Thoracic Spine Manual Traction With Mobilization Versus Manipulation
Condition: Thoracic
MeSH terms: Aortic Dissection
Study type: Interventional

Summary: 
      This project will be a Randomized clinical trial conducted to compare Short-term effects of
      thoracic spine manual traction with mobilization and Thoracic manipulation in patients with
      mid thoracic pain and pseudo visceral symptoms. Sample will be collected through
      non-probability convenient sampling, following eligibility criteria from Sehat Medical
      complex, Lahore. Eligibility criteria will be Age group between 20 to 40 years both male and
      female genders with mid thoracic pain having pseudo visceral symptoms. Referred by physician
      after exclusion of post-surgical condition from past 6 months Neurological, Pulmonological,
      Cardiac, Musculoskeletal and Esophageal conditions. Participants will be randomly allocated
      in two groups via sealed envelope method, baseline assessment will be done, Group A
      participants will be given baseline treatment along with Thoracic spine manual traction with
      mobilization, Group B participants will be given baseline treatment along with Thoracic
      manipulation protocol. Pre and post intervention assessment will be done via, Numeric pain
      rating scale(NPRS), Revised Oswestry thoracic pain disability questionnaire (ODI) and
      Inclinometer to measure ROM of Thoracic spine,3 sessions per week will be given for 4 weeks,
      data will be analyzed by using SPSS version 29.
    

Detailed description: 
      Spinal pain is a well-recognized condition associated with significant personal and community
      burdens. Compared to the lumbar and cervical spine, the thoracic spine has received less
      attention in terms of clinical, genetic and epidemiologic research, yet pain experienced in
      the thoracic spine can be equally disabling, imposing similar burdens on the individual,
      community and workforce. Pseudo visceral symptoms refer to physical sensations or symptoms
      that mimic those associated with underlying medical condition affecting the internal organs,
      but without any organic cause or pathology. Manipulation and mobilization are two manual
      techniques that are commonly used by osteopaths, chiropractors and physiotherapists to treat
      spinal pain and dysfunction. This study aims to compare Short-term effects of thoracic spine
      manual traction with mobilization and Thoracic manipulation in patients with mid thoracic
      pain and pseudo visceral symptoms.

      This randomized clinical trial will be conducted at Sehat medical complex, Lahore. It will
      include patients with age group between 20 to 40 years, both male and female gender with mid
      thoracic pain and pseudo visceral symptoms referred by physician after exclusion of visceral
      symptoms. Those patients with post-surgical condition from past 6 months, Neurological,
      Pulmonological or Cardiac conditions will be excluded. Participants will be divided into two
      groups. Group A will receive of thoracic spine manual traction with mobilization treatment
      protocol and Group B will receive Thoracic manipulation protocol. Both groups will receive
      baseline treatment including TENS and Hot pack. Short term effects would be assessed after
      treatment for 4 weeks. Patients will be assessed by Numeric pain rating scale, Inclinometer
      and Revised Oswestry thoracic pain disability questionnaire. The findings can contribute to
      the growing evidence based supporting whether the use of thoracic spine manual traction with
      mobilization or Thoracic manipulation improve pain, ROM and disability in patients with mid
      thoracic pain and pseudo visceral symptoms. Analysis will be done by statistical package for
      social sciences SPSS 29.
    

Intervention name(s): Thoracic spine manual traction with mobilization protocol.; Thoracic manipulation protocol
Intervention type(s): Other; Other
Intervention description(s): The therapist will perform one 30-second bout of grade I or II central posterior-anterior mobilization at the T3 spinous process as described by Maitland et al. After the 30-second bout, the therapist proceeded to T4 and performed the same technique. This process was continued sequentially in a caudal direction to T8, for an overall intervention time of approximately 3 minutes. In addition to mobilization, thoracic spine traction will be also given in sitting position.; To perform the manipulation, the stabilizing hand will be placed at the level immediately caudal to the restricted segment using a ''pistol grip''. Once the pre manipulative position will be achieved the patient will be instructed to take a deep inhalation and exhale. During the exhalation the treating clinician performed a high velocity, small amplitude thrust in a direction to facilitate relative closing or opening of the respective facet joint as indicated by the segmental examination.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Manipulation; Mobilization; Pseudo visceral symptoms; Pain; Spinal Traction