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Trial registered on ANZCTR
Registration number
ACTRN12606000498594
Ethics application status
Approved
Date submitted
29/11/2006
Date registered
4/12/2006
Date last updated
16/11/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
The effect of a specific medication or placebo on modulating induced muscle pain
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Scientific title
The pharmacologic modulation of experimentally simulated tennis elbow (lateral epicondylalgia) in healthy controls by administration of a ketamine (generic and specific name) or placebo lozenge: improving our understanding of musculoskeletal pain mechanisms
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Secondary ID [1]
287899
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Nil known
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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:
Experimentally simulated tennis elbow (lateral epicondylalgia) in healthy controls
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Condition category
Condition code
Musculoskeletal
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0
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Ketamine (25mg sublingual) will be administered prior to an intense bout of eccentric exercise used to induce delayed onset muscle soreness (DOMS) in the wrist extensors of healthy control subjects. Verum and placebo lozenges will look identical to maintain double blinding. Twenty four hours post-exercise, subjects will receive an infusion of hypertonic saline (1.0mls @ 5%) into the extensor carpi radialis brevis muscle.
Methodology: 1. Induced delayed onset muscle soreness:
The exercise protocol will be performed using the isokinetic mode of the Kin-Com dynamometer (Chattecx Corp. Hixson, TN) as previously described (Slater et al. 2005). The total exercise period will be 25 minutes, with 5 bouts each of 5 minutes duration (60 repetitions per bout), with each bout separated by a minute rest interval; 2. Intramuscular infusion of hypertonic saline: Hypertonic saline will be infused using a computer-controlled pump (IVAC, model 770, USA), with a 10 ml plastic syringe (Graven-Nielsen et al. 1997). A tube (IVAC G30303, extension set with polyethylene inner line) will be connected from the syringe to the disposable needle (27G, 20mm). A bolus injection of 1.0 ml of sterile hypertonic (5.8%) saline will be injected over 40 seconds.
The duration of the total experimental time will therefore be approximately 26 hours with the drug intervention (if active) peaking at 45 minutes after administration. Subjects will partake in one experimental session only and receive either ketamine or placebo, NOT both.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
Placebo will be administered prior to an intense bout of eccentric exercise used to induce delayed onset muscle soreness (DOMS) in the wrist extensors of healthy control subjects. Verum and placebo lozenges will look identical to maintain double blinding. Twenty four hours post-exercise, subjects will receive an infusion of hypertonic saline (1.0mls @ 5%) into the extensor carpi radialis brevis muscle. In healthy control subjects, DOMS will be induced with repeated eccentric wrist extension contractions in the non-dominant arm.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Quantitative sensory testing battery including: Mechanical pressure pain sensitivity in muscles
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Assessment method [1]
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Timepoint [1]
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Pre and post exercise at Day 0 and pre, during and post hypertonic saline induced muscle pain at Day 1and 2.
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Primary outcome [2]
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Quantitative sensory testing battery including: Pain intensity profile (VAS, onset, duration), and referred pain areas.
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Assessment method [2]
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Timepoint [2]
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During hypertonic saline induced muscle pain at Day 1and 3.
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Primary outcome [3]
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Quantitative sensory testing battery including: McGill Pain Questionnaire
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Assessment method [3]
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Timepoint [3]
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Post hypertonic saline induced muscle pain at Day 1 and 4.
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Primary outcome [4]
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Quantitative sensory testing battery including: Maximal grip strength and maximal wrist extension force.
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Assessment method [4]
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Timepoint [4]
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Pre and post exercise at Day 0 and at Day 1 pre, during and post hypertonic saline induced muscle pain
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Secondary outcome [1]
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Muscle soreness (modified Likert scale).
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Assessment method [1]
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Timepoint [1]
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Pre and post exercise at Day 0 and at Day 1 pre, during and post hypertonic saline induced muscle pain.
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Eligibility
Key inclusion criteria
Healthy controls; comprehensive musculoskeletal physical examination will be performed on both upper limbs to ensure full pain free range of elbow and wrist motion, and no abnormal tenderness to palpation of the soft tissues in the extensor muscles of the forearm and wrist (Haker 1993), or abnormally reduced muscle length.
