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Responses of People With Neck Pain Being Treated With Varying Doses of Manual Therapy: A Pilot Study

Not Applicable
Completed
Conditions
Whiplash Injuries
Interventions
Behavioral: Exercise and education twice/week for 6 weeks
Behavioral: Exercise and education 3 times/week for 6 weeks
Behavioral: Exercise and education once/week for 6 weeks
Other: Manual therapy 3 times/week for 6 weeks
Other: Manual therapy twice/week for 3 weeks
Other: Manual therapy once/week for 6 weeks
Other: Manual therapy 3 times/week for 3 weeks
Other: Manual therapy twice/week for 6 weeks
Other: Manual therapy once/week for 3 weeks
Registration Number
NCT01957033
Lead Sponsor
Jordan Miller, Graduate Student
Brief Summary

The purpose of this pilot project is to determine the feasibility of a study design to investigate how many sessions of manual therapy and exercise produce the best results for people with whiplash injuries. Also, this study will help us determine the best way to measure the effect of treatment. Finally, the investigators will study how closely the physiotherapists follow the treatment instruction provided in the study protocol and training. In order to achieve these objectives, 12 people will receive manual therapy and exercise at one of twelve different doses. the investigators will have each of these people fill out questionnaires, measure sensation changes, and measure changes in the way people move their necks while walking. This study will help us determine if the study protocol can be carried out as planned. This includes: the training of all people involved in carrying out the assessments and treatments, the willingness and ability of participants to take part in all of the treatment and measures involved. This will provide us with important information to help us plan a larger study with 226 people with whiplash injuries.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  • adults ≥ 21 years
  • main complaint must be neck pain, but we expect some patients will also report symptoms that radiate to the shoulder and arm regions or have an associated headache.
  • pain intensity must be ≥ 12/40 on the 4-item pain scale (P4).
Exclusion Criteria
  • non-mechanical sources of neck pain or over-riding comorbidity listed below:
  • rheumatoid arthritis
  • neurological diseases
  • fractures
  • dislocation
  • rheumatoid arthritis
  • upper motor neuron dysfunction or malignancy
  • pregnant women
  • closed head injury
  • on steroid-based medications within the past 6 months.

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Duration 6 weeks, frequency 3/weekManual therapy 3 times/week for 6 weeksExercise and education 3 times/week for 6 weeks Manual therapy 3 times/week for 6 weeks
Duration 3 weeks, Frequency twice/weekManual therapy twice/week for 3 weeksExercise and education twice/week for 6 weeks Manual therapy twice/week for first 3 weeks
Duration 0 weeks, Frequency twice/weekExercise and education twice/week for 6 weeksExercise and education twice/week for 6 weeks. No manual therapy
Duration 6 weeks, Frequency twice/weekExercise and education twice/week for 6 weeksExercise and education twice/week for 6 weeks Manual therapy twice/week for 6 weeks
Duration 6 weeks, frequency 3/weekExercise and education 3 times/week for 6 weeksExercise and education 3 times/week for 6 weeks Manual therapy 3 times/week for 6 weeks
Duration 6 weeks, Frequency once/weekManual therapy once/week for 6 weeksExercise and education once/week for 6 weeks Manual therapy once/week for first 6 weeks
Duration 3 weeks, Frequency 3 times/weekExercise and education 3 times/week for 6 weeksExercise and education 3 times/week for 6 weeks Manual therapy 3 times/week for first 3 weeks
Duration 0 weeks, Frequency 3 times/weekExercise and education 3 times/week for 6 weeksExercise and education 3 times/week for 6 weeks No manual therapy
Duration 3 weeks, Frequency 3 times/weekManual therapy 3 times/week for 3 weeksExercise and education 3 times/week for 6 weeks Manual therapy 3 times/week for first 3 weeks
Duration 3 weeks, Frequency twice/weekExercise and education twice/week for 6 weeksExercise and education twice/week for 6 weeks Manual therapy twice/week for first 3 weeks
Duration 0 weeks, Frequency once/weekExercise and education once/week for 6 weeksExercise and education once/week for 6 weeks No manual therapy
Duration 6 weeks, Frequency twice/weekManual therapy twice/week for 6 weeksExercise and education twice/week for 6 weeks Manual therapy twice/week for 6 weeks
Duration 6 weeks, Frequency once/weekExercise and education once/week for 6 weeksExercise and education once/week for 6 weeks Manual therapy once/week for first 6 weeks
Duration 3 weeks, frequency once/weekExercise and education once/week for 6 weeksExercise and education once/week for 6 weeks Manual therapy once/week for first 3 weeks
Duration 3 weeks, frequency once/weekManual therapy once/week for 3 weeksExercise and education once/week for 6 weeks Manual therapy once/week for first 3 weeks
Primary Outcome Measures
NameTimeMethod
Feasibility1 year

As a pilot study, the main outcome of interest is feasibility. This includes: ability to train assessors and health care providers, time it takes to complete all assessments, ability to recruit 12 patients within 1 year, and completeness of data collected.

Pain12 weeks (end of treatment) and 6- and 12- month follow-ups

Measured by the 4-item pain questionnaire (P4). This will be a primary outcome of the full trial.

Function12 weeks (end of treatment) and 6- and 12- month follow-up

Measured by the Neck Disability Index (NDI). This will be a primary outcome measure of the full powered study.

Secondary Outcome Measures
NameTimeMethod
Fidelity1 year

As a pilot study, the secondary outcome of interest is treatment fidelity. We will measure this through ability of health care providers to provide treatment at the dosage described in the protocol.

Psychological measures12 weeks (end of treatment)

Catastrophic thinking measured by Pain Catastrophizing Scale (PCS) Anxiety and Depression measured by Hospital Anxiety and Depression Scale (HADS) Psychological distress measured by Trauma Anxiety and Distress Scale (TADS)

Psychophysical measures12 weeks (end of treatment)

Vibration Pain Threshold (VPT), Current Perception Threshold (CPT), Pressure Pain Threshold (PPT), Response to Cold Provocation(RCP)

Upper extremity function12 weeks (end of treatment) and 6- and 12-month follow-ups

As measured by the shortened version of the Disability of the Arm, Shoulder, Hand (qDASH).

Motor coordination12 weeks (end of treatment)

Neck Walk Index (NWI)

Health Status12 weeks (end of study) and 6- and 12- month follow-ups

Measured by SF-36

Global perceived effect12 weeks (end of treatment) and 6- and 12-month follow-ups

Global perceived effect will be measured on a 7 point scale (-3 to +3)

Trial Locations

Locations (3)

McMaster Univervisty

🇨🇦

Hamilton, Ontario, Canada

Lifemark Health, Hamilton

🇨🇦

Hamilton, Ontario, Canada

Western University

🇨🇦

London, Ontario, Canada

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