Thoracic Spine Manual Traction With Mobilization Versus Manipulation

NCT06049264 | Completed

• 1 other identifier: REC/RCR&AHS/23/0132 Feroza
• Study Type: interventional
• Target: 34
• Locations: 1 country
• Sites: 1

Brief Summary

This project will be a Randomized clinical trial conducted to compare Short-term effects of thoracic spine manual traction with mobilization and Thoracic manipulation in patients with mid thoracic pain and pseudo visceral symptoms. Sample will be collected through non-probability convenient sampling, following eligibility criteria from Sehat Medical complex, Lahore. Eligibility criteria will be Age group between 20 to 40 years both male and female genders with mid thoracic pain having pseudo visceral symptoms. Referred by physician after exclusion of post-surgical condition from past 6 months Neurological, Pulmonological, Cardiac, Musculoskeletal and Esophageal conditions. Participants will be randomly allocated in two groups via sealed envelope method, baseline assessment will be done, Group A participants will be given baseline treatment along with Thoracic spine manual traction with mobilization, Group B participants will be given baseline treatment along with Thoracic manipulation protocol. Pre and post intervention assessment will be done via, Numeric pain rating scale(NPRS), Revised Oswestry thoracic pain disability questionnaire (ODI) and Inclinometer to measure ROM of Thoracic spine,3 sessions per week will be given for 4 weeks, data will be analyzed by using SPSS version 29.

Conditions

Thoracic

Keywords

Manipulation; Mobilization; Pseudo visceral symptoms; Pain; Spinal Traction

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale

  Changes from base Line Numeric Pain rating scale is a scale for pain starting from 0-10. where 0 indicate no pain and 10 indicate severe pain.

  4th Week

• Revised Oswestry thoracic pain disability questionnaire for disability

  This questionnaire is designed to evaluate Level of Disability in thoracic Pain patients. Disability was measured using the Oswestry Disability Index (ODI: range 0-no disability to 50-maximum disability possible). The ODI is a commonly used outcome measure amongst LBP patient.

  4th Week

• Inclinometer measurement of Thoracic ROM

  Inclinometers are portable, lightweight, and inexpensive pieces of equipment that are used to measure range of motion, like goniometry. Inclinometers are typically found in clinics and are used as a part of a physical examination. An intraclass correlation coefficient (ICC) was found to be between 0.87-0.95.

  4th Week

Study Arms (2)

Thoracic Spine Manual Traction with Mobilization

EXPERIMENTAL

Thoracic Spine Manual Traction with Mobilization

Other: Thoracic spine manual traction with mobilization protocol.

Thoracic Spine Manual Traction with Manipulation

ACTIVE COMPARATOR

Thoracic Spine Manual Traction with Manipulation

Other: Thoracic manipulation protocol

Interventions

Thoracic spine manual traction with mobilization protocol. OTHER

The therapist will perform one 30-second bout of grade I or II central posterior-anterior mobilization at the T3 spinous process as described by Maitland et al. After the 30-second bout, the therapist proceeded to T4 and performed the same technique. This process was continued sequentially in a caudal direction to T8, for an overall intervention time of approximately 3 minutes. In addition to mobilization, thoracic spine traction will be also given in sitting position.

Thoracic Spine Manual Traction with Mobilization

Thoracic manipulation protocol OTHER

To perform the manipulation, the stabilizing hand will be placed at the level immediately caudal to the restricted segment using a ''pistol grip''. Once the pre manipulative position will be achieved the patient will be instructed to take a deep inhalation and exhale. During the exhalation the treating clinician performed a high velocity, small amplitude thrust in a direction to facilitate relative closing or opening of the respective facet joint as indicated by the segmental examination.

Thoracic Spine Manual Traction with Manipulation

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age group between 20 to 40 years
• Both male and female gender.
• Mid thoracic pain with pseudo visceral symptoms.
• Participants with moderate and severe pain as ODI score should be within range of 30% to 68%.

