<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02261246</url>
  </required_header>
  <id_info>
    <org_study_id>NCCAM U19 AT006057 Project 2</org_study_id>
    <secondary_id>5U19AT006057-02</secondary_id>
    <nct_id>NCT02261246</nct_id>
  </id_info>
  <brief_title>Trunk Motor Control Performance Before and After Spinal Manipulation Treatment</brief_title>
  <acronym>TMCSMT</acronym>
  <official_title>Trunk Motor Control Performance Before and After Spinal Manipulation Treatment</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Michigan State University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>National Center for Complementary and Integrative Health (NCCIH)</agency>
      <agency_class>NIH</agency_class>
    </collaborator>
  </sponsors>
  <source>Michigan State University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      The overall goal of this project is to develop sensitive and objective clinical research&#xD;
      tools for the assessment of trunk motor control. In order to accomplish this goal, the&#xD;
      investigators aim to quantify changes in trunk motor control before and after spinal&#xD;
      manipulation treatment. The investigators hypothesize that trunk motor control will improve&#xD;
      in the low back pain participants after 4-weeks of spinal manipulation treatment.&#xD;
      Additionally, the investigators will compare position and force trunk motor control between&#xD;
      healthy controls and low back pain patients. The investigators hypothesize that baseline&#xD;
      tests of position and force trunk motor control will be better in healthy individuals than&#xD;
      low back pain patients.&#xD;
    </textblock>
  </brief_summary>
  <overall_status>Terminated</overall_status>
  <why_stopped>
    We no longer have the resources to complete enrollment&#xD;
  </why_stopped>
  <start_date type="Actual">June 1, 2014</start_date>
  <completion_date type="Actual">August 2018</completion_date>
  <primary_completion_date type="Actual">August 2018</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Crossover Assignment</intervention_model>
    <primary_purpose>Basic Science</primary_purpose>
    <masking>Triple (Care Provider, Investigator, Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Change from baseline to week 4 and from week 4 to 8 in trunk position tracking accuracy</measure>
    <time_frame>Change from baseline to week 4 and from week 4 to 8</time_frame>
    <description>Participants will be in a seated position during the position tracking task and will wear a chest harness with an attached position sensor. The angular position of the trunk will be displayed on a monitor 1 meter in front of the participants and they will be asked to follow a moving target by moving their trunk. Accuracy will be determined by taking the difference between the target position signal and the actual trunk position (measured in degrees with string potentiometers).</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change from baseline to week 4 and from week 4 to 8 in trunk force tracking accuracy</measure>
    <time_frame>Change from baseline to week 4 and from week 4 to 8</time_frame>
    <description>Participants will be in a seated position and will be asked to generate force with their trunk against a fixed pad. The pad will be attached to a load cell that monitors how much force is being generated by their trunk. The force level will be displayed on a monitor 1 meter in front of the participants and they will be asked to follow a moving target by generating force with their trunk. Accuracy will be determined by taking the difference between target force signal and the actual trunk force (measured in Newtons with the load cell).</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change from baseline to week 4 and from week 4 to 8 in trunk position stabilization accuracy</measure>
    <time_frame>Change from baseline to week 4 and from week 4 to 8</time_frame>
    <description>Participants will be sitting in a seat mounted to a robotic platform (Mikrolar Hexapod Robot) and will wear a chest harness with an attached position sensor. The robotic platform will provide an angular perturbation to the participant about the lumbar spine in the sagittal plane while the participant is asked to maintain (stabilize) their trunk position in the upright posture. Accuracy will be determined by measuring the amount of trunk displacement (measured in degrees with string potentiometers) during the perturbation trial.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change from baseline to week 4 and from week 4 to 8 in trunk force stabilization accuracy</measure>
    <time_frame>Change from baseline to week 4 and from week 4 to 8</time_frame>
    <description>Participants will be sitting in a seat mounted to a robotic platform (Mikrolar Hexapod Robot) and will be asked to generate force with their trunk against a fixed pad. The pad will be attached to a load cell that monitors how much force is being generated by their trunk. The robotic platform will provide an angular perturbation to the participant about the lumbar spine in the sagittal plane while the participant is asked to maintain (stabilize) a static force level (projected on a screen in front of them) with their trunk (10% of the average maximum trunk moment). Accuracy will be determined by measuring the difference between the target force level and the actual force level maintained (measured in Newtons with a load cell) during the perturbation trial.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change from baseline to week 4 and from week 4 to 8 in push stabilization accuracy</measure>
