Manipulative Therapy Techniques to Treat Chronic Low Back Pain
Condition: Low Back Pain; Chronic Disease
MeSH terms: Back Pain; Low Back Pain; Chronic Disease
Study type: Interventional

Summary: 
      The purpose of this study is to analyze the effectiveness of a three manipulative therapy
      techniques in People with Chronic Low Back Pain.
    

Detailed description: 
      Objective: To analyze the effectiveness of a three manipulative therapy techniques in
      individuals with chronic non-specific low back pain of mechanical etiology.

      Design: Randomized clinical trial. Setting: Almeria, South Spain. Participants: Sixty two
      with chronic non-specific low back pain will be randomly assigned to an experimental or
      control group.

      Intervention: For 3-week, the experimental group will undergo treatment comprising 3 sessions
      (1/week) of manipulative therapy techniques in the lumbar and sacral areas, and the control
      group will receive a functional technique in the lumbar area.

      Main Outcome Measures: Oswestry disability index, pain visual analogue scale, Tampa scale for
      kinesiophobia, Roland-Morris disability questionnaire, McQuade test, quality of life scores
      and the range of trunk anteflexion motion, which were all assessed before the treatment and
      immediately after the last treatment session.

      The primary outcome measure is the change in the RMDQ score at the end of the 3 weeks study
      period. A difference of 2.5 point is considered to be the minimum clinically important
      difference in the RMDQ score. A sample size of 62 patients (31 per group) would enable
      detection of a 2.5 point difference between groups given 80-90% power, a 5% (two-tailed)
      significance level, and a conservative standard derivation of 5 points. Key baseline
      demographic variables and clinical measure scores will be compared between groups by using
      independent Student t tests for continuous data and chi-square tests for categorical data.
      Separate 2x2 mixed model ANOVA with repeated measurements for the time factor need to be
      conducted in order to test between-groups differences in visual analogue scale, McQuade test,
      range of trunk anteflexion motion, Oswestry disability index, Roland Morris disability
      questionnaire, Tampa scale for kinesiophobia, and quality of life as the dependent variables,
      with group (functional technique or three manipulative therapy techniques) as the between
      subjects variable and time (baseline, post-treatment). A paired t-test will perform to test
      within-group differences in score changes from pre- to post-treatment. Effect size will test
      using Cohen's d. p = 0.05 will be considered significant in all tests.
    

Intervention name(s): Manipulative Therapy Techniques; Functional Technique
Intervention type(s): Other; Other
Intervention description(s): Global Technical bilateral pelvis: The technique involves inserting a small spine rotation and make a slack in three stages.
Indirect technique of lumbar roll in rotation for bilateral L3: to reduce the slack and make the body drop simultaneously, together with a high speed contraction pectoral muscles and triceps, iliac crest leading caudad which produces a rotation of the vertebra underlying joint space opening.
Dog-technic on D12: this technique reduces the slack in the abdomen toward the hand in contact with D12. Next, the therapist conducted a thrust in the direction of the reduction.; The therapist presses the two anterior superior iliac spines to open the back of the pelvis, this maintained throughout the technique. Then patient is asked to breathe deeply and exhale, sacrum makes a flexion-extension respectively. These movements should be symmetrical and of equal duration in time.
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Low back pain.; Manipulative therapy techniques.; Randomized controlled trial.; Chronic pain.