Immediate Effects of Manipulation Versus Stretching on Upper Trapezius Pressure Pain Thresholds

Study Overview
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Brief Summary
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The purpose of this study is to determine the immediate effects of cervicothoracic manipulation and upper trapezius stretching on upper trapezius pressure pain threshold and cervical ROM.

Official Title
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The Immediate Effects of Cervicothoracic Manipulation vs. Stretching on Upper Trapezius Pressure Pain Thresholds and Cervical Spine Range of Motion

Conditions
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Neurophysiological Mechanisms Manipulation

Intervention / Treatment
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* Procedure: CT Manipulation
* Procedure: Upper trapezius stretch


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Absence of current neck pain Aged 18 - 70 years Able to lie on stomach or back without difficulty Exclusion Criteria: 'Red flag' items indicated in Neck Medical Screening Questionnaire such as history of a tumor, bone fracture, metabolic diseases, Rheumatoid Arthritis, osteoporosis, severe atherosclerosis, prolonged history of steroid use, etc. History of neck whiplash injury Diagnosis from physician of cervical spinal stenosis (narrowing of spinal canal) or presence of symptoms (pain, pins and needles, numbness) down both arms Presence of central nervous system involvement such as exaggerated reflexes, changes in sensation in the hands, muscle wasting in the hands, impaired sensation of the face, altered taste, and presence of abnormal reflexes Evidence of neurological signs consistent with nerve root entrapment (pinched nerve in the neck) Prior surgery to neck or upper back A medical condition which may influence assessment of pain or pressure pain thresholds (i.e. taking analgesics, sedatives, history of substance abuse, or cognitive deficiency) Diagnosis from physician of fibromyalgia syndrome Currently pregnant, or could be pregnant

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CT Manipulation<br>Prone cervicothoracic manipulation | Procedure: CT Manipulation<br> <br> |
| Active Comparator: Upper trapezius stretch<br>Passive sustained stretch to upper trapezius muscle | Procedure: Upper trapezius stretch<br> <br> |
| No Intervention: Control<br>8 Minute wait | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Pressure Threshold | Using a standardized pain pressure algometer, subjects will have recordings of pressure at which onset of pain is noted | up to 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cervical Range of Motion | Using a CROM device, cervical spine range of motion will be measured in angular degrees | up to 10 minutes |