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The Effect of Thoracic Spine Manipulation on Peripheral Neurodynamic Mobility

Not Applicable
Completed
Conditions
Musculoskeletal Manipulations
Interventions
Procedure: Spinal Manual Therapy
Procedure: Spinal Range of Motion
Registration Number
NCT02842918
Lead Sponsor
Shenandoah University
Brief Summary

No studies have investigated the effects of a supine thoracic spine manipulation (TSM) on neurodynamic mobility, as compared to a sham intervention. This study aims to determine the immediate effects of TSM on the Upper Limb Provocation Test (ULPT) and Seated Slump Test (SST) compared to a sham intervention in asymptomatic subjects with neurodynamic limitations.

Detailed Description

A convenience sample will be utilized to obtain subjects. Subjects will be given a brief questionnaire to identify possible contraindications for spinal treatment techniques and exclude individuals if necessary. Subjects will be randomized into one of two groups (spinal manual therapy or spinal range of motion which will serve as the name for the placebo group) and participate in neurodynamic testing procedures of the upper extremity (Upper Limb Provocation Testing) as well as lower extremity (Seated Slump Test). Subjects who are determined to be positive for one or more limbs will receive either a thoracic spine manipulation technique (spinal manual therapy) or a thoracic spine sham manipulation technique (spinal range of motion/placebo). After application of the technique, previously positive limbs will be retested. In attempt to determine validity and believability of the sham procedure and perception of its effect, subjects will be asked if they believe their upper/lower quarter mobility will change based on the group name and after the technique is applied. Subjects will also be asked if they believed they were in the treatment or placebo group.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
43
Inclusion Criteria
  • Upper Limb Provocation Test results with limitation of greater than 60 deg of elbow extension at the time of measurement
  • Seated Slump Test results with limitation of greater than 22 deg of knee extension at the time of measurement
Exclusion Criteria
  • History of cervical or lumbar pain requiring medical intervention within the last two years, history of upper or lower extremity paresthesia/numbness, self reported bone density disorders, previous spinal cord injury, diagnosed intervertebral disc herniation, previous diagnosis of spinal stenosis or disc pathology, current pregnancy, history of circulatory or neurological disorders, history of spine and extremity fractures or dislocations in the last two years

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Spinal Manual TherapySpinal Range of MotionSupine thoracic spine manipulation located between the levels of T4-T7
Spinal Manual TherapySpinal Manual TherapySupine thoracic spine manipulation located between the levels of T4-T7
Spinal Range of MotionSpinal Manual TherapySupine thoracic spine sham manipulation located between the levels of T4-T7; identical procedure as the active treatment intervention but without the delivery of high velocity low amplitude thrust
Spinal Range of MotionSpinal Range of MotionSupine thoracic spine sham manipulation located between the levels of T4-T7; identical procedure as the active treatment intervention but without the delivery of high velocity low amplitude thrust
Primary Outcome Measures
NameTimeMethod
Seated Slump Test Range of Motion Change (measured in degrees of knee extension)Pre and Immediately Post Intervention

Subjects will sit at the edge of treatment table. Subjects will be asked to flex then neck towards their chest. The investigator will then apply a gentle force to their upper back and will ask the subject to remain in this position. The investigator will move the subjects foot upwards and straighten their leg until it is fully extended or until the subject reports discomfort or an abnormal feeling in their leg.This procedure will be completed before and immediately after either the treatment intervention (manipulation) or the sham intervention is completed.

Upper Limb Provocation Test Range of Motion Change (measured in degrees of elbow extension)Pre and Immediately Post Intervention

Subjects will lie on their back with their shoulder slightly off the edge of a treatment table. The investigator will then bend the subjects neck away from the shoulder being tested and position the arm into the starting test position. The investigator will then straighten the subjects elbow until it is fully extended, or until the subject reports discomfort or an abnormal feeling in their arm. This procedure will be completed before and immediately after either the treatment intervention (manipulation) or the sham intervention is completed.

Secondary Outcome Measures
NameTimeMethod
Perceived effect - measured via questionnairePre Intervention (immediately after initial measurements are recorded and prior to intervention)

Subjects will be asked whether they believe their upper and/or lower quarter mobility will change based on the group name they are assigned.

Believability of Sham - measured via questionnaireImmediately Post Intervention (after final measurements are read and recorded)

Subjects will be asked whether they believe they were in the active treatment group or the sham/placebo group after final measurements are taken.

Trial Locations

Locations (1)

Shenandoah University

🇺🇸

Winchester, Virginia, United States

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