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| ID | Type | Description | Link |
|---|---|---|---|
| U19AT004663 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| University of Iowa | OTHER |
| National Center for Complementary and Integrative Health (NCCIH) | NIH |
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This is a biomechanical study which is Project 1 in the Developmental Center for Clinical and Translational Research in Chiropractic (DCRC I) (NIH/NCCAM grant 1 U19 AT004663-01; principal investigator Christine Goertz, DC, PhD). This study is designed to monitor both physiological and patient self-report outcome variables. In addition, as there is little quantitative information on Spinal Manipulation Technique procedures reported in clinical trials, the study is designed to collect preliminary kinetic measures of the spinal manipulation technique delivery (i.e. force-time profiles).
Participants with narrowly defined chronic low back pain will be included in this study. Each participant will be treated 12 times over the course of 6 weeks. The following data will be collected: participant characteristics that may predict outcome or be modifiers of force used by provider (gender, age, height, weight, and Body Mass Index); spinal segment load during the pre-load and thrusting phases (force and moment in the pre-load phase, peak load, and loading rate); physiological measures (posterior-anterior global stiffness and flexion-relaxation); patient-centered outcomes of back pain and function; and adverse events.
Study participants (n= 80) will be recruited from the Quad Cities metro area. A team of experienced chiropractic clinicians working at the Palmer Center for Chiropractic Research will treat study participants. Each of the study participants will receive 2 High Velocity Low Amplitude Spinal Manipulation treatment visits per week over a 6 week period. The physiological assessments will be performed immediately before and after Spinal Manipulation delivery during treatment visits 1, 5 & 12 (6 sets of assessments in total). During these same treatment visits, we will also capture the kinetic measures during Spinal Manipulation delivery for spinal segment load analysis. Participant patient-centered outcomes will be measured at baseline 1, and treatment visits 6 and 13. For simplicity, data collection time points will be named as baseline, after 2 weeks, and after 6 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental: HVLA-SM | Other | Experimental High Velocity Low Amplitude Spinal Manipulation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HVLA-SM | Other | High Velocity Low Amplitude Spinal Manipulation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Patient-Centered Outcome Measurement Mean Change After 6 Weeks (VAS, RMDQ) | VAS - Visual Analog Scale - Scale: 0-100 mm (anchors: 0 mm = No Pain, 100 mm = Worst Imaginable Pain). VAS Interpretation: A higher score indicates greater pain intensity. In this study, improvement of 30% from the baseline value was considered clinically significant. RMDQ - Roland Morris disability questionnaire - Scale: 0 (no disability) to 24 (maximum disability). RMDQ Interpretation: Greater levels of disability are reflected by higher scores. In this study, improvement of 30% from the baseline value was considered clinically significant. | Baseline to 6 weeks |
| Lumbar-spine Stiffness (LSS) | LSS* contains 5 variables: global stiffness (GS, unit: Newton/mm) at L3 from 1) hand palpation 2) a hand-held device & 3) an automated indenter device; global stiffness variation (GSV, unit: Newton/mm) between GS from L1 to L5 from 4) hand palpation & 5) a hand-held device. *LSS Interpretation: The values of the outcome depend on testing procedure, instruction to participants, and equipment. Currently there is no consensus regarding what value is high than normal, normal, lower than normal. | Baseline, 2 weeks, 6 weeks |
| Lumbar-spine Stiffness (LSS) - Normalized Global Stiffness Variation | LSS contains 2 variables: Palpatory and Handheld device - normalized global stiffness variation (nGSV, unitless). LSS Interpretation: The values of the outcome depend on testing procedure, instruction to participants, and equipment. Currently there is no consensus regarding what value is higher than normal, normal, lower than normal. | Baseline, 2 weeks, 6 weeks |
