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CompletedNCT03049644Updated Apr 7, 2022

A Trial Comparing Mechanical Diagnosis and Treatment to Manual Therapy

An interventional study of Mechanical Diagnosis and Therapy and Manual Therapy in Chronic Lower Back Pain, sponsored by Canandaigua VA Medical Center. Completed at 1 site in United States. Open to participants aged 18 Years to 89 Years. Per ClinicalTrials.gov, last updated 2022-04-07.

Sponsored by Canandaigua VA Medical Center · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
15
Allocation
Randomized
Ages
18 Years to 89 Years
Sex
All
01

Study summary

Mechanical diagnosis and treatment (MDT) and Manual Therapy (MT) have both demonstrated efficacy in the management of CLBP. The use of a Point of Care (POC) design in this study will allow for comparison of these two treatment modalities in a clinical setting. The purpose of this study is to demonstrate the feasibility of recruiting, enrolling and collecting outcome data on CLBP patients utilizing the POC methodology.

Read the detailed description

20 new patients entering the chiropractic clinic who meet inclusion criteria including demonstrating a directional preference upon physical examination during their initial evaluation will be recruited. Patients will be queried as to interest and those interested will be consented. Patients will then be randomized utilizing a computer generated randomization chart to receive either MDT or MT delivered in a pragmatic manner. Outcomes will include: Pain (PEG), Quality of Life (PROMIS Global Health Survey (GHS)), psychosocial questions and Self Efficacy (2 Question). Outcomes will be collected at baseline, 4 weeks and 8 weeks post baseline.

02

Conditions studied

  • Chronic Lower Back Pain

Keywords

  • chronic lower back pain
  • Manual Therapy
  • Mechanical Diagnosis and Treatment
03

Who can participate

Ages eligible
18 Years to 89 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Chronic Lower back pain (CLBP) (>12 weeks)
  • Veteran
  • At least 18 years of age
  • Directional preference on physical examination

Exclusion criteria

Exclusion Criteria:

  • Non Veteran
  • >89 years of age
  • Non Mechanical Cause of LBP
  • Unable to identify directional preference on physical examination
  • Contraindications to manual therapy (cauda equina syndrome, spinal neoplasia or metastatic disease, destructive joint pathology such as rheumatoid arthritis, bowel/bladder dysfunction (associated with the back pain), peripheral neuropathy or progressive lumbosacral radiculopathy, progressive myelopathy or neurogenic claudication or any absolute contraindications to MT such as acute fracture of the lumbar spine)
  • Open Worker's compensation case
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
15 participants (actual)

Study arms

  • Active comparator
    Mechanical Diagnosis and Therapy

    Mechanical diagnosis refers to the classification based on examination of posture and range of motion of the spine, associated with the assessment of subjective symptomatic responses.

    Procedure: Mechanical Diagnosis and Therapy

  • Active comparator
    Manual Therapy

    Manual therapy (MT) is a broad term encompassing many techniques which attempt to affect possible pain contributors such as joints, tendons, ligaments, and muscles, typically using the therapist's hands but may also utilize a tool or instrument in the case of some soft tissue mobilization therapies as well as low force instrument assisted spinal manipulation therapy.

    Procedure: Manual Therapy

Interventions

  • ProcedureMechanical Diagnosis and Therapy

    Identification of directional preference.

    Also known as: McKenzie

  • ProcedureManual Therapy

    Mechanically based treatment based on taking joint to end range and thrusting or soft tissue manipulation.

    Also known as: Spinal Manipulative therapy

05

What researchers measure

Primary outcomes

  1. PROMIS Global Health Scale (GHS)

    Change in Quality of Life Measure

    Time frame: baseline, 4 week and 8 week (assessing change from baseline to 4 weeks and 8 weeks)

Secondary outcomes

  1. PEG (Pain/enjoyment of life/general activity)

    Change in Pain

    Time frame: baseline, 4 week and 8 week (assessing change from baseline to 4 weeks and 8 weeks)

  2. Fear Avoidance

    It's not really safe for a person with my back problem to be physically active (1-5 scale)

    Time frame: baseline, 4 week and 8 week (assessing change from baseline to 4 weeks and 8 weeks)

  3. Catastrophizing

    I feel that my back pain is terrible and it's never going to get any better (1-5 scale)

    Time frame: baseline, 4 week and 8 week (assessing change from baseline to 4 weeks and 8 weeks)

  4. Behavioral Disengagement

    Due to my chronic back pain, I no longer engage in activities that are enjoyable and pleasant (1-5 scale_

    Time frame: baseline, 4 week and 8 week (assessing change from baseline to 4 weeks and 8 weeks)

06

Study locations

1 site
  • Rochester Outpatient Clinic (ROPC) of the Canandaigua VA Medical Center
    Rochester, New York 14620, United States
07

References and documents

Individual participant data

Plan to share: Yes — We will publish results of study in a journal as a pilot study.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03049644
Lead sponsor
Canandaigua VA Medical Center
Responsible party
Paul Dougherty, DC (Chief of Chiropractic/Residency Director, Canandaigua VA Medical Center) — Principal investigator
First posted
Feb 10, 2017
Start date
Feb 1, 2017
Primary completion
Jun 30, 2017
Completion
Dec 30, 2018
Last update
Apr 7, 2022

Study contacts

Paul E Dougherty, DC
principal investigator · Canandaigua VA Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2022. You cannot join it, but the record below documents what was studied.

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