The Effects of Thrust Joint Manipulation on the Resting and Contracting Thickness of Transversus Abdominis in Subjects With Low Back Pain

Study Overview
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Brief Summary
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The primary aim of this study is to examine how different physical therapy interventions affect the resting state and contraction state of a certain abdominal muscle in patients with low back pain.

Detailed Description
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Patients with low back pain (LBP) will undergo ultrasound imaging of the transversus abdominis to measure the muscle thickness at rest and at the contracted state prior to intervention and again immediately after intervention. In this randomized controlled trial, patients will be randomized into one of two groups. One group will receive the intervention of thrust joint manipulation of the lumbar spine and the other group will receive the intervention of non-thrust joint manipulation of the lumbar spine.

Official Title
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The Effects of Thrust Joint Manipulation on the Resting and Contracting Thickness of Transversus Abdominis in Subjects With Low Back Pain

Conditions
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Low Back Pain

Intervention / Treatment
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* Other: Thrust Joint Manipulation of the Lumbar Spine
* Other: Non-thrust Joint Manipulation of the Lumbar Spine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults between 18-70 years of age with primary symptom of LBP, with or without referral into lower extremity. Subjects must be able to read and write in English. Exclusion Criteria: Presence of serious pathology. Diagnosis of spinal stenosis or symptoms in both lower legs (changes in sensation, muscle weakness). Any history of low back surgery, rheumatoid arthritis, osteoporosis, osteopenia, scoliosis, or ankylosing spondylitis. Pregnancy Pending legal action. Prior surgery to the lumbar spine or fractures of the lumbar spine.

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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No

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 |
| --- | --- |
| Active Comparator: Thrust Joint Manipulation<br>Patients will receive thrust joint manipulation to their lumbar spine in side lying. | Other: Thrust Joint Manipulation of the Lumbar Spine<br> <br> |
| Sham Comparator: Non-thrust Joint Manipulation<br>Patients will receive non-thrust joint manipulation, oscillations into slight rotation, without cavitation, to their lumbar spine in side lying. | Other: Non-thrust Joint Manipulation of the Lumbar Spine<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Transversus Abdominis thickness change. | Measurement of change in thickness from resting to contraction will be compared at baseline (pre-intervention) to immediately following the intervention (post-intervention). The study is looking at the immediate effects so there is no short-term or longer follow up. | Baseline to immediately after the intervention (within 5 minutes). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Oswestry Low Back Pain Questionnaire | The score of the Oswestry Low Back Pain Questionnaire will be compared from baseline, immediately post-intervention (within 5 minutes), and follow-up within 48 hours over the phone. | Baseline, immediately post-intervention (within 5 minutes), and follow-up within 48 hours over the phone. | 
| Numeric Pain Rating Scale | The score of the Numeric Pain Rating Scale will be compared from baseline, immediately post-intervention (within 5 minutes), and follow-up within 48 hours over the phone. | Baseline, immediately post-intervention (within 5 minutes), and follow-up within 48 hours over the phone. | 
| Fear-Avoidance Beliefs Questionnaire | The score of the Fear-Avoidance Beliefs Questionnaire will be compared from baseline, immediately post-intervention (within 5 minutes), and follow-up within 48 hours over the phone. | Baseline, immediately post-intervention (within 5 minutes), and follow-up within 48 hours over the phone. | 
| Global Rating of Change | The score of the Global Rating of Change will be compared from immediately post-intervention (within 5 minutes) and follow-up within 48 hours over the phone. | Immediately post-intervention (within 5 minutes) and at follow-up within 48 hours over the phone. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Thrust Joint Manipulation, Non-thrust Joint Manipulation, Transversus Abdominis