Effects of Lumbopelvic Manipulation on Neuromuscular Activity of Back & Hip Muscles in Adults With Chronic Low Back Pain
Condition: Chronic Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      The purposes of this study are:

        1. To examine the within-day and between-day test-retest reliability of a testing protocol
           measuring the back and hip muscles fatigability using EMG median frequency

        2. To examine the immediate and the carry-over effects of the lumbopelvic manipulation on
           the EMG median frequency of the lumbar multifidus (MULT), gluteus medius (GMED) and
           gluteus maximus (GMAX) muscles in patients with chronic low back pain (CLBP)

        3. To compare the fatigability levels of the MULT, GMED and GMAX muscles by measuring the
           EMG median frequency between the participants who will receive lumbopelvic manipulation.

      The research hypotheses are:

        1. The testing protocol using EMG median frequency as a fatigue indicator for MULT,GMED and
           GMAX muscles will have good (ICC ≥ 0.80) within-day and between-day test-retest
           reliability.

        2. The fatigability level of the MULT, GMED and GMAX muscles will significantly decrease
           immediately after the lumbopelvic manipulation and will be maintained over two to four
           days following the manipulation.

        3. The fatigability of the MULT, GMED and GMAX muscles will significantly decrease after
           the intervention in the manipulation group while no change will occur in the placebo
           group.
    


Intervention name(s): Lumbopelvic Manipulation; Sham manipulation
Intervention type(s): Other; Other
Intervention description(s): Participant will lie in supine position. The treating investigator (TI) will stand on opposite side of low back pain. Participant will clasp his/her hand behind the neck. TI will side bend participant's spine towards non-painful side. TI will reach through participant's hands and perform spinal rotation away from painful side. TI's other hand will be placed over anterior superior iliac spine (ASIS) of painful side. TI will take up the slack and maintain pressure on the ASIS for 5-10 seconds and ask the participant whether he/she can tolerate the pressure. If participant can tolerate the pressure for at least 5 seconds, verbal permission will be obtained from participant and TI will proceed and apply a high-velocity low-amplitude posterior thrust force over the ASIS.; Each participant will be asked to lie in a supine position. The treating investigator will stand on the opposite side of the low back pain. Then, the participant will be asked to clasp his/her hand behind the neck. The treating investigator will side bend the participant's spine towards the non-painful side to mid-range. The treating investigator will reach through the participant's hands and perform a spinal rotation away from the painful side to the mid-range. The treating investigator's other hand will be placed over the anterior superior iliac spine (ASIS) of the painful side.
Other intervention name(s): Chicago Manipulation Technique
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: chronic low back pain; low back pain; lumbopelvic manipulation; Chicago manipulation; EMG median frequency; electromyography; reliability