Clinical trial NCT06277700: Effects of Dynamic Stabilizatıon Exercises and HVLA Manipulatıon in Low Back Paın
Official title: A Comparison of the Effectiveness of Dynamic Neuromuscular Stabilizatıon Exercises and Chiropractıc HVLALumbar Manipulatıon in Individuals with Chronic Non-specific Low Back Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Low Back Pain
Neuromuscular Subluxation of Joint
Keywords: Spinal Manipulation
Dynamic Neuromuscular Stabilization
Low Back Pain
Posture
Non - spesific
Lead sponsor: Sinop University
Sponsor class: OTHER
First posted: 2024-02-26
Enrollment: 60
Sex: ALL
Minimum age (years): 20
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: 60 people will participate in the study and the participants will be divided into four groups. The groups will be formed as chiropractic manipulation (CM) group (n=15), dynamic neuromuscular stabilization (DNS) group (n=15), CM + DNS group (n=15) and control group (CG) (n=15). Chiropractic manipulation will be performed once in the side-lying position. An individualized exercise program will be applied to the DNS group under the supervision of a physiotherapist. Kruskal Wallis test for comparisons of quantitative variables between 4 independent groups; Mann Whitney U test with Bonferonni correction will be used in double subgroup comparisons of significant variables. Friedman test was used for comparisons of quantitative variables in 3 dependent groups. Wilcoxon test with Bonferonni correction will be used for two-way subgroup comparisons for significant variables. In all statistical analyzes in the study, results with a p value below 0.05 will be considered statistically significant.
Primary purpose: BASIC_SCIENCE

Brief summary: Our aim is to contribute to the literature by comparatively examining the effects of DNS exercises and chiropractic HVLA manipulation on pain, pain-related functional impairment (disability), physical competence level, dynamic fitness level of core muscles and postural deviations in patients with chronic nonspecific low back pain.

Detailed description: Sixty volunteers aged between 20 and 45 years will participate in this study. Before starting the study, anthropological measurements (height, weight, body mass index) were made. After these measurements, the participants will be randomly divided into four groups.

The groups will be formed as chiropractic manipulation (CM) group (n=15), dynamic neuromuscular stabilization (DNS) group (n=15), CM + DNS group (n=15) and control group (CG) (n=15).

The KM group will receive 8 sessions of High Velocity Low Amplitude (HVLA) chiropractic manipulation twice a week for 4 weeks and the DNS group will receive 8 sessions of (DNS) exercise twice a week for 4 weeks and each session will last 50 minutes. The KM+DNS group will receive a total of 8 sessions of DNS exercises and HVLA chiropractic manipulation twice a week for 4 weeks.

Participants will be assessed a total of 3 times during the study; just before the intervention starts, 2 weeks after the intervention starts, after the 4th session, 4 weeks after completing the intervention, after the 8th session.

Participants will be assessed with Visual Analog Scale (VAS), Roland Morris Disability Questionnaire (RMDQ), Dynamic Neuromuscular Stabilization - Heel Slip Test (DNS-HS), Oswety Disability Index (ODI) and posture assessment will be performed using PostureScreen Mobile application.

Eligibility criteria: Inclusion Criteria:

* 7 points in Oswetry Disability Index (ODI)
* Participants should be between the ages of 20 and 45
* Normal radicular tests
* Being diagnosed with low back pain 6 months
* Not having perception problems and being able to cooperate well
* Signing the voluntary consent form

Exclusion Criteria:

* Pregnancy
* History of previous spinal canal surgery
* Presence of neurological deficits
* Presence of cancer
* Having an inflammatory or rheumatologic disease
* Spinal deformities (due to infection or trauma, compression fracture)

Primary outcomes:
measure: Visual Analog Scale
timeFrame: This scale will be used to subjectively assess the pain levels of the participants in the 4-week protocol; just before the beginning of the study, in the second week and in the 4th week of the study.
measure: Physical Adequacy Level
timeFrame: This scale will be used to subjectively assess the physical adequacy level of the participants in the 4-week protocol; just before the beginning of the study, in the second week and in the 4th week of the study.
measure: Disability Level
timeFrame: This scale will be used to subjectively assess the disability levels of the participants in the 4-week protocol; just before the beginning of the study, in the second week and in the 4th week of the study.
measure: Dynamic Stabilization and Adaptibility
timeFrame: This scale will be used to subjectively assess the dynamic stabilization and adaptibility levels of the participants in the 4-week protocol; just before the beginning of the study, in the second week and in the 4th week of the study.
measure: Posture
timeFrame: This mobile app will be used to assess the postural dysfunctions of the participants in the 4-week protocol; just before the beginning of the study, in the second week and in the 4th week of the study.
Secondary outcomes:
Other outcomes:
Locations:
city: Sinop
country: Turkey
facility: Sefa Haktan Haktik
Study officials:
affiliation: Sinop University
name: SEFA HAKTAN HATIK
role: STUDY_DIRECTOR
References: