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Trial registered on ANZCTR
Registration number
ACTRN12610000823077
Ethics application status
Approved
Date submitted
19/09/2010
Date registered
1/10/2010
Date last updated
1/10/2010
Type of registration
Retrospectively registered
Titles & IDs
Public title
Novel approaches to improve pain and function in those with sacro-iliac joint dysfunction
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Scientific title
Prolotherapy versus placebo injections to improve pain and function in patients with form failure of load transfer of the sacroiliac joint
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Secondary ID [1]
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Nil
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Universal Trial Number (UTN)
U1111-1117-1011
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Trial acronym
prolosij
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
failure of form closure of the sacro-iliac joint
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Condition category
Condition code
Musculoskeletal
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Injection of 1.0ml of 20% Dextrose in 0.5% Bupivicaine in the dorsal interosseous ligament of the Sacro-Iliac Joint (SIJ)versus placebo needle. Maximum of six injections. A previous observational trial with three injections (same protocol) yielded good results (Cusi et al, BJSM 2010). The total six injections maximum corresponds to three placebo injections and the cross over three Dextrose injections. Injections are every six weeks. Unblinding after the third injection. If the patient has made adequate improvement no further injections may be required. Six weeks after the third injection unblinding takes place, and cross over takes place at that time.
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Intervention code [1]
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Treatment: Other
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Intervention code [2]
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Treatment: Drugs
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Comparator / control treatment
Placebo dry needle in a more superficial plane, without reaching the posterior interosseous ligament of the sacro-iliac joint
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Control group
Placebo
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Outcomes
Primary outcome [1]
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clinical assessment: Active straight leg raise, palpation of long dorsal sacro-iliac ligament, Stork test and posterior pelvic pain provocation test
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Assessment method [1]
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Timepoint [1]
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Three months post final injection
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Primary outcome [2]
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Pain. Visual Analogue Scale
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Assessment method [2]
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Timepoint [2]
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Three months post final injection
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Primary outcome [3]
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Functional questionnaires: Quebec Disability Index, Roland Morris 24 and Roland Morris 24 multi,
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Assessment method [3]
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Timepoint [3]
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Three months post final injection
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Secondary outcome [1]
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Patient perception of function. Patient Generated Index
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Assessment method [1]
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Timepoint [1]
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three months post post final injection
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Eligibility
Key inclusion criteria
Failure of load transfer not improved with specific lumbopelvic stability exercises
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Minimum age
18
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Infection, fracture, cancer, psychiatric disorders, pregnancy, previous prolotherapy in the same SIJ
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients who fulfil the criteria for diagnosis of failure of load transfer through the sacroiliac joint -history, clinical examination and Single Photon Emission Computerised Tomography - Computed X-ray Tomography (SPECT-CT)- will be asked to participate in this randomised double blind crossover trial. Allocation is concealed by sealed opaque envelopes held by the radiologist who carries out the injections, in a different site to where patients are assessed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
random number generator where an odd number is placebo and an even number prolotherapy injection. Allocation concealment to be done with sealed envelopes
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 2 / Phase 3
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
17/09/2010
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
80
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Dr Manuel (Mel) Cusi
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Address [1]
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160 Belmore Road
Randwick NSW 2031
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Dr Manuel (Mel) Cusi
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Address
15 Vernon Street
Strathfield NSW 2135
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Hans van der Wall
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Address [1]
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4 Hospital Road
Concord West NSW 2138
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Country [1]
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Louise Wong
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Address [1]
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4 Hospital Road
Concord West NSW 2138
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Notre Dame Australia, Sydney Medical School
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Ethics committee address [1]
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160 Oxford Street Darlinghurst NSW 2010
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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03/07/2008
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Ethics approval number [1]
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Ethics committee name [2]
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Australian Institute of Sports Ethics Committee
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Ethics committee address [2]
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Australian INstitute of Sport PO Box 176 Belconnen ACT 2616
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
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Approval date [2]
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02/02/2010
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Ethics approval number [2]
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20091007
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Summary
Brief summary
Patients with low back pain who fulfil the diagnostic criteria for deficient load transfer through the sacro-iliac joint (SIJ) (Hungerford et al, 2004; Mens et al, 2001) (sacro-iliac joint dysfunction) and who do not respond to exercise therapy have deficient ligamentous function. 1. The primary hypothesis of this study is that the injection of 20% Glucose solution into the posterior ligaments of the SIJ will stimulate the formation of new collagen and increase ligament strength. Tis will be measured by improvement in the following tests: a) Stork test (Hungerford et al Spine 2004), b) Active straight leg raise (ASLR) (Mens et al, 2001 and 2002) , c) Posterior pelvic pain provocation test (PPPP) (Ostgaard et al, 1994, Vleeming et al, 2002) d) Palpation of the long dorsal sacro-iliac ligament (Vleeming at al, 1996) 2. The secondary hypothesis is that the improvement in the ligament function will lead to a decrease in symptoms and an improvement in quality of life measured by a) Quebec Back Pain Disability Scale (Kopek et al, 1995) and b) Patient Generated Index Questionnaire (PGI) Ruta at al, 1994 Both have been used previously in back pain studies. The aim of the study is to compare by randomised trial wether CT guided injection of 20% glucose solution into the ligaments of the sacroiliac joint as compared to a sham injection control results in a) A negative Stork test b) A negative ASLR test c) A negative PPPP test d) A lower Quebec score e) Improvement in the PGI, as measured three months after the intervention
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Manuel (Mel) Cusi
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Address
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160 Belmore Road
Randwick NSW 2031
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Country
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Australia
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Phone
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61-2-9399 5333
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Manuel (Mel) Cusi
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Address
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160 Belmore Road
Randwick NSW 2031
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Country
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Australia
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Phone
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61-2-93995333
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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