    <time_frame>Change from baseline to week 4 and from week 4 to 8</time_frame>
    <description>Participants will be standing and will be asked to generate push force while holding onto a bar (arms along the body, elbows flexed at 90º). The bar will be attached to a load cell that monitors how much force is being applied with the hands. The robotic platform will provide a linear movement (perturbation) of the bar in the horizontal plane while the participant is asked to maintain (stabilize) a static force level (projected on a screen in front of them) with their hands (10% of the average maximum trunk moment). Accuracy will be determined by measuring the difference between the target force level and the actual force level maintained (measured in Newtons with a load cell) during the perturbation trial.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change from baseline to week 4 and from week 4 to 8 in pull stabilization accuracy</measure>
    <time_frame>Change from baseline to week 4 and from week 4 to 8</time_frame>
    <description>Participants will be standing and will be asked to generate pull force while holding onto a bar (arms along the body, elbows flexed at 90º). The bar will be attached to a load cell that monitors how much force is being applied with the hands. The robotic platform will provide a linear movement (perturbation) of the bar in the horizontal plane while the participant is asked to maintain (stabilize) a static force level (projected on a screen in front of them) with their hands (10% of the average maximum trunk moment). Accuracy will be determined by measuring the difference between the target force level and the actual force level maintained (measured in Newtons with a load cell) during the perturbation trial.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Change in Patient Reported Outcomes Measurement Information System (PROMIS)</measure>
    <time_frame>The expected average is weekly for this outcome measure until the end of week 8</time_frame>
    <description>Assesses weekly changes in physical function, anxiety, depression, fatigue, sleep, satisfaction with social role, and pain with PROMIS-29 questionnaire.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in concomitant medication</measure>
    <time_frame>The expected average is weekly for this outcome measure until the end of week 8</time_frame>
    <description>Assesses weekly changes in the use of medication for treating neck pain, including the type of medication and the quantity of medication (i.e., number of pills) with a questionnaire.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in back-related disability</measure>
    <time_frame>The expected average is weekly for this outcome measure until the end of week 8</time_frame>
    <description>Assesses weekly changes in functional limitations related to back pain with the Modified Oswestry Disability questionnaire.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in fear avoidance behavior</measure>
    <time_frame>The expected average is weekly for this outcome measure until the end of week 8</time_frame>
    <description>Assesses weekly changes in fear avoidance behavior using the Fear Avoidance Belief questionnaire.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Treatment effectiveness belief</measure>
    <time_frame>This outcome measure will be assessed at baseline</time_frame>
    <description>Assesses the patient's belief in how effective the treatment will be prior to treatment using the Credibility Expectancy questionnaire.</description>
  </secondary_outcome>
  <number_of_arms>3</number_of_arms>
  <enrollment type="Actual">80</enrollment>
  <condition>Low Back Pain</condition>
  <arm_group>
    <arm_group_label>Immediate treatment</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>This arm receives spinal manipulation treatment shortly after enrollment</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Delayed treatment</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>This arm receives spinal manipulation treatment approximately 4 weeks after enrollment</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Healthy control (no low back pain)</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>In this arm, healthy controls are tested at baseline.</description>
  </arm_group>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Spinal manipulation treatment</intervention_name>
    <description>Up to 4 sessions of spinal manipulation treatment (once per week).</description>
    <arm_group_label>Delayed treatment</arm_group_label>
    <arm_group_label>Immediate treatment</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        All participants must meet all of the inclusion criteria to participate in the study. Below&#xD;
        is a list of inclusion criteria for ALL participants:&#xD;
&#xD;
          -  Age 21-65 years&#xD;
&#xD;
          -  Independently ambulatory&#xD;
&#xD;
          -  Able to speak and read English&#xD;
&#xD;
          -  Able to understand study procedures and to comply with them for the entire length of&#xD;
             the study.&#xD;
&#xD;
        Below is an additional list of inclusion criteria for low back pain participants:&#xD;
&#xD;
          -  Willing to be randomized to either immediate or delayed treatment group.&#xD;
&#xD;
          -  Musculoskeletal pain - primarily in the lumbar region&#xD;
