Effect of Two Osteopathic Techniques on Thickness of Paravertebral Muscles of the Lumbar Spine

Study Overview
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Brief Summary
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The objective of this randomized controlled trial is to describe the effect of two osteopathic techniques - high velocity, low amplitude (HVLA) and muscle energy (ME) - on thickness, activation, strength, pressure pain threshold (PPT) of the paravertebral muscles at the lumbar spine, as well as the peak plantar pressures immediately and after a two-day follow-up. The muscle thickness of the paravertebral muscles at the lumbar spine, namely internal oblique, external oblique and transversus abdominis can be altered after the application of 'high-velocity low-amplitude'(HVLA)and 'muscle energy' (ME)techniques immediately and after a two-day follow-up.

Official Title
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Effect of Two Osteopathic Techniques on Thickness of Paravertebral Muscles of the Lumbar Spine: Randomized Controlled Trial

Conditions
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Low Back Pain

Intervention / Treatment
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* Other: High-velocity, low-amplitude (HVLA)
* Other: Muscle energy (ME)
* Other: Sham


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: At least one episode of low back pain over the last three months; confirmation of lumbar spine dysfunction by an experienced osteopath; age between 18 and 40 years; do not have performed physical stress activities over the last 24 hours; do not be physically active (physical activity for at least three times a week); fulfill the orientations to the follow-up assessment. Exclusion Criteria: History of surgery, fracture or fixation on the lumbar spine and/or the pelvis; being pregnant; signs of radiculopathy; disc herniation at the lumbar spine; degenerative process at the lumbar spine; have received any kind of manipulative treatments over the past four weeks;

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: HVLA<br>The subjects allocated to this group will receive a 'High-velocity, low-amplitude (HVLA) technique over the lumbar spine. | Other: High-velocity, low-amplitude (HVLA)<br>* With the subject lying on his/her side, the therapist will rotate the patient's trunk, flex his/her hip and knee of the upper leg. The therapist positions his caudad forearm over the hip, while the cephalad forearm lies over the patient's shoulder. The therapist's hands will be positioned over the lumbar spine's spinous process to be manipulated.<br>* Other names: Thrust manipulation;|
| Experimental: ME<br>Subjects allocated to this group will receive a muscle energy (ME) technique. | Other: Muscle energy (ME)<br>* This technique involves the active movement of the patient to activate a specific musculature in order to move a bony segment of a given joint in a specific direction in relation to the adjacent bone. This technique aims to restore the restricted movement of the joint in question.<br>* Other names: Mitchell's technique;|
| Sham Comparator: Sham group<br>The individuals allocated to this group received an intervention of the sham. The sample of this group will consist of subjects with history of dysfunctions of the lumbar spine. | Other: Sham<br>* Individuals in this group received a sham intervention type, in order to simulate an intervention.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle thickness | We will evaluate the muscle thickness of four muscles that comprises the paravertebral musculature at the lumbar spine: internal oblique, external oblique, lumbar multifidus and transversus abdominis. | immediate | 
| Muscle thickness | We will evaluate the muscle thickness of four muscles that comprises the paravertebral musculature at the lumbar spine: internal oblique, external oblique, lumbar multifidus and transversus abdominis. | Two days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pressure pain threshold | subjects will be evaluated regarding their pressure pain threshold (PPT) on the spinous process of all of the lumbar vertebrae. | Immediate | 
| Pressure pain threshold | subjects will be evaluated regarding their pressure pain threshold (PPT) on the spinous process of all of the lumbar vertebrae. | Two days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Low back pain, Spinal manipulation, Osteopathy, Muscle energy technique, Muscle thickness