Non-Specific Effects of Manual Therapy

Shenandoah University

Status: Completed

Conditions: Musculoskeletal Manipulations; Placebo Effect

Treatments: Procedure: Spinal Manual Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT03017534

ShenandoahU (2)

Details and patient eligibility

About

The mechanism responsible for improvement following manual physical therapy techniques is unknown. Previous studies have indicated both biomechanical and neurophysiologic effects which may be responsible for clinical changes observed. Yet, other studies report clinical changes following sham interventions. Through a mixed-methods design, this study aims to gain more understanding of the social and contextual factors that may be related to the improvement often observed following manual therapy techniques.

Full description

A convenience sample will be utilized to obtain subjects. Subjects will be given a brief questionnaire to identify possible contraindications for manual therapy treatment techniques and exclude individuals if necessary. Subjects will be randomized into one of eight groups (three variables, each with two conditions including: therapist gender match/mismatch, lab coat worn/not worn, detailed explanation/colloquial conversation about the technique) and participate in neurodynamic testing for the upper quarter via the Upper Limb Provocation Test. Subjects who are determined to be positive for one or more extremities will receive a sham thoracic spine manipulation technique. After application of the technique, previously positive limbs will be retested. Individuals who respond favorably to the sham technique upon reassessment will participate in an exit interview with open-ended questions in attempt to gain more insight into the factors which may have influenced their neurodynamic mobility improvement.

Enrollment: 24 patients

Sex: All

Ages: 18 to 70 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Upper Limb Provocation Test results with limitation greater than 60 deg of elbow extension at the time of measurement

Exclusion criteria

• History of cervical or lumbar pain requiring medical intervention within the last two years, history of upper or lower extremity paresthesia/numbness, self reported bone density disorders, previous spinal cord injury, diagnosed intervertebral disc herniation, previous diagnosis of spinal stenosis or disc pathology, current pregnancy, history of circulatory or neurological disorders, history of spine and extremity fractures or dislocations in the last two years

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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24 participants in 8 patient groups

Gender Match, Labcoat, Explanation

Experimental group

Description:

Subjects will receive Spinal Manual Therapy (sham thoracic spine manipulation) by a gender matched therapist, wearing a labcoat and receive a detailed anatomic explanation of the technique.

Treatment:

Procedure: Spinal Manual Therapy

Gender Match, Labcoat, No Explanation

Experimental group

Description:

Subjects will receive Spinal Manual Therapy (sham thoracic spine manipulation) by a gender matched therapist, wearing a labcoat, and receive a colloquial discussion of the technique.

Treatment:

Procedure: Spinal Manual Therapy

Gender Match, No Labcoat, Explanation

Experimental group

Description:

Subjects will receive Spinal Manual Therapy (sham thoracic spine manipulation) by a gender matched therapist, not wearing a labcoat, and receive a detailed anatomic explanation of the technique.

Treatment:

Procedure: Spinal Manual Therapy

Gender Match, No Labcoat, No Explanation

Experimental group

Description:

Subjects will receive Spinal Manual Therapy (sham thoracic spine manipulation) by a gender matched therapist, not wearing a labcoat, and receive a colloquial discussion of the technique.

Treatment:

Procedure: Spinal Manual Therapy

Gender Mis-match, Labcoat, Explanation

Experimental group

Description:

Subjects will receive Spinal Manual Therapy (sham thoracic spine manipulation) by a gender mis-matched therapist, wearing a labcoat and receive a detailed anatomic explanation of the technique.

Treatment:

Procedure: Spinal Manual Therapy

Gender Mis-match, Labcoat, No Explan.

Experimental group

Description:

Subjects will receive Spinal Manual Therapy (sham thoracic spine manipulation) by a gender mis-matched therapist, wearing a labcoat, and receive a colloquial discussion of the technique.

Treatment:

Procedure: Spinal Manual Therapy

Gender Mis-match, No Labcoat, Explan.

Experimental group

Description:

Subjects will receive Spinal Manual Therapy (sham thoracic spine manipulation) by a gender mis-matched therapist, not wearing a labcoat, and receive a detailed anatomic explanation of the technique.

Treatment:

Procedure: Spinal Manual Therapy

Gender Mis-match, No Labcoat, No Explan.

Experimental group

Description:

Subjects will receive Spinal Manual Therapy (sham thoracic spine manipulation) by a gender matched therapist, not wearing a labcoat, and receive a colloquial discussion of the technique.

Treatment:

Procedure: Spinal Manual Therapy