| Flexion-Relaxation Ratio (FRR) | FRR contains 4 variables, which are the average right and left back muscle FRR obtained using 1) maximum EMG during flexion, and 2) maximum EMG during extension to normalize EMG during full flexion; and asymmetry between the right and left back muscle FRRs using 3) maximum EMG during flexion, and 4) maximum EMG during extension to normalize EMG during full flexion FRR Interpretation: The values of the outcome depend on testing procedure, instruction to participants, and equipment. Currently there is no consensus regarding what value is high than normal, normal, lower than normal. |
| Measure | Description | Time Frame |
|---|---|---|
| Kinetic Measure - Spinal Segment Load (SSL) Force | SSL* contains variables: maximum amplitude (Newton) during preload and peak thrust force in anterior-posterior (X), side-to-side (Y), head-to-toe direction (Z) and combined force (C). *Interpretation: the purpose of the outcomes is to quantify force-time profile of SM. The values of the outcome depend on the doctor who delivers SM, location and direction of SM, participant body position, and equipment. Currently there is no consensus regarding what value is higher than normal, normal, or lower than normal. Sign convention: because patient position would affect the sign of some measurements, the right side up position was used as the reference position (i.e., the affected measurements assessed in the left side up position had their sign inverted) in order to calculate mean and SD. The value reported is the change from baseline to week 6. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ting Xia, PhD | Palmer College of Chiropractic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Palmer College of Chiropractic | Davenport | Iowa | 52803 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25106673 | Background | Xia T, Wilder DG, Gudavalli MR, DeVocht JW, Vining RD, Pohlman KA, Kawchuk GN, Long CR, Goertz CM. Study protocol for patient response to spinal manipulation - a prospective observational clinical trial on physiological and patient-centered outcomes in patients with chronic low back pain. BMC Complement Altern Med. 2014 Aug 8;14:292. doi: 10.1186/1472-6882-14-292. | |
| 26500365 | Background | Minkalis AL, Vining RD. What is the pain source? A case report of a patient with low back pain and bilateral hip osteonecrosis. J Can Chiropr Assoc. 2015 Sep;59(3):300-10. |
| Label | URL |
|---|---|
| Study protocol for patient response to spinal manipulation - a prospective observational clinical trial on physiological and patient-centered outcomes in patients with chronic low back pain | View source |
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Once the resulting manuscripts have been published, data sets will be provided for public access. Potential investigators can contact one of the Co-PIs to present their hypothesis, study design, instruments and/or data on which to focus, and resources required. Depending upon the needs and desires of the requesting party, the data that are shared may include analytic tables or de-identified or limited data sets that are transmitted to the requesting parties for additional analyses.
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| ID | Title | Description |
|---|---|---|
| FG000 | Experimental: HVLA-SM | Experimental High Velocity Low Amplitude Spinal Manipulation HVLA-SM: High Velocity Low Amplitude Spinal Manipulation Participants receive treatments of HVLA-SM to the lumbar spine in the side-lying position. Treatment frequency is twice per week for 6 weeks. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Experimental: HVLA-SM | Experimental High Velocity Low Amplitude Spinal Manipulation HVLA-SM: High Velocity Low Amplitude Spinal Manipulation |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Patient-Centered Outcome Measurement Mean Change After 6 Weeks (VAS, RMDQ) | VAS - Visual Analog Scale - Scale: 0-100 mm (anchors: 0 mm = No Pain, 100 mm = Worst Imaginable Pain). VAS Interpretation: A higher score indicates greater pain intensity. In this study, improvement of 30% from the baseline value was considered clinically significant. RMDQ - Roland Morris disability questionnaire - Scale: 0 (no disability) to 24 (maximum disability). RMDQ Interpretation: Greater levels of disability are reflected by higher scores. In this study, improvement of 30% from the baseline value was considered clinically significant. | 82 and 68 participants completed at baseline and after 6 weeks, respectively. Data from all participants (n=82) were used in statistical analysis. The reported data represents the mean change from baseline to week 6. | Posted | Mean | 95% Confidence Interval | units on a scale (see description above) | Baseline to 6 weeks |
|
6 weeks
Any untoward medical occurrence that may present itself during the conduct of the study which may or may not have a causal relationship with the study procedures.
