Effects of Spinal Manipulation on Vertebrobasilar and Internal Carotis Arteries in Healthy Population
- Conditions
- Vertebral Artery Dissection, TraumaticNeck Pain
- Interventions
- Diagnostic Test: Doppler UltrasonographyProcedure: Manual Chiropractic Spinal ManipulationDevice: Instrumental Chiropractic Spinal Manipulation
- Registration Number
- NCT03435159
- Lead Sponsor
- Bahçeşehir University
- Brief Summary
After lumbar pain, neck pain is the most common cause of patients needing chiropractic care; the second most common cause of spinal manipulation use (1). Manipulation and mobilization are commonly used by chiropractors, osteopaths and manipulative physiotherapists in the treatment of neck pain. Many studies show that the Activator instrument is also used for this purpose in the chiropractic profession (2) There are several published case reports that relate to neck manipulation to vertebral artery dissection and stroke. The prevailing theory is that the neck extension and / or rotation may damage the vertebral artery in the foramen transversarium, especially at the C1-C2 level (2). However, most cases of extracranial vertebral artery dissection are thought to be spontaneous (3).
In the literature, there have been no studies investigating the effects of instrument-assisted spinal manipulation on vertebrobasilar and internal carotis arteries. the aim of this study to compare the effect of manual and instrumental spinal manipulation on blood flow parameters of vertebrobasilar and internal carotis arteries on healthy persons which have mechanical neck pain and asymptomatic in vertebrobasilar insufficiency test.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 30
- Being between 20-40 years of age
- Having non-specific mechanical neck pain for more than 3 months with symptoms provoked by neck postures, movements, or palpation
- Willingly participating to the study
- Signing the confirmation form.
- Spinal root compression (radiculopathy)
- Neurological symptoms like weakness and numbness in extremities and face, uncontrolled movements, abnormal gait, dizziness, undefined nausea/vomiting, swallowing and speaking difficulties
- Acute inflammatory disease
- Spontaneously vertebral artery dissection in family
- Tested positive in premanipulative vertebrobasilar artery insufficiency test
- Being on anticoagulant and antiaggregant medication.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Manual Chiropractic Spinal Manipulation Doppler Ultrasonography Demographic informations, pain, previous trauma, diseases, current medicine, past surgical operations, pregnancy, smoking use and cervical artery dissection history in family are questioned. Cervical flexion, extension, right and left rotations, right and left lateral flexions are measured by physiotherapist, in sitting position and with goniometer.Upper extremity muscle strength was measured with manual muscle testing in sitting position by physical therapist. The muscles innervated by C4, C5, C6, C7, C8 and T1 cervical nerves were examined bilaterally. Cervical foraminal compression test was used to eliminate cervical root compression.Vertebrobasilar artery was assessed by premanipulative vertebrobasilar insufficiency test.Neck Disability Index was used to evaluate the functional neck status of the participants. After all assessments, participants who were eligible for this study were undertaken Doppler Ultrasonography before and after manual manipulative intervention. Instrumental Chiropractic Spinal Manipulation Doppler Ultrasonography The same assessments were applied to determine the eligibility of participants for this study. After all assessments, participants who were eligible for this study were undertaken Doppler Ultrasonography before and after instrumental manipulative intervention. Manual Chiropractic Spinal Manipulation Manual Chiropractic Spinal Manipulation Demographic informations, pain, previous trauma, diseases, current medicine, past surgical operations, pregnancy, smoking use and cervical artery dissection history in family are questioned. Cervical flexion, extension, right and left rotations, right and left lateral flexions are measured by physiotherapist, in sitting position and with goniometer.Upper extremity muscle strength was measured with manual muscle testing in sitting position by physical therapist. The muscles innervated by C4, C5, C6, C7, C8 and T1 cervical nerves were examined bilaterally. Cervical foraminal compression test was used to eliminate cervical root compression.Vertebrobasilar artery was assessed by premanipulative vertebrobasilar insufficiency test.Neck Disability Index was used to evaluate the functional neck status of the participants. After all assessments, participants who were eligible for this study were undertaken Doppler Ultrasonography before and after manual manipulative intervention. Instrumental Chiropractic Spinal Manipulation Instrumental Chiropractic Spinal Manipulation The same assessments were applied to determine the eligibility of participants for this study. After all assessments, participants who were eligible for this study were undertaken Doppler Ultrasonography before and after instrumental manipulative intervention.
- Primary Outcome Measures
Name Time Method Change in Peak Systolic Velocity (PSV) 1 minute cm/s, measured in each group
Change in End Diastolic Velocity (EDV) 1 minute cm/s, measured in each group
Change in Resistive Index (RI) 1 minute The Formula: RI = (PSV- EDV) / PSV, it has no unit, measured in each group
Change in Volume Flow (VF) 1 minute ml/min, measured only for right and left vertebral arteries
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Maslak Acıbadem Hospital
🇹🇷Istanbul, Turkey