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Central sensitization (CS) is defined as the increased responsiveness of nociceptive neurons in the central nervous system to normal or subthreshold afferent input. CS has been proposed as an underlying mechanism of chronic pain in musculoskeletal disorders including low back pain (LBP).
The aim of this study is to investigate the effect of manual therapy on central sensitization in patients with nonspecific chronic LBP.
A total of 40 LBP patients aged between 24-64 with CSS will be randomized into two groups. The manual therapy group will receive a 4-week manual therapy (two sessions/week) plus the conventional physiotherapy program, while the control group will only receive conventional physiotherapy. Before and after the interventions pain intensity (VAS), and scores of three questionnaires: Oswestry Disability Index (ODI), Central Sensitization Inventory (CSI), and the 36-item Short Form Health Survey Questionnaire (SF-36) will be recorded.The outcomes of the study will be analyzed by appropriate statistical methods.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Manual therapy | Experimental | Manual therapy group |
|
| Conventional physiotherapy | Other | Conventional physiotherapy group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| manual therapy | Other | The manual therapy group will receive a 4-week manual therapy plus conventionel physiotherapy. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Pain intensity | A 10 cm Visual Analog Scale will be used to determine the severity of pain, with numbers ranging from "0" (no pain) to "10" (unbearable pain) | Up to one month |
| Central Sensitization | Central Sensitization Inventory (CSI) scale will be used severity of central sensitization.The total score range of the scale, which consists of a total of 25 questions, is between 0-100 points. Central sensitization with a score of 40 and above is considered positive. An increase in the total score indicates an increase in the level of central sensitization. | Up to one month |
| Measure | Description | Time Frame |
|---|---|---|
| Oswestry Disability Index | Oswestry Disability Index (ODI) will be used to measure disability level | Up to one month |
| Health Survey | 36-item Short Form Health Survey Questionnaire (SF-36) will be used |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Naime Ulug | Ankara | Select State | 06830 | Turkey (Türkiye) | ||
| Atılım University |
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| ID | Term |
|---|---|
| D026201 | Musculoskeletal Manipulations |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |
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prospective randomized controlled study
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Participant will not informed about the intervention
|
| conventional physiotherapy | Other | Control group will only receive conventionel physiotherapy intervention. |
|
| Up to one month |
| Hospital Anxeity and depresssion | Hospital Anxeity and Depression Scale will be used. The cut-off points for caseness of anxiety or depression is 8/21 for anxiety or depression. For anxiety (HADS-A) this gave a specificity of 0.78 and a sensitivity of 0.9. For depression (HADS-D) this gave a specificity of 0.79 and a sensitivity of 0.83. The scores of the scale are as follows: 0-7 = Normal 8-10 = Borderline abnormal (borderline case) 11-21 = Abnormal (case) | Up to one month |
| Ankara |
| Turkey (Türkiye) |