You may not qualify if:

• Post-surgical condition (6 months)
• Neurological Conditions
• Pulmonological conditions
• Cardiac conditions such as angina pectoris, coronary artery disease, Arrhythmia, pericarditis or aortic aneurysm.
• Musculoskeletal disorders
• Esophageal disorders

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Sehat Medical Complex, Hanjarwal Lahore

Lahore, Punjab Province, Pakistan

Location

Related Publications (11)

• Izzo R, Popolizio T, D'Aprile P, Muto M. Spinal pain. Eur J Radiol. 2015 May;84(5):746-56. doi: 10.1016/j.ejrad.2015.01.018. Epub 2015 Feb 13.

  PMID: 25824642 BACKGROUND

• Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic spine pain in the general population: prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord. 2009 Jun 29;10:77. doi: 10.1186/1471-2474-10-77.

  PMID: 19563667 BACKGROUND

• Romanchuk O. The Immediate Effects of the Manual Therapy Traction Manipulations on Parameters of Cardiorespiratory System Functioning. International Journal of Human Movement and Sports Sciences. 2022;10(4):832-40.

  BACKGROUND

• Morningstar MW. Cervical hyperlordosis, forward head posture, and lumbar kyphosis correction: A novel treatment for mid-thoracic pain. J Chiropr Med. 2003 Summer;2(3):111-5. doi: 10.1016/S0899-3467(07)60055-X.

  PMID: 19674605 BACKGROUND

• Manchikanti L, Singh V, Pampati V, Beyer CD, Damron KS. Evaluation of the prevalence of facet joint pain in chronic thoracic pain. Pain Physician. 2002 Oct;5(4):354-9.

  PMID: 16886012 BACKGROUND

• Takatalo J, Ylinen J, Pienimaki T, Hakkinen A. Intra- and inter-rater reliability of thoracic spine mobility and posture assessments in subjects with thoracic spine pain. BMC Musculoskelet Disord. 2020 Aug 10;21(1):529. doi: 10.1186/s12891-020-03551-4.

  PMID: 32778081 BACKGROUND

• Cleland JA, Flynn TW, Childs JD, Eberhart S. The audible pop from thoracic spine thrust manipulation and its relation to short-term outcomes in patients with neck pain. J Man Manip Ther. 2007;15(3):143-54. doi: 10.1179/106698107790819828.

  PMID: 19066662 BACKGROUND

• . Fryer G, Carub J, McIver S. The effect of manipulation and mobilisation on pressure pain thresholds in the thoracic spine. Journal of Osteopathic Medicine. 2004;7(1):8-14.

  BACKGROUND

• Vicenzino B, Collins D, Wright A. The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain. 1996 Nov;68(1):69-74. doi: 10.1016/S0304-3959(96)03221-6.

  PMID: 9252000 BACKGROUND

• Park SJ, Kim SH, Kim SH. Effects of Thoracic Mobilization and Extension Exercise on Thoracic Alignment and Shoulder Function in Patients with Subacromial Impingement Syndrome: A Randomized Controlled Pilot Study. Healthcare (Basel). 2020 Sep 2;8(3):316. doi: 10.3390/healthcare8030316.

  PMID: 32887287 BACKGROUND

• Anandkumar S M Sc Pt Bpt C-Ompt Cafs Cert Dnt, Manivasagam M Bpt Dyt Comt Fsr Dnp Ces. Effect of fascia dry needling on non-specific thoracic pain - A proposed dry needling grading system. Physiother Theory Pract. 2017 May;33(5):420-428. doi: 10.1080/09593985.2017.1318423. Epub 2017 May 8.

  PMID: 28481688 BACKGROUND

MeSH Terms

Conditions

Pain

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Syed Shakil ur Rehman

  Riphah International University, Lahore

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 15, 2023
• First Posted: September 22, 2023
• Study Start: September 25, 2023
• Primary Completion: January 10, 2024
• Study Completion: January 15, 2024
• Last Updated: January 30, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)