*The total number of AEs may exceed the total # of people affected because some people experienced multiple AEs.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Experimental: HVLA-SM* | Experimental High Velocity Low Amplitude Spinal Manipulation HVLA-SM: High Velocity Low Amplitude Spinal Manipulation |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Neck pain/stiffness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Ting Xia | Palmer Center for Chiropractic Research | 563-884-5161 | ting.xia@palmer.edu |
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| Baseline, 2 weeks, 6 weeks |
| 6 weeks |
| Kinetic Measure - Spinal Segment Load (SSL) Moment | SSL* contains variables: maximum amplitude (Newton*Meter for moment) during preload and peak thrust force in anterior-posterior (X), side-to-side (Y), head-to-toe direction (Z) and combined force (C). *Interpretation: the purpose of the outcomes is to quantify force-time profile of SM. The values of the outcome depend on the doctor who delivers SM, location and direction of SM, participant body position, and equipment. Currently there is no consensus regarding what value is higher than normal, normal, or lower than normal. Sign convention: because patient position would affect the sign of some measurements, the right side up position was used as the reference position (i.e., the affected measurements assessed in the left side up position had their sign inverted) in order to calculate mean and SD. The value reported is the change from baseline to week 6. | 6 weeks |
| Kinetic Measure - Spinal Segment Load (SSL) Rate of Loading for Force | SSL* contains variables: rate of loading for force in anterior-posterior (X), side-to-side (Y), head-to-toe direction (Z) and combined force (C). *Interpretation: the purpose of the outcomes is to quantify force-time profile of SM. The values of the outcome depend on the doctor who delivers SM, location and direction of SM, participant body position, and equipment. Currently there is no consensus regarding what value is higher than normal, normal, or lower than normal. Sign convention: because patient position would affect the sign of some measurements, the right side up position was used as the reference position (i.e., the affected measurements assessed in the left side up position had their sign inverted) in order to calculate mean and SD. The value reported is the change from baseline to week 6. | 6 weeks |
| Kinetic Measure - Spinal Segment Load (SSL) Rate of Loading for Moment | SSL* contains variables: rate of loading for moment in anterior-posterior (X), side-to-side (Y), head-to-toe direction (Z) and combined force (C). *Interpretation: the purpose of the outcomes is to quantify force-time profile of SM. The values of the outcome depend on the doctor who delivers SM, location and direction of SM, participant body position, and equipment. Currently there is no consensus regarding what value is higher than normal, normal, or lower than normal. Sign convention: because patient position would affect the sign of some measurements, the right side up position was used as the reference position (i.e., the affected measurements assessed in the left side up position had their sign inverted) in order to calculate mean and SD. The value reported is the change from baseline to week 6. | 6 weeks |
| PROMIS-29 - Patient Reported Outcomes Measurement Information Scale-29: General Health Status Scale | 1) The questionnaire contains 7 PROMIS-29 specific items: Anxiety, Depression, Fatigue, Pain Interference, Physical Function, Sleep Disturbance, and Satisfaction with Participation in Social Role (anchors: 1= 'Not at all', 5= 'Very much', higher score is worse). Each PROMIS-29 specific item is reported in raw score (4-20) and scored in T-score (T), which rescales the raw score into a standardized score with a mean of 50 and a standard deviation (SD) of 10 for a population. On the T-score metric & interpretation:
| Baseline, 2 weeks, 6 weeks |
| PROMIS-29 - Patient Reported Outcomes Measurement Information Scale-29: Global Item, Pain NRS | 1) The PROMIS questionnaire contains 1 PROMIS global item: Pain NRS, Scale: 0-10 (anchors: 0 = No Pain, 10 = Worst Imaginable Pain, higher score is worse). The PROMIS global item is not scored but reported in raw score. | Baseline, 2 weeks, 6 weeks |
| Bothersomeness | Question asked of participants: "During the past week, how bothersome have each of the following symptoms been?" The bothersomeness questionnaire contains two items: a) low back pain & b) leg pain (sciatica). Scale: 0-10 (anchors: 0 = Not at all bothersome, 10 = Extremely bothersome) | Baseline, 2 weeks, 6 weeks |
