Clinical trial NCT04668729: Effects of Lumbosacral Chiropractic on the Olympic Style Weightlifting Athletes
Official title: Effects of Lumbosacral Chiropractic Spinal Manipulative Therapy on Muscle Strength, Range of Motion, Balance and Pain in Olympic Style Weightlifting Athletes
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Athletic Injuries
Keywords: Athletes
Balance
Muscle strenght
Musculoskeletal manipulations
Pain
Range of motion
Lead sponsor: Bahçeşehir University
Sponsor class: OTHER
Collaborators: name: Necmettin Erbakan University
First posted: 2020-12-16
Enrollment: 37
Sex: MALE
Minimum age (years): 13
Maximum age (years): 32
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: The individuals are randomly allocated into control and chiropractic groups.
Primary purpose: TREATMENT

Brief summary: It is known that low back injuries experienced by weightlifting athletes cause a decrease in performance. The effects of spinal manipulative therapy, which has been found to positively affect performance in various sports, are not known in the Olympic style weightlifting athletes. This study is aimed to investigate the effects of lumbosacral chiropractic spinal manipulative therapy on muscle strength, range of motion, balance, and pain in Olympic style weightlifting athletes.

In this research, 40 male Olympic style weightlifting athletes are planned to take place. Male athletes will be randomly divided into two groups as a control and a treatment group. To the individuals in the treatment group; lumbal region chiropractic high-speed, low amplitude (High Velocity, Low amplitude: HVLA) spinal manipulation and sacroiliac joint chiropractic HVLA manipulation are planned to perform once a week for a total of three weeks. No manipulation will be made to individuals in the treatment group. Before and after the manipulation; the maximum isometric muscular force, the lumbar spine range of motion, balance performance and pain intensity will be evaluated by a back dynamometer, hand finger-ground distance test (HFGD), and Modified Schober test, flamingo balance test, and visual analog scale. SPPS 25 (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.) version will be used to analyze the data.

Detailed description: There are studies in the literature regarding the positive effect of chiropractic treatment on musculoskeletal injuries. In a study, it is found that the group that received cervical chiropractic manipulation on judo athletes showed a statistically significant (p \<0.05) increase in grip strength compared to those who received sham practice. In another study, it is found that a single lumbar spinal manipulation reduced the relative strength difference between the limbs for knee and hip flexion (p \<0.05). In another study, it is shown that a single spinal manipulation session increased the muscle strength of the ankle plantar flexor muscles and corticospinal excitability (p \<0.05) in elite Taekwondo athletes. Likewise, according to another study, lumbopelvic joint manipulation increased quadriceps activation and strength.

A study claims that young female athletes with talocrural joint dysfunction showed a statistically significant (p \<0.05) improvement in vertical jump height after chiropractic manipulation. In addition, in a study investigating the effect of pelvic manipulation on vertical jump height in female university students with functional leg length inequality, it was found that after the intervention, jump height improved significantly only in the pelvic manipulation group compared to pre-intervention height, while improvement in female university students with functional leg length inequality was found to be statistically significant (p \<0.05) in both manipulation and stretching groups after the manipulation.

A study showed that chiropractic spinal manipulative therapy can increase hip extension ability in young running athletes (p \<0.05). According to a study conducted on football players, it was shown that combined manipulative interventions caused significantly (p \<0.05) increases in the range of motion in the lumbar region and sacroiliac joint flexion. In addition, it was reported that the group who received chiropractic manipulation (compared to the group that received sham manipulation) caused a significant increase in kick speed (p \<0.05) after the manipulation.

Again, in another research, it is found that an increase in cervical range of motion and a decrease in neck pain with a single cervical HVLA (High Velocity, Low amplitude: HVLA) manipulation (p \<0.05) and stated that HVLA manipulation was more effective than mobilization.

