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Trial registered on ANZCTR
Registration number
ACTRN12613001257752
Ethics application status
Not yet submitted
Date submitted
14/11/2013
Date registered
18/11/2013
Date last updated
18/11/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
Chiropractic care for adolescent low back pain: a pilot study
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Scientific title
Chiropractic care for adolescent low back pain: a sham controlled feasibility study
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Secondary ID [1]
283492
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NIL
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
adolescent low back pain
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Condition category
Condition code
Musculoskeletal
290800
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0
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Other muscular and skeletal disorders
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Physical Medicine / Rehabilitation
290922
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Chiropractic group: the chiropractic care protocol will be semi-standardised, involving both fixed components and any other treatment the chiropractors deem necessary. The fixed components have been derived from a Delphi study undertaken to identify elements of best chiropractic practice for adolescent low back pain, and comprise: spinal manipulation in the lumbo-pelvic area; mobilisation in the lumbo-pelvic area; advice to stay active; advice about modification of activities; and recommending back-specific exercises and general exercise. The chiropractors will be encouraged to use all of the fixed components in each consultation, but may use their discretion whether they are used on a particular patient or not. Four treatments will provided to each participant. The initial consultation will include a detailed medical history assessment and will last for about one hour. The three subsequent treatments, spaced at weekly intervals, will last for about 20-30 minutes.
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Intervention code [1]
288198
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Treatment: Other
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Comparator / control treatment
Sham group: participants will receive de-tuned ultrasound and de-tuned Activator treatment by the chiropractor to the regions where spinal pain is experienced. To increase the perceived “hands on” credibility, the chiropractor will be trained to gently place one hand on an area adjacent to the participant’s spine while delivering the ultrasound and Activator therapies. The frequency, duration and patient contact with the chiropractor will match that of the active chiropractic arm. The chiropractors will be trained to give the same enthusiasm as when delivering the chiropractic care.Four treatments will provided to each participant. The initial consultation will include a detailed medical history assessment and will last for about one hour. The three subsequent treatments, spaced at weekly intervals, will last for about 20-30 minutes.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Pain intensity, assessed on a 11-point numerical rating scale
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Assessment method [1]
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Timepoint [1]
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1 week; 2 weeks; and 4 weeks
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Secondary outcome [1]
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global perceived change, assessed on a 11-point scale
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Assessment method [1]
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Timepoint [1]
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1 week; 2 weeks; and 4 weeks
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Secondary outcome [2]
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treatment satisfaction, assessed on a 5-point scale
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Assessment method [2]
305303
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Timepoint [2]
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4 weeks
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Secondary outcome [3]
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Disability, assessed by the Roland-Morris Disability Questionnaire
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Assessment method [3]
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Timepoint [3]
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1 week; 2 weeks; and 4 weeks
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Secondary outcome [4]
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Blinding, assessed by the Bang Index
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Assessment method [4]
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Timepoint [4]
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4 weeks
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Eligibility
Key inclusion criteria
Young people will be eligible to participate in the pilot study if they meet the following criteria: aged between 13 and 17 years (inclusive) who have experienced non-specific low back pain once a week for at least 6 weeks; and have a NRS for low back pain of 3 out of 10 on the day that baseline measures are collected
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Minimum age
13
Years
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Maximum age
17
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
Young people will be excluded if they meet any of the following exclusion criteria: known pathology causing their low back pain (for example, fracture, spinal infection, neoplastic disorders); clinical signs and symptoms of a lumbar disc herniation; a history of spinal surgery; not fluent and/or literate in the English language; currently receiving care for low-back pain from any other healthcare provider; unable to consent to treatment. Young people will also be excluded if they have previously received manipulation, as previous experience of manipulation may affect successfully maintaining blinding. If eligible informed consent will be obtained.
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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)
Allocation will occur directly after baseline measures are undertaken. A statistician will generate the randomisation sequence and then place the allocation (A or B) in sequentially numbered, opaque, sealed envelopes and distribute them to the participating chiropractors. As each participant enters the trial the next consecutive opaque, sealed envelope will be opened to allocate the participant to chiropractic care or sham.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised random number generator
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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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
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/02/2014
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Actual
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Date of last participant enrolment
Anticipated
28/02/2014
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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
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Funding & Sponsors
Funding source category [1]
288192
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Charities/Societies/Foundations
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Name [1]
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Chiropractic and Osteopathic College of Australasia Research Pty Ltd
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Address [1]
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Suite 2, 1 Rooks Road, Nunawading, Victoria, 3131
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Murdoch University
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Address
90 South ST, Murdoch, WA, 6150
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
286916
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Country [1]
286916
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
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Murdoch University Human Research Ethics Committee
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Ethics committee address [1]
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90 South ST, Murdoch, WA, 6150
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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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22/11/2013
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Approval date [1]
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Ethics approval number [1]
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Summary
Brief summary
Health in early life has a profound impact on health and quality of life in later years. Up to 75% of adolescents have experienced back pain with children and adolescents more likely to have recurrent pain in adulthood that may develop into disabling psychological distress and illness behaviour. Chiropractors treat adolescents with low back pain primarily using various forms of spinal manipulation. However, there is no high quality evidence to support or refute the effectiveness of chiropractic, or other manual approaches, for back pain in adolescents. There is also no agreement on what is thought to be the “best” approach for chiropractors to care for adolescents with non-specific low back pain. Hence, we undertook a Delphi study to construct a best chiropractic practice guideline for adolescent low back pain which we intend to administer in a randomised controlled trial. The objectives of this study are to: examine the feasibility of implementing a protocol of best practice chiropractic care for adolescents with non-specific low back pain; and undertake a pilot study of a randomised trial of chiropractic care for non-specific low-back pain in adolescents to examine the feasibility of conducting a fully powered randomised trial.
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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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A/Prof Bruce Walker
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Address
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School of Health Professions, Murdoch University, 90 South ST Murdoch, WA, 6150
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Country
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Australia
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Phone
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+61 8 9360 1297
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Bruce Walker
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Address
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School of Health Professions, Murdoch University, 90 South ST Murdoch, WA, 6150
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Country
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Australia
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Phone
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+61 8 9360 1297
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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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Bruce Walker
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Address
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School of Health professions, Murdoch University, 90 South ST Murdoch, WA, 6150
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Country
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Australia
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Phone
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+61 8 9360 1297
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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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