Clinical trial NCT04653870: Comparison of Cyriax Manipulation and Decompression in LDP
Official title: Comparison the Effect of Cyriax Manipulation and Decompression in Patient With Lumber Disc Protrusion
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Lumbar Disc Herniation
Keywords: Herniation
Cyriax manipulation
decompression
bulge
protruded
extruded
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2020-12-04
Enrollment: 20
Sex: ALL
Minimum age (years): 30
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: In this study, compare the effects of Cyriax manipulation and Decompression in patient with lumber disc prolapseThis research will provide an important addition to the evidence based treatment intervention in physical therapy in the field of manipulation as there is no such research work have been done on comparative study of cyriax manipulation and decompression in lumber disc protrusion.

Detailed description: According to an estimate, 70 to 80% of the adult population will experience a clinically relevant episode of LBP at some time in their lives. Within the vast differential of LBP, the most common source is intervertebral degeneration leading to degenerative disc disease and LDH. The efficacy of manipulative physical therapy, physical therapy intervention and therapy by general practitioner (GP) for persistent general LBP and neck pain was investigated on 256 patients how didn't received any of the above therapy in last two years were contained in this study. Physical therapy included workout exercises, massage, and physical therapy (related to hot pack, different pain modalities like therapeutic ultrasound, shortwave diathermy, and electrotherapy). Manual therapy includes manual reduction by manipulation and mobilization of the back. Interventions received by GP is medicine related (different types of pain killer and muscles relaxant), guidance about the posture, home plan exercises and different healthy activities and proper rest. Placebo intervention included adjustable shortwave diathermy session for (10 minutes), and adjusted therapeutic ultrasound session for (10 minutes). Recovery rate in the leading complaint was increased with the group receiving manual therapy intervention (4.5) as compare to physical therapy (3.8), after a detailed one year of continuous therapy. There is a great progression seen in physical work by manual therapy. Moreover, manipulation is get going improved gradually, as compare to physiotherapy following in period of 12 months.

The first meta-analysis estimated the efficacy of SMT for LBP due to LDH with other therapies come to the result that SMT was equally effective when compare to other traditional therapies. However a past systematic review was come to the conclusion that SMT was secure and effective in relation to its costs for managing SLDD like LDH, that conclusion was quoted to promote by a very few publications.

One of the present research studies after one year of continuation showed decrease in pain and increase in recreational activities to a long period of time, an additional research work in 2016 described, a remarkable progression in sciatica after 30 days, in patients with lumber discs extrusion and sequestration, as a result of HVLA thrust.

In spite of the factor that there is only average numbers of documentation in the written work which promoted the utilization of SMT to manage LDH, it is extensively applied by therapist.

the comparison of cyriax manipulation and decompresion is an important adding to the researches in evidence based practices. there is no such work done before on comparison of both intervention.

Eligibility criteria: Inclusion Criteria:

* Patients having Lumber disc prolapse of L1-L5 and S1 (both gender)
* Patients having MRI reports of protruded disc

Exclusion Criteria:

* Inflammatory condition( systemic inflammatory disease of spine)
* Spinal diseases (other than Musculoskeletal)
* Severe radiculopathies (bilateral)
* Operated patients (spine)

Primary outcomes:
measure: Inclinometer
timeFrame: 2nd week
measure: goniometer
timeFrame: 2nd week
measure: Numeric pain rating scale
timeFrame: 2nd week
measure: Oswestry disability index (ODI)
timeFrame: 2nd week
Secondary outcomes:
Other outcomes:
Locations:
city: Islamabad
country: Pakistan
facility: Max health hospital and rehab center G8 islamabad
state: Punjab
Study officials:
affiliation: Riphah International University
name: Affan Iqbal, Phd*
role: PRINCIPAL_INVESTIGATOR
References:
citation: Kocak FA, Tunc H, Tomruk Sutbeyaz S, Akkus S, Koseoglu BF, Yilmaz E. Comparison of the short-term effects of the conventional motorized traction with non-surgical spinal decompression performed with a DRX9000 device on pain, functionality, depression, and quality of life in patients with low back pain associated with lumbar disc herniation: A single-blind randomized-controlled trial. Turk J Phys Med Rehabil. 2017 Feb 16;64(1):17-27. doi: 10.5606/tftrd.2017.154. eCollection 2018 Mar.
citation: Koes BW, Bouter LM, van Mameren H, Essers AH, Verstegen GM, Hofhuizen DM, Houben JP, Knipschild PG. Randomised clinical trial of manipulative therapy and physiotherapy for persistent back and neck complaints: results of one year follow up. BMJ. 1992 Mar 7;304(6827):601-5. doi: 10.1136/bmj.304.6827.601.
citation: Leemann S, Peterson CK, Schmid C, Anklin B, Humphreys BK. Outcomes of acute and chronic patients with magnetic resonance imaging-confirmed symptomatic lumbar disc herniations receiving high-velocity, low-amplitude, spinal manipulative therapy: a prospective observational cohort study with one-year follow-up. J Manipulative Physiol Ther. 2014 Mar-Apr;37(3):155-63. doi: 10.1016/j.jmpt.2013.12.011. Epub 2014 Mar 11.
citation: Ehrler M, Peterson C, Leemann S, Schmid C, Anklin B, Humphreys BK. Symptomatic, MRI Confirmed, Lumbar Disc Herniations: A Comparison of Outcomes Depending on the Type and Anatomical Axial Location of the Hernia in Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulation. J Manipulative Physiol Ther. 2016 Mar-Apr;39(3):192-9. doi: 10.1016/j.jmpt.2016.02.013. Epub 2016 Mar 28.
citation: Oh H-J, Jeon C-B, Jeong M-G, Choi S-J. The effects of spinal decompression therapy on pain and disability in patients with chronic low back pain. The Journal of Korean Physical Therapy. 2017;29(6):299-302.