The effect of the spinal mobilization in subjects with acute low back pain

ISRCTN ISRCTN16069685
DOI https://doi.org/10.1186/ISRCTN16069685
Secondary identifying numbers N/A
Submission date
11/03/2015
Registration date
23/03/2015
Last edited
15/10/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Plain English summary under review

Contact information

Mr François Reumont
Scientific

Rue du camp, 48
Marbais
1495
Belgium

ORCiD logoORCID ID 0000-0001-6950-3595
Dr Frédéric Dierick
Scientific

134, Rue Trieu Kaisin
Montignies-sur-Sambre
6061
Belgium

Mr Paul Thiry
Scientific

Avenue Gambetta, 51
La Louvière
7100
Belgium

Study information

Study designNon randomized single-center trial
Primary study designInterventional
Secondary study designNon randomised study
Study setting(s)Hospital
Study typeTreatment
Scientific titleDiffusion of water within lumbar intervertebral discs after a single session of postero-anterior spinal mobilization in subjects with acute low back pain
Study objectivesThe objective of our research project is to study the effectiveness of a single session of postero-anterior (PA) spinal mobilization of lumbar vertebrae in patients suffering from acute low back pain. The evaluation of the effectiveness of the PA will be mainly based on the analysis of MRI diffusion-weighted images and the computation of the apparent diffusion coefficient (ADC). Our main hypothesis is that in vivo diffusion of water within lumbar intervertebral discs will be increased at least at the level of the PA pressure.
Ethics approval(s)Saint-Luc Hospital and Departmental Ethics Committee (2014/07AOU/419), 06/10/2014, ref: B403201421675.
Health condition(s) or problem(s) studiedLow back pain (LBP). By definition, LBP is a lumbar pain localization, between the twelfth thoracic vertebra (Th12) and lumbosacral junction, with radiating pain in the gluteal area or towards the knee.
InterventionDuring data collection, each subject was assessed by two therapists. The first therapist filled in the Visual Analogue Scale for pain and 2 questionnaires with the subject (Saint-Antoine and DN4). The second therapist, carried out various musculoskeletal clinical tests (flexion, extension and lateral flexion of the trunk in standing) and a neuro-dynamic test (SLUMP test). Then, a first MRI scan of the lumbar region of the subject was carried out. After this first MRI, a spinal mobilization type PA (Maitland) was carried by the second therapist. To complete the data collection, a second MRI scanner, identical to the first, was carried out on the subject within an hour after the spinal manipulation. During this time, all questionnaires (except DN4) and clinical tests are again carried out by the two therapists.
Intervention typeProcedure/Surgery
Primary outcome measureWe used the diffusion-weighted sequences to quantify the “micro” movements of water molecules within the intervertebral discs (IVDs) of the lumbar spine. The apparent diffusion coefficient (ADC) provides the image of the mobility of water molecules.
Secondary outcome measures1. VAS: The visual analogue scale is a slider that allows the subject to self-evaluate the pain using a cursor. The patient moves the cursor to the end of "no pain" to the end "worst pain imaginable ". On the back of the slider, the therapist can evaluate the pain felt by the subject, using a scale in millimeters.
2. Trunk flexion before onset of pain: Positioning the patient standing with knees extended. Asked to flex the trunk while specifying it to properly wrap one by one the vertebrae trying to go touch her toes until the onset of pain. Finally, the therapist noted measuring the distance between the fingertips and the ground.
3. Trunk extension before onset of pain: Positioning the patient standing knees, in strict extension. It then requests extension of the column leaving the arms hang vertically. The therapist must be careful to secure the patient's pelvis to look only at the extension of the column. Finally, the therapist noted measuring the distance between the fingertips and the ground.
4. Lateral flexion of the trunk before onset of pain: Measuring the distance over which the hand moves along the lower member in a lateral flexion of the trunk
Overall study start date06/10/2014
Completion date30/08/2015

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participantsn=20
Total final enrolment16
Key inclusion criteria1. Acute low back pain
2. A period of less than 6 consecutive weeks of pain
3. More than 1 month without pain between the current and previous episodes of low back pain
4. The patient must have had more days without pain than days with pain in the past year
Key exclusion criteria1. Aversion to spinal manipulation
2. Patients with chronic low back pain (pain for more than 3 months)
3. Radiating pain below the knees
4. Spine fracture
5. Spine Surgery
6. Osteoporosis
7. Pregnancy
8. Implanted devices that could interact with the magnetic field of the MRI
9. Intolerance using MRI (claustrophobia)
10. Safety issue related to the equipment's weight capacity (obesity)
11. Alcohol or drug abuse, mental illness or lack of cognitive ability
Date of first enrolment07/10/2014
Date of final enrolment30/08/2015

Locations

Countries of recruitment

  • Belgium

Study participating centre

HELHa (Haute Ecole Louvain en Hainaut)
134, rue Trieu Kaisin
Montignies -sur-Sambre
6061
Belgium

Sponsor information

Haute École Louvain en Hainaut
University/education

134, rue Trieu Kaisin
Montignies-sur-Sambre
6061
Belgium

Website http://www.helha.be/#1
ROR logo "ROR" https://ror.org/03sfp2d76
GEPTO A.S.B.L
Other

51, Avenue Gambetta
La Louvière
7100
Belgium

Siemens s.a. - Healthcare
Industry

123, Guido Gezellestraat
Huizingen
1654
Belgium

GHdC a.s.b.l.
Hospital/treatment centre

3, Grand'Rue
Charleroi
6000
Belgium

Funders

Funder type

Other

Investigator initiated and funded

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination plan
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 29/05/2018 15/10/2020 Yes No

Editorial Notes

15/10/2020: Publication reference and total final enrolment number added.