform a spinal rotation away from the painful side. TI's other hand will be placed over the anterior superior iliac spine (ASIS) of the painful side. The TI will take up the slack and maintain pressure on the ASIS for 5-10 seconds and ask participant whether he/she can tolerate the pressure. If participant can tolerate the pressure for at least 5 seconds, verbal permission will be obtained from the participant and the TI will proceed and apply a high-velocity low-amplitude posterior thrust force over the ASIS.

Treatment:

Other: Lumbopelvic Manipulation