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Trial registered on ANZCTR
Registration number
ACTRN12611000374965
Ethics application status
Approved
Date submitted
24/03/2011
Date registered
11/04/2011
Date last updated
26/11/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Dose Optimisation for Spinal treatment Effectiveness (The DOSE Study): A randomised controlled pilot trial investigating the effects of high and low mobilisation forces in patients with neck pain
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Scientific title
In patients with chornic non-specific neck pain, is a high force mobilisation better than a low force mobilisation or laser for immediate improvement in pressure pain threshold scores?
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Secondary ID [1]
259857
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Nil
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Universal Trial Number (UTN)
U1111-1120-2738
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Trial acronym
The DOSE Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic non-specific neck pain
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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
1. High force mobilisation will consist of a single application of 3 sets of 30 seconds of oscillating pressures manually applied by thhe physiotherapist' thumbs with a mean peak force of 90N to the symptomatic spinal level. 2. Low force mobilisation will consist of a single application of 3 sets of 30 seconds of oscillating pressures manually applied by thhe physiotherapist' thumbs with a mean peak force of 30N to the symptomatic spinal level. 3. Laser will consist of a single application of 3 sets of 30 seconds application applied using the Echolac with probe to skin contact over the symptomatic level. Laser was detuned (i.e., not active) and represented the placebo group, or an inactive treatment control.
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Intervention code [1]
264275
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Treatment: Other
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Comparator / control treatment
treatment: 1. High force mobilisation will consist of a single application of 3 sets of 30 seconds of oscillating pressures manually applied by thhe physiotherapist' thumbs with a mean peak force of 90N to the symptomatic spinal level. 2. Low force mobilisation will consist of a single application of 3 sets of 30 seconds of oscillating pressures manually applied by thhe physiotherapist' thumbs with a mean peak force of 30N to the symptomatic spinal level. 3. Laser will consist of a single application of 3 sets of 30 seconds application applied using the Echolac with probe to skin contact over the symptomatic level. Laser was deactivated and therefore was the placebo control group.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Pressure pain threshold (PPT) will be measured with the J-tech algometer (Tracker Freedom Algometry, J-tech Medical (http://jtechmedical.net/products/pain_eval/freedom/freedom_algometry.cfm) over the following landmarks in randomised order: (1) Adjacent to the spinous process at the treated spinal level (right side) (2) Right upper trapezius muscle (3) Right median nerve trunk at the elbow. Measurements will be taken in triplicate and averaged for each landmark.
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Assessment method [1]
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Timepoint [1]
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Immediately before treatment application, immediately after treatment application and one follow-up 3-5 days later
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Secondary outcome [1]
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Cervical range of motion will be measured with a Cervical Range of Motion instrument (CROM, Performance Attainment Associates, Minnesota, USA, http://www.spineproducts.com/) in the following ranges: (1)Total sagittal plane ROM, (2) Total horizontal plane ROM and (3) Position (degrees) at first onset or increase in pain with movement towards the most painful movement direction. Measurements will be taken in triplicate and averaged.
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Assessment method [1]
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Timepoint [1]
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Immediately before treatment application, immediately after treatment application and one follow-up 3-5 days later
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Secondary outcome [2]
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Cervical spine stiffness will be measured with a customised device that applied 5 standardised oscillating pressures to the spinous process using a probe while recording the resistance to movement and the distance the probe travels. The relationship between resistance and displacement (distance) represents the spinal stiffness (N/mm). The symptomatic spinal level as well as C7 (for normalisation)will be measured.
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Assessment method [2]
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Timepoint [2]
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Immediately before treatment application, immediately after treatment application and one follow-up 3-5 days later
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Secondary outcome [3]
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Patient reported pain (visual analogue scale)
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Assessment method [3]
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Timepoint [3]
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Immediately before treatment application, immediately after treatment application and one follow-up 3-5 days later
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Eligibility
Key inclusion criteria
chronic non-specific neck pain (> 90 days)
aged between 18 and 55 years
minimum average resting pain level over the previous 3 days of 3/10
report of neck pain that at least ‘moderately’ interferes with their normal work (work and housework)
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Minimum age
18
Years
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Maximum age
55
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
upper cervical pain, headache or dizziness as their primary complaint
migraine
history of trauma related to the neck,
surgery to the neck
diabetes
peripheral vascular disease
referred arm pain past the tip of the shoulder
currently receiving other physical treatments for their neck pain (e.g., physiotherapy, chiropractic, acupuncture or similar)
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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)
Subjects will be screened for contraindicated conditions prior to enrolling in the study. Patients will be assigned to treatment groups through random allocation using opaque envelopes, opened on the day of data collection affter initial measurements are taken. The researcher doing the recruiting will have no knowledge of the treattment group of potential participants.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The randomised number sequence is generated through a computer program available online.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
6/04/2011
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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
66
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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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Charities/Societies/Foundations
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Name [1]
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Physiotherapy Research Foundation
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Address [1]
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Australian Physiotherapy Association
Level 1, 1175 Toorak Rd
Camberwell, VIC 3124
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Suzanne Snodgrass
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Address
School of Health Sciences
Hunter Building
Callaghan, NSW 2308
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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The University of Newcastle
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Address [1]
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School of Health Sciences
Hunter Building
Callaghan, NSW 2308
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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 Newcastle Human Research Ethics Committee
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Ethics committee address [1]
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Research Services Research Integrity Unit HA148, Hunter Building The University of Newcastle Callaghan NSW 2308
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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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21/03/2011
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Ethics approval number [1]
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H-2011-0044
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Summary
Brief summary
Around 30-50% of adults will experience neck pain over a 12 month period, and many are treated with manual therapy. Although evidence supports manual therapy treatment when combined with exercise, the dose is not defined. Up until now, there were few methods for objectively quantifying a manual technique to establish its optimal dose. This pilot randomised controlled trial will investigate two specific doses of posterior-to-anterior (PA) mobilisation, the most common manual technique therapists use when treating the cervical spine. Sixty patients will be randomised to receive either a high force or low force PA mobilisation, or sham treatment, with patients’ pressure pain threshold, resting pain, cervical range and stiffness measured before, immediately after and 3-5 days post-treatment. We will utilise innovative equipment we developed to standardise the manually applied forces, conducting the trial using demonstrable methods from our previous research. Determining dose-response relationships for manual therapy is essential for establishing optimal treatment strategies for patients with neck pain. The cost of neck pain is increasing, and many patients do not achieve symptom resolution. Therefore there is an urgent need for physiotherapists to provide effective treatment dosages with demonstrated patient outcomes, impacting spinal pain and advancing physiotherapy as the preferred treatment choice.
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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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Suzanne Snodgrass
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Address
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School of Health Sciences
Faculty of Health
The University of Newcastle
Hunter Building
Callaghan NSW 2308
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Country
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Australia
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Phone
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+61 24921 2089
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Fax
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+61 2 4921 7053
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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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same
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Address
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School of Health Sciences Faculty of Health The University of Newcastle Hunter Building Callaghan NSW 2308
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Country
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Australia
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Phone
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+61 2 49212089
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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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