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Minimum age
18
Years
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Maximum age
35
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
Involvement of the contralateral arm, cervicothoracic spinal pathology, other upper limb musculoskeletal disorders or neurological disorders.
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Study design
Purpose of the study
Prevention
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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 involves contacting the holder of the allocation schedule who is at central administration
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation by using a randomization table
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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
Subjects and assessor (CI) will be blinded. Drug randomisation will be performed independently by Curtin Pharmacy ensuring blinding of allocation. Initial data analysis of will be performed by a research assistant blinded to subject allocation.
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Phase
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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
3/12/2006
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Actual
3/12/2006
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Date of last participant enrolment
Anticipated
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Actual
20/12/2007
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
22
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Recruitment in Australia
Recruitment state(s)
WA
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Curtin University
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Address [1]
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GPO Box U1987, Perth WA 6845
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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 Helen Slater
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Address
School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth WA 6845
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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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Professor Tony Wright
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Address [1]
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School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845
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Country [1]
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Australia
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Secondary sponsor category [2]
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Individual
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Name [2]
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Professor Stephan Schug
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Address [2]
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Chair of Anaesthesiology,
Pharmacology, Pharmacy and Anaesthesiology Unit,
School of Medicine and Pharmacology, University of Western Australia
Director of Pain Medicine, Royal Perth Hospital
Faculty of Medicine, Dentistry & Health Sciences | The University of Western Australia¦
UWA Anaesthesiology¦Level 2, MRF Building, Royal Perth Hospital, GPO Box X2213, Perth, 6847
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Country [2]
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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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School of Physiotherapy, Curtin University of Technology
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Ethics committee address [1]
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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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12/10/2006
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Ethics approval number [1]
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107/2006
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Summary
Brief summary
The primary aim of this study is to quantitatively measure, in healthy controls, the effects of a pharmacologic agent in attenuating experimentally induced responses simulating the clinical characteristics of lateral epicondylalgia (“tennis elbow”). The primary hypothesis to be tested in this study is: in comparison with a placebo intervention, a pharmacological intervention targeting processes of central sensitisation via blockade of the N-methyl-D-asparate (NMDA) receptor will attenuate the somatosensory and motor effects of experimentally induced pain in healthy control subjects with simulated characteristics of clinical lateral epicondylalgia Lay version: In the experiment we will investigate what happens to forearm muscle function and pressure pain sensitivity when given a lozenge containing either an active medication or placebo prior to experimentally induced pain in those muscles. These muscles are involved in “tennis elbow” problems in occupational and sporting settings. What does it involve? This experiment will be conducted over two days taking about 1.5 hour per session. At the first session you will be given a lozenge (either placebo or an active drug) 1 hour prior to undertaking an intense bout of eccentric exercise in your non-dominant arm. One day later, a muscle in your exercised arm will be injected with hypertonic saline. This injection may generate a short period of muscle pain. Before and after each session a number of measures will be taken: 1. Pressure pain sensitivity at sites around forearm muscles and tendons using a device to measure mechanical pressure sensitivity (pressure algometer); 2. muscle strength of specific elbow muscles. These measures will also be repeated at Day 1 during the hypertonic saline-induced pain.
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Trial website
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Trial related presentations / publications
Slater H, Graven-Nielsen T, Wright A, Schug SA, Low-Dose Sublingual Ketamine Does Not Modulate Experimentally Induced Mechanical Hyperalgesia in Healthy Subjects, Pain Medicine 2012; 13: 1235–1246
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Helen Slater
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Address
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School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth WA 6845
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Country
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Australia
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Phone
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+61 8 9266 3099
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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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A/prof Helen Slater
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Address
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School of Physiotherapy and Exercise Science, Curtin University
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Country
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Australia
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Phone
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+61 8 92663099
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Fax
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+61 8 92663699
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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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A/Prof Helen Slater
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Address
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School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth WA 6845
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Country
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Australia
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Phone
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+61 8 92663099
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Fax
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+61 8 92663699
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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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