Extremity Manipulation Impact on Postural Sway Characteristics

Not Applicable

Completed

• Conditions: Healthy
• Interventions: Procedure: Lower Extremity First (LEF); Procedure: Upper Extremity First (UEF)

• Registration Number: NCT03414749
• Lead Sponsor: Parker University

Brief Summary

This study will evaluate the multi-segmental postural sway after upper versus lower extremity manipulation.

Detailed Description

The focus of this study is to explore the effect of upper and lower extremity chiropractic adjustments (manipulation) as well as surface condition (hard surface vs rocker board) on multisegmental postural control as represented by postural sway. Using a rocker (tilt) board, the participant cannot stand still, but has to adjust posture continuously to maintain balance. Body sways are considered to be self-induced because the design of the rocker board creates a natural instability without any external perturbation. This task provides a self-driven sensorimotor condition in addition to amplifying the sway dynamics. Because the rocker board has only one degree of freedom of motion, anteroposterior and lateral sways were considered separately on the device.

The investigators had the following hypotheses.

Hypothesis 1: Lower extremity adjustments will lead to reduced postural sway magnitude compared to upper extremity adjustments.

Hypothesis 2: Lower extremity adjustments will reduce sway variability of the rocker board, trunk and head compared to upper extremity adjustments.

Hypothesis 3: Lower extremity adjustments will facilitate the organization of sway behavior as assessed by the chaotic structure of sway.

Study Timeline

• Study Start: 2017-07-24
• Primary Completion: 2017-08-09
• Study Completion: 2017-08-09
• Study First Submitted: 2018-01-22
• Study First Submitted QC: 2018-01-26
• Study First Posted: 2018-01-30
• Status Verified: 2020-02
• Last Update Submitted: 2020-02-05
• Last Update Posted: 2020-02-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 25

Inclusion Criteria

• student in Parker University's Doctor of Chiropractic program and patient at the Parker University Wellness Clinic;
• available to take part in the study for all 3 test days;
• willing to forgo all non-normal daily activities and chiropractic treatments during the test days;

Exclusion Criteria

• pregnant;
• previous major injury involving the extremities;
• previous surgeries to an extremity joint; and
• known neurological or systemic diseases.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Lower Extremity First (LEF)	Lower Extremity First (LEF)	The treatment was a non-specific long-axis distraction to the ankle, knee, and hip provided was at the discretion of the clinic doctor (over 25 years experience).
Upper Extremity First (UEF)	Upper Extremity First (UEF)	The treatment was a non-specific long-axis distraction to the shoulder, elbow and wrist provided was at the discretion of the clinic doctor (over 25 years experience).

Primary Outcome Measures

Name	Time	Method
Postural Assessment	Pre Treatment on Day 3	Each participant was fitted with two Shimmer3 sensors (Shimmer Sensing, Dublin, Ireland) on their head (occiput) and low back (over S2 tubercle) (see Figure 2) with a third Shimmer3 sensor placed on the surface (ground or rocker board). Participants were asked to perform a series of four postural tasks with two surface conditions (floor or rocker board) and two variations of each (eyes open or closed, and AP or ML rocker board direction). The conditions were randomized (using REDCap) such that either both floor or both rocker board conditions were performed first, with the remainder performed second. The order of variation within the surface type was held consistent for all occasions; eyes open then eyes closed on the floor, and AP then ML rotation direction on the rocker board.

Trial Locations

Locations (1)

Parker University; 🇺🇸 Dallas, Texas, United States