Investigating the Effects of a Spinal Mobilisation Intervention in People With Lower Back Pain
Condition: Lower Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      The objective of the study is to measure and analyse the effect of a spinal mobilisation
      intervention on muscle tissue quality in people with lower back pain. The mobilisation
      intervention will be compared to a control with participants taking part in both conditions
      for a factorial, within-subject repeated measures study. The study will analyse lumbar muscle
      response to the manual intervention and analyse the potential influence of anthropometric
      measures of participants. The study hypothesises a decrease in lumbar stiffness post the
      intervention, compared to the control session.
    

Detailed description: 
      Various types of spinal manual therapies have been common practice for many years,
      particularly for treatment of lower back pain. Spinal mobilisation is a specific technique
      within spinal physiotherapy, often used as a treatment for lower back pain. This is despite
      limited objective evidence of the effect on muscle tissue quality.

      The objective of this study is to measure and analyse the acute effect of a spinal
      mobilisation intervention on muscle tissue quality in people with lower back pain. The
      intervention consists of the mobilisation of the lumbar spine for 30 minutes, at a specific
      rate and pressure. This will be performed by a chartered physiotherapist. This will be tested
      with 40 participants with lower back pain. This was the recommended sample size given by G
      Power for a medium effect size, a power of 0.95 and alpha level of 0.05.

      Participants will take part in an intervention and a control condition. Lumbar muscle
      response will be measured for stiffness, tone and elasticity immediately before and after the
      intervention and the control. The control session consists of lying still for the 30 minutes.
      Results for both sessions will then be compared. A myometer (MyotonPRO) will be used to
      assess the change in lumbar muscle objectively. This is a non-invasive, handheld device with
      many reliability studies on its functionality. Analysis will consider the degree of muscle
      response with individual covariates involved. This includes gender, height, weight, waist
      circumference, BMI and level of back pain (discerned by score on Oswestry Disability Index).

      The results will compared in 2-way repeated measures, within participant ANOVA for
      significant differences between conditions and time. Anthropometric measures will be analysed
      in separate ANOCOVAs to determine any significant factors contributing to level of change.
    

Intervention name(s): Manual spinal mobilisations
Intervention type(s): Other
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: Cross-over study design, within-subject repeated measures (intervention versus no intervention).
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: lower back pain; myometer; muscle stiffness; spinal mobilisations