The Effect of High-Velocity Low-Amplitude Thrust Manipulation of the Cervical Spine on Pain Biomarkers in Females With Non-Specific Mechanical Neck Pain
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 28
- 试验地点
- 1
- 主要终点
- Plasma Concentration of Oxytocin
研究概览
简要总结
This study evaluates the effect of high-velocity low-amplitude thrust (HVLAT) manipulation to the cervical spine on neuropeptide expression as determined by the plasma concentration of oxytocin, neurotensin, orexin A and cortisol; and Examine the effect of HVLAT manipulation on pain perception in symptomatic females with non-specific mechanical cervical spine pain
详细描述
A high-velocity low-amplitude thrust (HVLAT) manipulation or commonly known as a spinal manipulation, is an intervention frequently used by physical therapists and other healthcare practitioners as an alternative treatment to help relieve spinal pain The mechanism by which HVLAT manipulation modulates pain remains undefined, although this does not contradict the clinical effects from HVLAT manipulation. Furthermore, there is evidence that suggests analgesia after HVLAT manipulation. There is a variety of observed and proposed phenomena that can explain the mechanisms for the psychological, mechanical, or neurophysiological responses from a HVLAT manipulation associated with alterations in pain processing or sympathetic and motor systems' excitation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Basic Science
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 20 Years 至 45 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •20 - 45 years of age
- •A score of 10 or more out of 50 on the Neck Disability Index (NDI) questionnaire
- •Symptoms of pain present for 30 days or less and no pain symptoms below your shoulder
排除标准
- •Serious condition (such as cancer, spondylolisthesis, rheumatoid arthritis, or ankylosing spondylitis)
- •Cervical spinal stenosis signs (such as incoordination in hands, arms and legs, inability of walking at a brisk pace, or bowel and bladder incontinence)
- •Nerve root compression (such as changes in sensation, muscle weakness, or decreased reflexes)
- •Works the night shift
- •Steroid medication within 3 months
- •Pregnancy or postpartum
- •Pending legal action regarding their neck pain
- •History of whiplash associated disorder and/or cervical spine surgery
研究组 & 干预措施
HVLAT manipulation
An HVLAT manipulation is applied to the site of pain or restriction with the patient in supine. This technique uses both primary levers (pre-manipulation rotation - away (30 ° - 45 °) from the side of pain or limitation) and secondary levers (Side bending - towards coupled with lateral shift - away, and posterior-anterior (PA) shift (extension). This is a bimanual technique. For the applicator hand, the anterolateral portion of the first or second phalanx of the second ray was positioned on the superior joint partner of the target vertebrae using a cradle hold. The other hand is placed on the posterolateral aspect of the occiput (above the ear). While maintaining these positions the clinician performed the thrust with the arc of rotation dependent on the level of the target vertebrae.
干预措施: HVLAT manipulation (Procedure)
Sham HVLAT manipulation
Subjects in the control group were instructed to lay on a table in the same position as the HVLAT manipulation group. The clinician went through the same basic steps as the HVLAT manipulation, localizing the appropriate vertebral landmarks but without carrying out the final HVLA thrust procedure.
干预措施: Sham HVLAT manipulation (Procedure)
结局指标
主要结局
Plasma Concentration of Oxytocin
时间窗: Blood will be drawn immediately after HVLAT procedure.
Samples were analyzed for Human Oxytocin, using the Multiplex Luminex-100 platform (Luminex, Inc., USA).
Plasma Concentration of Oxytocin
时间窗: Blood will be drawn 10 minutes prior to HVLAT procedure.
Samples were analyzed for Human Oxytocin, using the Multiplex Luminex-100 platform (Luminex, Inc., USA).
次要结局
- Plasma Concentration of Neurotensin(Blood will be drawn immediately after HVLAT procedure.)
- Plasma Concentration of Cortisol(Blood will be drawn immediately after HVLAT procedure.)
- Plasma Concentration of Orexin A(Blood will be drawn immediately after HVLAT procedure.)
- Plasma Concentration of Neurotensin(Within 10 minutes after consent signature completion)
- Plasma Concentration of Orexin A(Within 10 minutes after consent signature completion)
- Plasma Concentration of Cortisol(Within 10 minutes after consent signature completion)
研究者
Everett Lohman
D.Sc., P.T., OCS Professor Allied Health.
Loma Linda University