The Biomechanical Effects of Manual Therapy - A Feasibility Study
Condition: Low Back Pain, Mechanical
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      The aim of this study is to determine the feasibility of conducting a full-scale trial to
      explore if there is a change in intervertebral movement following a course of manual therapy
      in patients with acute non-specific low back pain (NSLBP).

      Research Questions:

        1. In patients with acute NSLBP, does lumbar intervertebral movement change following a
           course of manual therapy?

        2. In patients with acute NSLBP, do those who respond to manual therapy (established by
           patient reported outcomes measures) have different intervertebral movement to those who
           do not?
    

Detailed description: 
      Non-specific low back pain (NSLBP) is a leading cause of disability and work-days lost
      worldwide. Yet, in most cases we do not know the specific cause. It is thought to be due to
      abnormal movement between the spinal bones (vertebrae). The investigators can now measure
      movement between vertebrae using low-dose quantitative fluoroscopy (QF), or motion x-ray
      videos. QF is a reliable method of measuring spinal movement which is non-invasive and does
      not expose the patient to a lot of radiation. In this study, QF will be used as a measuring
      tool to measure spinal movement in patients with acute NSLBP before manual therapy versus
      after manual therapy to explore if there is a change in spinal movement. Research suggests
      that some patients respond to manual therapy and some do not, a secondary question in this
      study is to explore if there are differences in spinal movement between those who respond to
      manual therapy (measured using pain and disability questionnaires) and those who do not.

      This study is a feasibility study to determine whether the study can be carried out as a
      full-scale trial. Participants will be recruited from the AECC University College (AECC UC)
      Clinic. Following an examination, patients with acute low back pain, and who are eligible for
      the study will be invited to join. Participants will proceed with initial measurements which
      include validated questionnaires and QF. Following these measurements participants will be
      randomised into two groups, each containing 15 participants. Both groups will receive an
      evidence-informed home management booklet, the manual therapy group will receive five manual
      therapy treatments in two weeks. Participants will return for follow-up measurements two
      weeks after baseline measurements.
    

Intervention name(s): Manual therapy; Evidence-informed home management booklet
Intervention type(s): Other; Other
Intervention description(s): Manual therapy, which includes spinal manipulation; spinal mobilisation; light massage; and trigger point therapy.; The home management booklet includes advice on posture, over the counter pain medication, cold and heat packs. The booklet also includes a section on patient reassurance and where to seek help from a medical professional in an emergency.
Other intervention name(s): Low back pain self help booklet
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants are assigned to one of two groups in parallel for the duration of the study.
Masking: Single (Outcomes Assessor)
Primary purpose: Basic Science
Keywords: Manual Therapy; Fluoroscope; Mechanics; Kinematics