Effectiveness of cervical osteopathic manipulation techniques of high velocity and low amplitude in patients with whiplash-associated disorders

ISRCTN ISRCTN87221762
DOI https://doi.org/10.1186/ISRCTN87221762
Secondary identifying numbers N/A
Submission date
14/05/2014
Registration date
21/07/2014
Last edited
18/12/2017
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

Background and study aims
Whiplash is a neck injury caused by a sudden movement forward, backward or sideways movement of the head. It often happens after a sudden impact from, for example, a road traffic accident and results in damage to the ligaments and tendons in the neck. Road traffic accidents and their effects on social-health costs are an important problem for society. Whiplash and whiplash associated disorders (WAD – for example pain, reduced range of neck movement, neurological damage and even fracture) are the number one reason for people visiting the emergency room after being involved in a road traffic accident. Osteopathic high velocity, low amplitude (HVLA) techniques, and mobilization techniques of the cervical spine, either alone or combined with other treatments, are methods used to treat neck problems. Both treatments result in similar short term changes, but there is not enough data to assess their long-term effects, making it difficult to develop the best technique and when and how long the treatments should be applied. The aim of this study is to precisely and objectively contribute to the knowledge available on how good HVLA techniques are at treating whiplash and WAD. HVLA techniques are compared with other physiotherapy techniques, looking at how long the treatments are needed, the degree of pain relief they offer, how much they improve the function and mobility of the spine and analysing radiological changes in cervical curvature.

Who can participate?
Patients aged 18 to 65 with WAD admitted to the Osteopathic Centre in Terrassa.

What does the study involve?
Participants are randomly allocated into one of two groups. Those in the study group receive HVLA treatment and the control group receive conventional manual osteopathic therapy and therapeutic exercises. The results from the two groups are then compared to assess how well they treat whiplash and WAD.

What are the possible benefits and risks of participating?
Participants are unlikely to directly benefit from the study, but the results could help future sufferers of whiplash, resulting in better management of their symptoms and avoiding excessive procedures. The risks associated with this study are rare and generally mild, but include some neurodegenerative reactions (sweating, low blood pressure, feeling sick and/or rapid heart rate) during, or immediately after, the therapy.

Where is the study run from?
Health Consortium of Terrassa (Spain)

When is the study starting and how long is it expected to run for?
May 2014 to December 2015

Who is funding the study?
The Osteopathic Centre, Terrassa and the Health Consortium of Terrassa (Consorci Sanitari de Terrassa) (Spain)

Who is the main contact?
Mr Joan Parera
Joanpt1@gmail.com

Contact information

Mr Joan Parera
Scientific

Sant Marian 99 5-2
Terrassa
08221
Spain

ORCiD logoORCID ID 0000-0002-3969-2433
Email joanpt1@gmail.com

Study information

Study designRandomized controlled single-blind trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleResearch project on the effectiveness of cervical OSTEOpathic manipulation techniques of high velocity and low amplitude in patients with whiplash-associated disorders: a Randomized Controlled single-blind Trial
Study acronymOSTEO-RCT
Study objectivesPatients who have suffered cervical whiplash, specific osteopathic techniques to adjust the treatment, of high velocity and low amplitude (SAT-HVLA) of the cervical spine, obtain better results than those treated with combined treatments found in cervical therapeutic exercise manuals.
Ethics approval(s)Ethics Committee at the Health Consortium of Terrassa - Terrassa Hospital (Consorci Sanitari de Terrassa – Hospital de Terrassa), 20/12/2013
Health condition(s) or problem(s) studiedWhiplash associated disorders (WAD)
InterventionThe participants are randomised to two groups:
1. Treatment: The technique of choice, will be the Specific Adjusting Technique (SAT). This is a High Velocity Low Amplitude Technique, whose objective is to reverse the injury caused by the trauma.
Throughout the trial we will make three interventions with SAT (one every two weeks)
In the first intervention, we will manipulate the upper cervical segment (C2/C3)
In the second intervention, we will manipulate the low cervical segment (C5/C6)
In the third intervention, we will manipulate the upper thoracic segment (T1/T2)
2. Control: The participants will receive conventional treatment, consisting in manual therapy techniques and therapeutic exercises, over four weeks.

Participants are followed up at 11 days, 30 days, and 110 days after treatment.
Intervention typeOther
Primary outcome measureCurrent primary outcome measures as of 01/02/2017:
1. Functionality (disability), measured using the Northwick Park Neck Pain Questionnaire (NPQ) at baseline, 11 days, 30 days, and 110 days after treatment
2. Cervical mobility, measured using the Cervical Range Of Motion Instrument (CROM) at baseline, 11 days, 30 days, and 110 days after treatment
3. Radiological changes in the cervical curvature, measured using the Cobb method (COOB) at baseline and 30 days after treatment

Previous primary outcome measures:
1. Functionality, measured using the Northwick Park Neck Pain Questionnaire (NPQ)
2. Cervical mobility, measured using the Cervical Range Of Motion Instrument (CROM)
3. Radiological changes in the cervical curvature (CA)
Secondary outcome measuresCurrent secondary outcome measures as of 01/02/2017:
1. Pain, measured using the Visual Analogue Scale (VAS) at baseline, 11 days, 30 days, and 110 days after treatment
2. Anxiety, measured using the Hospital Anxiety and Depression Scale (HAD) at baseline, 30 days, and 110 days after treatment
3. Depression, measured using the Hospital Anxiety and Depression Scale (HAD) at baseline, 30 days, and 110 days after treatment

Previous secondary outcome measures:
1. Quality of life
2. Mobility of the cervical spine
3. Lordosis of the cervical spine
Overall study start date22/05/2014
Completion date31/12/2015

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants148
Key inclusion criteria1. Patients ages 18 to 65 years presenting whiplash syndrome (WAD)
2. They must have radiological studies (A-P and lateral projections) with previous signed informed consent
Key exclusion criteria1. Chronic cervical pain
2. Bone pathology
3. Systemic pathologies (acute infections, cancerous or inflammatory processes)
Date of first enrolment22/05/2014
Date of final enrolment01/07/2015

Locations

Countries of recruitment

  • Spain

Study participating centre

The Osteopathic Centre, Terrassa (Centre d'osteopatia Terrassa)
08224
Spain

Sponsor information

The Osteopathic Centre, Terrassa (Centre d'osteopatia Terrassa) (Spain)
Hospital/treatment centre

Pintor Torras 2 1-2
Terrassa
08224
Spain

Email osteo@osteopatiaterrassa.com
Website http://www.osteopatiaterrassa.com

Funders

Funder type

Hospital/treatment centre

The Osteopathic Centre, Terrassa (Centre d'osteopatia Terrassa) (Spain)

No information available

Health Consortium of Terrassa (Consorci Sanitari de Terrassa) (Spain)

No information available

Results and Publications

Intention to publish date01/06/2017
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal in 2017.
IPD sharing planThe current data sharing plans for the current study are unknown and will be made available at a later date.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Basic results 31/01/2017 15/02/2017 No No

Additional files

ISRCTN87221762_BasicResults_31Jan17.docx
Uploaded 15/02/2017

Editorial Notes

18/12/2017: Internal review.
15/02/2017: Results summary uploaded.