The Effect of Thoracic Spine Manipulation on Peripheral Neurodynamic Mobility

NCT02842918 | Completed

• 1 other identifier: ShenandoahU
• Study Type: interventional
• Target: 43
• Locations: 1 country
• Sites: 1

Brief Summary

No studies have investigated the effects of a supine thoracic spine manipulation (TSM) on neurodynamic mobility, as compared to a sham intervention. This study aims to determine the immediate effects of TSM on the Upper Limb Provocation Test (ULPT) and Seated Slump Test (SST) compared to a sham intervention in asymptomatic subjects with neurodynamic limitations.

Conditions

Musculoskeletal Manipulations

Keywords

Thoracic Spine Manipulation; Neurodynamics; Sham

Outcome Measures

Primary Outcomes (2)

• Upper Limb Provocation Test Range of Motion Change (measured in degrees of elbow extension)

  Subjects will lie on their back with their shoulder slightly off the edge of a treatment table. The investigator will then bend the subjects neck away from the shoulder being tested and position the arm into the starting test position. The investigator will then straighten the subjects elbow until it is fully extended, or until the subject reports discomfort or an abnormal feeling in their arm. This procedure will be completed before and immediately after either the treatment intervention (manipulation) or the sham intervention is completed.

  Pre and Immediately Post Intervention

• Seated Slump Test Range of Motion Change (measured in degrees of knee extension)

  Subjects will sit at the edge of treatment table. Subjects will be asked to flex then neck towards their chest. The investigator will then apply a gentle force to their upper back and will ask the subject to remain in this position. The investigator will move the subjects foot upwards and straighten their leg until it is fully extended or until the subject reports discomfort or an abnormal feeling in their leg.This procedure will be completed before and immediately after either the treatment intervention (manipulation) or the sham intervention is completed.

  Pre and Immediately Post Intervention

Secondary Outcomes (2)

• Believability of Sham - measured via questionnaire

  Immediately Post Intervention (after final measurements are read and recorded)

• Perceived effect - measured via questionnaire

  Pre Intervention (immediately after initial measurements are recorded and prior to intervention)

Study Arms (2)

Spinal Manual Therapy

ACTIVE COMPARATOR

Supine thoracic spine manipulation located between the levels of T4-T7

Procedure: Spinal Manual Therapy; Procedure: Spinal Range of Motion

Spinal Range of Motion

SHAM COMPARATOR

Supine thoracic spine sham manipulation located between the levels of T4-T7; identical procedure as the active treatment intervention but without the delivery of high velocity low amplitude thrust

Procedure: Spinal Manual Therapy; Procedure: Spinal Range of Motion

Interventions

Spinal Manual Therapy PROCEDURE

Also known as: Active treatment group

Spinal Manual Therapy; Spinal Range of Motion

Spinal Range of Motion PROCEDURE

Also known as: Placebo/Sham group

Spinal Manual Therapy; Spinal Range of Motion

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Upper Limb Provocation Test results with limitation of greater than 60 deg of elbow extension at the time of measurement
• Seated Slump Test results with limitation of greater than 22 deg of knee extension at the time of measurement

You may not qualify if:

• History of cervical or lumbar pain requiring medical intervention within the last two years, history of upper or lower extremity paresthesia/numbness, self reported bone density disorders, previous spinal cord injury, diagnosed intervertebral disc herniation, previous diagnosis of spinal stenosis or disc pathology, current pregnancy, history of circulatory or neurological disorders, history of spine and extremity fractures or dislocations in the last two years

Sponsors & Collaborators

• Shenandoah University: lead

Study Sites (1)

Shenandoah University

Winchester, Virginia, 22601, United States

Location

Related Publications (5)

• Michener LA, Kardouni JR, Sousa CO, Ely JM. Validation of a sham comparator for thoracic spinal manipulation in patients with shoulder pain. Man Ther. 2015 Feb;20(1):171-5. doi: 10.1016/j.math.2014.08.008. Epub 2014 Sep 6.

  PMID: 25261090 RESULT

• Davis DS, Anderson IB, Carson MG, Elkins CL, Stuckey LB. Upper Limb Neural Tension and Seated Slump Tests: The False Positive Rate among Healthy Young Adults without Cervical or Lumbar Symptoms. J Man Manip Ther. 2008;16(3):136-41. doi: 10.1179/jmt.2008.16.3.136.

  PMID: 19119402 RESULT

• Szlezak AM, Georgilopoulos P, Bullock-Saxton JE, Steele MC. The immediate effect of unilateral lumbar Z-joint mobilisation on posterior chain neurodynamics: a randomised controlled study. Man Ther. 2011 Dec;16(6):609-13. doi: 10.1016/j.math.2011.06.004. Epub 2011 Jul 13.

  PMID: 21742541 RESULT

• Chu J, Allen DD, Pawlowsky S, Smoot B. Peripheral response to cervical or thoracic spinal manual therapy: an evidence-based review with meta analysis. J Man Manip Ther. 2014 Nov;22(4):220-9. doi: 10.1179/2042618613Y.0000000062.

  PMID: 25395830 RESULT

• Schmid A, Brunner F, Wright A, Bachmann LM. Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation. Man Ther. 2008 Oct;13(5):387-96. doi: 10.1016/j.math.2007.12.007. Epub 2008 Mar 3.

  PMID: 18316238 RESULT

Study Officials

• Sheri A Hale, PhD, PT, ATC

  Shenandoah University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor Division of Physical Therapy

Study Record Dates

• First Submitted: July 19, 2016
• First Posted: July 25, 2016
• Study Start: February 1, 2016
• Primary Completion: December 1, 2016
• Study Completion: February 1, 2017
• Last Updated: April 25, 2017

Record last verified: 2017-04

Data Sharing

• IPD Sharing: Will share

Locations

US (1)