Manual Cervical Distraction: Measuring Chiropractic Delivery for Neck Pain Clinical Trial
Condition: Neck Pain; Pain in Arm, Unspecified
MeSH terms: Neck Pain
Study type: Interventional

Summary: 
      The purpose of the Manual Cervical Distraction: Measuring Chiropractic Delivery for Neck Pain
      Clinical Trial is to examine the patient-centered clinical and biomechanical outcomes, doctor
      treatment delivery, and believability characteristics of a commonly used chiropractic
      procedure for the treatment of neck- or neck-related arm pain or disability.
    

Detailed description: 
      The purpose of the Manual Cervical Distraction (MCD): Measuring Chiropractic Delivery for
      Neck Pain Clinical Trial is to examine the patient-centered clinical and biomechanical
      outcomes, and believability characteristics of a manually-localized cervical distraction
      procedure for the treatment of neck- or neck-related arm pain or disability. One challenging
      issue in the study of manual therapies, including spinal manipulation (SM), is the
      development of sham and/or minimal intervention procedures suitable for use with control
      groups in clinical trials. With SM, active treatment requires substantial physical contact
      between a study clinician and the study participant, either directly or through a mechanical
      intermediary. Consequently, it is difficult to introduce differences in manual therapy
      procedures that distinguish sham and/or minimal interventions from the active treatment, but
      are not immediately obvious to the study participant. Another challenging issue is training
      clinicians to deliver a standardized SM treatment within specified force ranges. The muscles
      surrounding the neck could alter the forces transmitted to the cervical spine, and could
      alter the treatment effectiveness. The purpose of this pilot randomized controlled trial is
      to examine the patient-centered clinical, biomechanical, and believability outcome
      characteristics of a manually-localized cervical distraction procedure for the treatment of
      neck or neck-related arm pain or disability. We also will evaluate the ability of the doctor
      of chiropractic to deliver the MCD treatment within specified force ranges. An exploratory
      aim of this study is to evaluate EMG measurement during MCD delivery.
    

Intervention name(s): Manual Cervical Distraction
Intervention type(s): Procedure
Intervention description(s): Manual Cervical Distraction (MCD) is a form of Low Velocity Variable Amplitude Spinal Manipulation (LVVA-SM). MCD procedure is performed with participant lying prone on a load instrumented table with moveable headpiece allowing guided head movement while recumbent. Clinician gently grasps posterior aspect of participant's neck with a broad contact (contact hand) between thumb and index finger at specific vertebral level. With opposite hand, clinician grasps control handle. Using contact hand, clinician exhibits superior traction to maintain a contact at a single vertebral level and ensuring a gentle movement via contact with control handle. Goal is to create a slow rhythmic (1-3 sec) localized distractive movement. In this trial, only axial distraction (Cox protocol 1) will be used.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Cervical pain; Neck pain; Arm pain