| 28599647 | Derived | Xia T, Long CR, Vining RD, Gudavalli MR, DeVocht JW, Kawchuk GN, Wilder DG, Goertz CM. Association of lumbar spine stiffness and flexion-relaxation phenomenon with patient-reported outcomes in adults with chronic low back pain - a single-arm clinical trial investigating the effects of thrust spinal manipulation. BMC Complement Altern Med. 2017 Jun 9;17(1):303. doi: 10.1186/s12906-017-1821-1. |
| What is the pain source? A case report of a patient with low back pain and bilateral hip osteonecrosis. | View source |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Baseline Patient-Centered Outcome Measures | VAS - Visual Analog Scale: The VAS is a single-item, unidimensional measure for pain. Score interpretations for the VAS include the following cut points: no pain (0 to 4 mm), mild pain (5 to 44 mm), moderate pain (45 to 74 mm), and severe pain (75 to 100 mm). RMDQ - Roland Morris disability questionnaire: The RMDQ consists of 24 questions related to disability, with each question worth one point. Scores can range from 0 (no disability) to 24 (severe disability). | Mean | Standard Deviation | units on a scale |
|
Experimental High Velocity Low Amplitude Spinal Manipulation HVLA-SM: High Velocity Low Amplitude Spinal Manipulation |
|
|
| Primary | Lumbar-spine Stiffness (LSS) | LSS* contains 5 variables: global stiffness (GS, unit: Newton/mm) at L3 from 1) hand palpation 2) a hand-held device & 3) an automated indenter device; global stiffness variation (GSV, unit: Newton/mm) between GS from L1 to L5 from 4) hand palpation & 5) a hand-held device. *LSS Interpretation: The values of the outcome depend on testing procedure, instruction to participants, and equipment. Currently there is no consensus regarding what value is high than normal, normal, lower than normal. | 82, 71 and 68 participants completed at baseline, after 2 weeks and after 6 weeks, respectively. The number of observations at each of the 3 time points for individual measures is equal to or lower than these numbers due to missing data. | Posted | Mean | Standard Deviation | N/mm | Baseline, 2 weeks, 6 weeks |
|
|
|
| Primary | Lumbar-spine Stiffness (LSS) - Normalized Global Stiffness Variation | LSS contains 2 variables: Palpatory and Handheld device - normalized global stiffness variation (nGSV, unitless). LSS Interpretation: The values of the outcome depend on testing procedure, instruction to participants, and equipment. Currently there is no consensus regarding what value is higher than normal, normal, lower than normal. | Posted | Mean | Standard Deviation | unitless | Baseline, 2 weeks, 6 weeks |
|
|
|
| Primary | Flexion-Relaxation Ratio (FRR) | FRR contains 4 variables, which are the average right and left back muscle FRR obtained using 1) maximum EMG during flexion, and 2) maximum EMG during extension to normalize EMG during full flexion; and asymmetry between the right and left back muscle FRRs using 3) maximum EMG during flexion, and 4) maximum EMG during extension to normalize EMG during full flexion FRR Interpretation: The values of the outcome depend on testing procedure, instruction to participants, and equipment. Currently there is no consensus regarding what value is high than normal, normal, lower than normal. | Posted | Mean | Standard Deviation | ratio | Baseline, 2 weeks, 6 weeks |
|
|
|
| Secondary | Kinetic Measure - Spinal Segment Load (SSL) Force | SSL* contains variables: maximum amplitude (Newton) during preload and peak thrust force in anterior-posterior (X), side-to-side (Y), head-to-toe direction (Z) and combined force (C). *Interpretation: the purpose of the outcomes is to quantify force-time profile of SM. The values of the outcome depend on the doctor who delivers SM, location and direction of SM, participant body position, and equipment. Currently there is no consensus regarding what value is higher than normal, normal, or lower than normal. Sign convention: because patient position would affect the sign of some measurements, the right side up position was used as the reference position (i.e., the affected measurements assessed in the left side up position had their sign inverted) in order to calculate mean and SD. The value reported is the change from baseline to week 6. | Note: 82, 71 and 68 participants completed at baseline, after 2 weeks and after 6 weeks, respectively, and a total of 593 SM was delivered during visits 1, 5, and 12. The number of observations for individual measures is lower than the total number of analyzable SM (n=575) due to missing data in corresponding components. | Posted | Mean | Standard Deviation | Newton (N) | 6 weeks | Spinal Manipulations | Spinal Manipulations |