Eligibility criteria: Inclusion Criteria:

* Being a weightlifting athlete
* Presence of sacroiliac and lumbar spine asymptomatic dysfunctions in tests

Exclusion Criteria:

* Not wanting to continue education
* Not being able to come to assessments
* Having a musculoskeletal injury in the upper and lower extremities in the last month
* Having any neurological or psychiatric illness
* Having a fracture in the past
* Having a tumor in the past
* Lumbar disc hernias, spondylosis, spondylolisthesis
* Having a disease related to the cardiac and respiratory system
* Having an infectious, rheumatological, metabolic, and endocrine disease
* Having dislocation, osteoporosis, ankylosing spondylitis, discopathy, rheumatoid arthritis
* Being in the treatment of instability, acute myelopathy, anticoagulants
* Recently had a surgery

Primary outcomes:
measure: Muscle Strength
timeFrame: 3 weeks
measure: Lumbal Area Joint Range of Motion: Hand Finger-Ground Distance (HFGD)
timeFrame: 3 weeks
measure: Lumbal Area Joint Range of Motion: Modified Schober Test
timeFrame: 3 weeks
measure: Balance Performance
timeFrame: 3 weeks
measure: Pain Intensity
timeFrame: 3 weeks
Secondary outcomes:
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Ankara Türkiye Olimpiyat Hazirlik Merkezi
Study officials:
affiliation: Bahçeşehir University
name: Leyla Ataş Balcı, assist prof
role: STUDY_DIRECTOR
affiliation: Necmettin Erbakan University
name: Kenan Erdağı, assist prof
role: STUDY_DIRECTOR
References:
citation: Botelho MB, Andrade BB. Effect of cervical spine manipulative therapy on judo athletes' grip strength. J Manipulative Physiol Ther. 2012 Jan;35(1):38-44. doi: 10.1016/j.jmpt.2011.09.005. Epub 2011 Nov 10.
citation: Chilibeck PD, Cornish SM, Schulte A, Jantz N, Magnus CR, Schwanbeck S, Juurlink BH. The effect of spinal manipulation on imbalances in leg strength. J Can Chiropr Assoc. 2011 Sep;55(3):183-92.
citation: Christiansen TL, Niazi IK, Holt K, Nedergaard RW, Duehr J, Allen K, Marshall P, Turker KS, Hartvigsen J, Haavik H. The effects of a single session of spinal manipulation on strength and cortical drive in athletes. Eur J Appl Physiol. 2018 Apr;118(4):737-749. doi: 10.1007/s00421-018-3799-x. Epub 2018 Jan 11.
citation: Grindstaff TL, Hertel J, Beazell JR, Magrum EM, Ingersoll CD. Effects of lumbopelvic joint manipulation on quadriceps activation and strength in healthy individuals. Man Ther. 2009 Aug;14(4):415-20. doi: 10.1016/j.math.2008.06.005. Epub 2008 Sep 20.
citation: Hedlund S, Nilsson H, Lenz M, Sundberg T. Effect of chiropractic manipulation on vertical jump height in young female athletes with talocrural joint dysfunction: a single-blind randomized clinical pilot trial. J Manipulative Physiol Ther. 2014 Feb;37(2):116-23. doi: 10.1016/j.jmpt.2013.11.004. Epub 2014 Jan 2.
citation: Gong W. The influence of pelvic adjustment on vertical jump height in female university students with functional leg length inequality. J Phys Ther Sci. 2015 Jan;27(1):251-3. doi: 10.1589/jpts.27.251. Epub 2015 Jan 9.
citation: Sandell J, Palmgren PJ, Bjorndahl L. Effect of chiropractic treatment on hip extension ability and running velocity among young male running athletes. J Chiropr Med. 2008 Jun;7(2):39-47. doi: 10.1016/j.jcme.2008.02.003.
citation: Deutschmann KC, Jones AD, Korporaal CM. A non-randomised experimental feasibility study into the immediate effect of three different spinal manipulative protocols on kicking speed performance in soccer players. Chiropr Man Therap. 2015 Jan 13;23(1):1. doi: 10.1186/s12998-014-0046-3. eCollection 2015.
citation: Martinez-Segura R, Fernandez-de-las-Penas C, Ruiz-Saez M, Lopez-Jimenez C, Rodriguez-Blanco C. Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: a randomized controlled trial. J Manipulative Physiol Ther. 2006 Sep;29(7):511-7. doi: 10.1016/j.jmpt.2006.06.022.