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Trial registered on ANZCTR
Registration number
ACTRN12614000880640
Ethics application status
Approved
Date submitted
12/08/2014
Date registered
19/08/2014
Date last updated
19/12/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
The effects of chiropractic care on trunk muscle function.
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Scientific title
The effects of a single session of chiropractic care compared to passive movements on trunk muscle reflex function in individuals with recurrent low back pain.
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Secondary ID [1]
285156
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None
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Universal Trial Number (UTN)
U111111581513
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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:
Low back pain
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Condition category
Condition code
Musculoskeletal
293038
293038
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0
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Other muscular and skeletal disorders
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Physical Medicine / Rehabilitation
293072
293072
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0
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Other physical medicine / rehabilitation
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Neurological
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293073
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The participants will attend two intervention sessions in random order, one will be an experimental session where they will receive chiropractic care, and the other will be a control session where they will receive no adjustments but will be repositioned as if the chiropractor was going to adjust their spine (i.e. cervical, thoracic and lumbar adjustment setups). This will act as a physiological control for time, as well as the vestibular, cutaneous and muscular afferent discharge changes involved in moving and touching the subject when preparing for the adjustments. Care will be taken to ensure no forces are applied to individual segments during the control intervention. Full spine adjustments will be carried out during the experimental session. The entire spine and sacroiliac joints will be assessed for vertebral subluxations and adjusted where deemed necessary by a registered chiropractor with at least ten years clinical experience. Each intervention session will take approximately 1 hour and there will be a minimum 1 week washout period between each session.
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Intervention code [1]
290004
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Prevention
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Intervention code [2]
290036
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Treatment: Other
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Comparator / control treatment
The control intervention will consist of passive and active movements of the subject’s head, spine and body that will be carried out by the same chiropractor who pre-checks the participants for vertebral subluxations and who performs the adjustments in the experimental intervention session. This control intervention will involve the participants being moved into the adjustment setup positions where the chiropractor would normally apply a thrust to the spine to achieve the adjustments. However, the experimenter will be particularly careful not to put pressure on any individual spinal segments. Loading a joint, as is done prior to spinal adjustments has been shown to alter paraspinal proprioceptive firing in anesthetised cats (Pickar & Wheeler, 2001), and will therefore be carefully avoided by ending the movement prior to end-range-of-motion when passively moving the participants. No spinal adjustments will be performed during any control intervention. This control intervention is not intended to act as a sham adjustment but to act as a physiological control for possible changes occurring due to the cutaneous, muscular or vestibular input that will occur with the type of passive and active movements involved in preparing a patient for an adjustment. It also acts as a control for the effects of the stimulation necessary to collect the dependent measures of the study, and acts as a control for the time required to carry out the adjustment intervention.
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Control group
Active
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Outcomes
Primary outcome [1]
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Onset of muscle activation during postural perturbations (feed forward activation) will be measured using electromyography (EMG) and will be the primary outcome measure.
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Assessment method [1]
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Timepoint [1]
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Immediately post-intervention
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Secondary outcome [1]
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The secondary outcome measure will be muscle reflex latency following force release in trunk flexion, extension, and lateral bending. This will be will be measured using electromyography (EMG)
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Assessment method [1]
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Timepoint [1]
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Immendiately post-intervention.
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Eligibility
Key inclusion criteria
Participants will be eligible for inclusion if they are English speaking, aged 18-50, have a history of recurring low back pain, and display evidence of delayed feed forward activation times for abdominal muscles compared to deltoid.
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Minimum age
18
Years
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Maximum age
50
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
Participants will be ineligible to participate if they exhibit no evidence of vertebral subluxations, have absolute contraindications to spinal adjustments, have experienced previous significant adverse reactions to chiropractic care, or they are suffering from current LBP.
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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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
1/07/2018
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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
20
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
6291
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New Zealand
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State/province [1]
6291
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Auckland
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Funding & Sponsors
Funding source category [1]
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Other
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Name [1]
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New Zealand College of Chiropractic
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Address [1]
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6 Harrison Road
Mount Wellington
Auckland 1060
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Country [1]
289758
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New Zealand
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Primary sponsor type
Other
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Name
New Zealand College of Chiropractic
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Address
6 Harrison Road
Mount Wellington
Auckland 1060
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Country
New Zealand
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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]
288447
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Country [1]
288447
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern B Health and Disability Ethics Committee
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Ethics committee address [1]
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Health and Disability Ethics Committees Ministry of Health C/- MEDSAFE, Level 6, Deloitte House 10 Brandon Street PO Box 5013 Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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18/06/2014
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Approval date [1]
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16/07/2014
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Ethics approval number [1]
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14/NTB/84
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Summary
Brief summary
Low back pain (LBP) is a major health problem that affects up to 90% of people during their lifetime (Darlow et al., 2014). Approximately one third of individuals will suffer recurrent episodes of low back pain that require treatment after becoming pain free and apparently returning to full function (Wasiak, Kim, & Pransky, 2006). It is unclear why some people develop recurrent low back pain while others don’t (MacDonald, Moseley, & Hodges, 2009). Recently evidence has been accumulating that suggests that recurrent low back pain may be due to a change in neural control of the muscles of the trunk (Cholewicki et al., 2005; MacDonald et al., 2009). Proper function of the spinal muscles is critical for spinal motion and stability and spinal health (MacDonald et al., 2009). It is therefore not surprising that changes in spinal muscle control have been observed in individuals suffering from chronic LBP and sciatica and they are even present in sufferers of recurrent LBP between episodes of pain (MacDonald et al., 2009). These alterations in motor control that are associated with LBP include delayed onset of muscle activation during postural perturbations (delayed feed forward activation) (MacDonald et al., 2009) and delayed muscle reflex latency following force release in different directions of trunk movement (Cholewicki et al., 2005). Recent evidence suggests that chiropractic care alters the neural control of spinal muscles and may have a beneficial effect on reflex activity that is associated with LBP (Haavik & Murphy, 2012; Marshall & Murphy, 2006). The purpose of this study is to investigate whether a single session of chiropractic care alters trunk muscle activity that is associated with LBP in people with recurrent LBP who are in remission at the time of the study.
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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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Dr Heidi Haavik
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Address
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New Zealand College of Chiropractic
6 Harrison Road
Mount Wellington
Auckland 1060
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Country
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New Zealand
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Phone
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+6495266789
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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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Heidi Haavik
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Address
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New Zealand College of Chiropractic
6 Harrison Road
Mount Wellington
Auckland 1060
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Country
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New Zealand
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Phone
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+6495266789
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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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Heidi Haavik
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Address
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New Zealand College of Chiropractic
6 Harrison Road
Mount Wellington
Auckland 1060
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Country
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New Zealand
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Phone
50652
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+6495266789
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Fax
50652
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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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