|
|
|
| Secondary | Kinetic Measure - Spinal Segment Load (SSL) Moment | SSL* contains variables: maximum amplitude (Newton*Meter for moment) during preload and peak thrust force in anterior-posterior (X), side-to-side (Y), head-to-toe direction (Z) and combined force (C). *Interpretation: the purpose of the outcomes is to quantify force-time profile of SM. The values of the outcome depend on the doctor who delivers SM, location and direction of SM, participant body position, and equipment. Currently there is no consensus regarding what value is higher than normal, normal, or lower than normal. Sign convention: because patient position would affect the sign of some measurements, the right side up position was used as the reference position (i.e., the affected measurements assessed in the left side up position had their sign inverted) in order to calculate mean and SD. The value reported is the change from baseline to week 6. | Note: 82, 71 and 68 participants completed at baseline, after 2 weeks and after 6 weeks, respectively, and a total of 593 SM was delivered during visits 1, 5, and 12. The number of observations for individual measures is lower than the total number of analyzable SM (n=575) due to missing data in corresponding components. | Posted | Mean | Standard Deviation | Newton*Meter | 6 weeks | Spinal Manipulations | Spinal Manipulations |
|
|
|
| Secondary | Kinetic Measure - Spinal Segment Load (SSL) Rate of Loading for Force | SSL* contains variables: rate of loading for force in anterior-posterior (X), side-to-side (Y), head-to-toe direction (Z) and combined force (C). *Interpretation: the purpose of the outcomes is to quantify force-time profile of SM. The values of the outcome depend on the doctor who delivers SM, location and direction of SM, participant body position, and equipment. Currently there is no consensus regarding what value is higher than normal, normal, or lower than normal. Sign convention: because patient position would affect the sign of some measurements, the right side up position was used as the reference position (i.e., the affected measurements assessed in the left side up position had their sign inverted) in order to calculate mean and SD. The value reported is the change from baseline to week 6. | Note: 82, 71 and 68 participants completed at baseline, after 2 weeks and after 6 weeks, respectively, and a total of 593 SM was delivered during visits 1, 5, and 12. The number of observations for individual measures is lower than the total number of analyzable SM (n=575) due to missing data in corresponding components. | Posted | Mean | Standard Deviation | Newton/second | 6 weeks | Spinal Manipulations | Spinal Manipulations |
|
|
|
| Secondary | Kinetic Measure - Spinal Segment Load (SSL) Rate of Loading for Moment | SSL* contains variables: rate of loading for moment in anterior-posterior (X), side-to-side (Y), head-to-toe direction (Z) and combined force (C). *Interpretation: the purpose of the outcomes is to quantify force-time profile of SM. The values of the outcome depend on the doctor who delivers SM, location and direction of SM, participant body position, and equipment. Currently there is no consensus regarding what value is higher than normal, normal, or lower than normal. Sign convention: because patient position would affect the sign of some measurements, the right side up position was used as the reference position (i.e., the affected measurements assessed in the left side up position had their sign inverted) in order to calculate mean and SD. The value reported is the change from baseline to week 6. | Note: 82, 71 and 68 participants completed at baseline, after 2 weeks and after 6 weeks, respectively, and a total of 593 SM was delivered during visits 1, 5, and 12. The number of observations for individual measures is lower than the total number of analyzable SM (n=575) due to missing data in corresponding components. | Posted | Mean | Standard Deviation | Newton*Meters/second | 6 weeks | Spinal Manipulations | Spinal Manipulations |
|
|
|
| Secondary | PROMIS-29 - Patient Reported Outcomes Measurement Information Scale-29: General Health Status Scale | 1) The questionnaire contains 7 PROMIS-29 specific items: Anxiety, Depression, Fatigue, Pain Interference, Physical Function, Sleep Disturbance, and Satisfaction with Participation in Social Role (anchors: 1= 'Not at all', 5= 'Very much', higher score is worse). Each PROMIS-29 specific item is reported in raw score (4-20) and scored in T-score (T), which rescales the raw score into a standardized score with a mean of 50 and a standard deviation (SD) of 10 for a population. On the T-score metric & interpretation:
