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This study aims to verify the effects of Thrust Versus Non-thrust Manipulation on Pain, Trunk Proprioception and Postural Stability in Subjects With Chronic Low Back Pain.
Forty individuals with chronic low back pain will be randomly assigned, by a researcher not involved in data collection, to two treatment groups: Thrust manipulation (side-lying rotational manipulation standardized to the L4-L5 level) or non-thrust manipulation (side-lying grade III rotational non-thrust manipulation). A single treatment session will be provided.
Outcome measurement will be conducted immediately after the treatment session. Data will be collected by a blinded assessor. Between-group differences will be calculated by constructing mixed linear models following an intention-to-treat principle.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Thrust manipulation (TM) | Experimental | The patients allocated to the TM group will receive TM aimed at the L4-L5 intervertebral segments. All the patients will be positioned in a standardized position (right side-lying) and will receive a rotational TM technique. The treating therapist will have up to two attempts to perform the TM in each patient. There is no need for cavitation in order to consider the TM successful; the occurence of cavitation, however, will be recorded. A single treatment will be provided. |
|
| Non-thrust manipulation (NTM) | Experimental | The patients allocated to the NTM group will receive TM aimed at the L4-L5 intervertebral segments. All the patients will be positioned in a standardized position (right side-lying) and will receive 30 oscilations of a grade III rotational NTM. A single treatment will be provided |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Thrust Manipulation | Other | After positioning patients in right side-lying, a rotational TM technique will be addressed at the L4-L5 lumbar segments. The treating therapist will have up to two attempts to apply the TM. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain | Pain will me measured Up to 10 minutes after intervention by an 11 point (0-11) Numeric Pain Rating Scale (NPRS) | Up to 10 minutes after intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Global Perceived Effect | Global Perceived effect will be measured by an 11 point (-5-+5) Global Perceived Effect (GPE) | Up to 10 minutes after intervention |
| Lumbar joint position sense | Lumbar joint position sense will be measured by a isokinetic dynamometer (BIODEX System 4 Proâ„¢, Shirley, NY) |
| Measure | Description | Time Frame |
|---|---|---|
| Foot contact area | Foot contact area will be measured by a digital baropodometer (FootWork Pro) | Up to 10 minutes after intervention |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Marcelo F Silva, PhD | Adjunct professor | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Federal University of Health Sciences of Porto Alegre | Porto Alegre | Rio Grande do Sul | 90050-170 | Brazil |
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| D001416 | Back Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D020393 | Manipulation, Spinal |
| D026201 | Musculoskeletal Manipulations |
| ID | Term |
|---|---|
| D026741 | Physical Therapy Modalities |
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
| D000529 | Complementary Therapies |
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| Non-thrust manipulation (NTM) | Other | A grade III rotational non-thrust manipulation will be addressed at the L4-L5 lumbar segments. Thirty oscilations will be performed. |
|
|
| Up to 10 minutes after intervention |
| Peak plantar pressure | Peak plantar pressure will be measured by a digital baropodometer (FootWork Pro) | Up to 10 minutes after intervention |
| Center of Pressure displacement | CoP displacement will be measured by a digital baropodometer (FootWork Pro) by means of stabilometry | Up to 10 minutes after intervention |