| Note: 82, 71 and 68 participants completed at baseline, after 2 weeks and after 6 weeks, respectively. Number of observations made at the three time points were 82, 70, and 68, respectively. | Posted | Mean | Standard Deviation | T-score | Baseline, 2 weeks, 6 weeks |
|
|
|
| Secondary | PROMIS-29 - Patient Reported Outcomes Measurement Information Scale-29: Global Item, Pain NRS | 1) The PROMIS questionnaire contains 1 PROMIS global item: Pain NRS, Scale: 0-10 (anchors: 0 = No Pain, 10 = Worst Imaginable Pain, higher score is worse). The PROMIS global item is not scored but reported in raw score. | Note: 82, 71 and 68 participants completed at baseline, after 2 weeks and after 6 weeks, respectively. Number of observations made at the three time points were 82, 70, and 68, respectively. | Posted | Mean | Standard Deviation | units on a scale | Baseline, 2 weeks, 6 weeks |
|
|
|
| Secondary | Bothersomeness | Question asked of participants: "During the past week, how bothersome have each of the following symptoms been?" The bothersomeness questionnaire contains two items: a) low back pain & b) leg pain (sciatica). Scale: 0-10 (anchors: 0 = Not at all bothersome, 10 = Extremely bothersome) | Note: 82, 71 and 68 participants completed at baseline, after 2 weeks and after 6 weeks, respectively. Number of observations made at the three time points were 82, 70, and 68, respectively. | Posted | Mean | Standard Deviation | units on a scale | Baseline, 2 weeks, 6 weeks |
|
|
|
| 0 |
| 82 |
| 0 |
| 82 |
| 74 |
| 82 |
| Low back pain/stiffness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Neck and back pain/stiffness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Headache and neck/back pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Back pain and extremity pain/stiffness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Thoracic and low back pain/stiffness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Neck, back and extremity pain/stiffness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Back and extremity pain/stiffness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Neck and extremity pain/stiffness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Pain/stiffness in the extremities | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Lower/extremity pain/stiffness | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Neck and back pain and extremity pain and headache | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Back pain/stiffness and numbness/tingling | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Back pain and extremity pain and numbness/tingling | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Upper respiratory infection | General disorders | Systematic Assessment |
|
| Sinus congestion/upper respiratory symptoms/allergy | General disorders | Systematic Assessment |
|
| Insect bite | General disorders | Systematic Assessment |
|
| Hypertension | General disorders | Systematic Assessment |
|
| Gastrointestinal symptoms | General disorders | Systematic Assessment |
|
| Hemorrhoids | General disorders | Systematic Assessment |
|
| Nausea and tooth/facial pain and sinus congestion | General disorders | Systematic Assessment |
|
| Nausea and back pain/stiffness | General disorders | Systematic Assessment |
|
| Dental caries | General disorders | Systematic Assessment |
|
| Asthma and lower respiratory infection | General disorders | Systematic Assessment |
|
| Upper respiratory infection and allergy | General disorders | Systematic Assessment |
|
| Hemorrhoids and nasal congestion | General disorders | Systematic Assessment |
|
| Laceration | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| Blister | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
Not provided
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| D013568 |
| Pathological Conditions, Signs and Symptoms |
|
| LSS - Automated - GS (N/mm) at Ant |
|
| LSS - Palpatory - GSV (N/mm) |
|
| LSS - Hand-held - GSV (N/mm) |
|
|
|
| Asymmetry in flexion FRR |
|
| Asymmetry in extension FRR |
|
| Spinal Manipulations |
|
| Peak thrust force (N) |
|
| Spinal Manipulations |
|
| Peak thrust moment (N*M) |
|
| Spinal Manipulations |
|
| Spinal Manipulations |
|
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| P29 - Fatigue |
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| P-29 - Pain Interference |
|
| P29 - Physical Function |
|
| P29- Sleep Disturbance |
|
| P29 - Satisfaction w/ Participation in Social Role |
|
|