&#xD;
          -  Pain rating greater or equal to 3 out of 10 as indicated on the Numeric Rating Scale&#xD;
             for Pain&#xD;
&#xD;
          -  Back Disability greater or equal to 26% as indicated on the Oswestry Disability Index&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        All candidates meeting any of the exclusion criteria at baseline will be excluded from&#xD;
        study participation. Exclusion criteria will be self-reported. However, during each&#xD;
        treatment session, the physicians will be watching for clinical signs and symptoms not&#xD;
        consistent with physical findings that are suggestive of the presence of any of the&#xD;
        exclusion criteria. In such a case, further treatment will be discontinued and the subject&#xD;
        will be excluded.&#xD;
&#xD;
        Below is a list of exclusion criteria for ALL participants:&#xD;
&#xD;
          -  Inability or unwillingness of individual to give written informed consent.&#xD;
&#xD;
          -  Physical therapy or any other form of manual medicine (e.g., Osteopathic Manipulative&#xD;
             Medicine, Chiropractic Manipulation, etc.), acupuncture or spinal injections within&#xD;
             one month prior to study enrollment&#xD;
&#xD;
          -  Workers' compensation benefits in the past 3 months or ongoing medical legal issues&#xD;
&#xD;
          -  Possibly pregnant&#xD;
&#xD;
          -  Extreme obesity (BMI&gt;36)&#xD;
&#xD;
          -  Currently using electrical implants (e.g., cardiac pacemakers, drug delivery pumps,&#xD;
             etc.)&#xD;
&#xD;
        History of:&#xD;
&#xD;
          -  Spinal surgery&#xD;
&#xD;
          -  Spinal fracture&#xD;
&#xD;
          -  Spinal infection (e.g., osteomyelitis)&#xD;
&#xD;
          -  Cancer&#xD;
&#xD;
        Unresolved symptoms from:&#xD;
&#xD;
          -  Head trauma&#xD;
&#xD;
          -  Inner ear infection with associated balance and coordination problems&#xD;
&#xD;
          -  Orthostatic hypotension&#xD;
&#xD;
          -  Uncontrolled hypertension&#xD;
&#xD;
          -  Vestibular disorder (e.g. vertigo)&#xD;
&#xD;
        Current diagnosis of:&#xD;
&#xD;
          -  Significant spinal deformity (e.g., scoliosis &gt; 20 degrees, torticollis)&#xD;
&#xD;
          -  Ankylosing spondylitis&#xD;
&#xD;
          -  Spondylolisthesis grades III or IV&#xD;
&#xD;
          -  Cauda equine syndrome&#xD;
&#xD;
          -  Rheumatoid arthritis&#xD;
&#xD;
          -  Osteoporosis&#xD;
&#xD;
          -  Angina or congestive heart failure symptoms&#xD;
&#xD;
          -  Active bleeding or infection in the back&#xD;
&#xD;
          -  Blindness&#xD;
&#xD;
          -  Seizures&#xD;
&#xD;
          -  Neurologic disease (e.g., Parkinson's disease, multiple sclerosis, cerebral palsy,&#xD;
             Alzheimer's disease, amyotrophic lateral sclerosis, stroke or transient ischemic&#xD;
             attack in the past year, cervical dystonia)&#xD;
&#xD;
        Conditions recognized by a physician any time during the study:&#xD;
&#xD;
          -  Significant or worsening signs of neurologic deficit&#xD;
&#xD;
          -  Symptoms are not consistent with mechanical findings&#xD;
&#xD;
          -  Other conditions impeding protocol implementation&#xD;
&#xD;
        Below is an additional exclusion criterion for healthy control participants:&#xD;
&#xD;
        • Based on the minimal clinically important difference of 2 points (Childs et al., 2005),&#xD;
        &quot;healthy controls&quot; with 2 points or greater pain on NRS will not be eligible to&#xD;
        participate.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>21 Years</minimum_age>
    <maximum_age>65 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Norman P Reeves, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Sumaq Life LLC</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Jacek Cholewicki, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Michigan State University</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>MSU Osteopathic Manual Medicine</name>
      <address>
        <city>East Lansing</city>
        <state>Michigan</state>
        <zip>48823</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MSU Musculoskeletal Rehabilitation</name>
      <address>
        <city>Lansing</city>
        <state>Michigan</state>
        <zip>48891</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Michigan State University Center for Orthopedic Research</name>
      <address>
        <city>Lansing</city>
        <state>Michigan</state>
        <zip>48910</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <link>
    <url>http://orthopedicresearch.msu.edu/</url>
    <description>Website for Michigan State University Center for Orthopedic Research</description>
  </link>
  <link>
    <url>http://nccam.nih.gov/</url>
    <description>Website for the National Center for Complementary and Alternative Medicine (Sponsor)</description>
  </link>
  <reference>
    <citation>Reeves NP, Popovich JM Jr, Priess MC, Cholewicki J, Choi J, Radcliffe CJ. Reliability of assessing trunk motor control using position and force tracking and stabilization tasks. J Biomech. 2014 Jan 3;47(1):44-9. doi: 10.1016/j.jbiomech.2013.10.018. Epub 2013 Oct 22.</citation>
    <PMID>24262851</PMID>
  </reference>
  <verification_date>January 2019</verification_date>
  <study_first_submitted>September 19, 2014</study_first_submitted>
  <study_first_submitted_qc>October 9, 2014</study_first_submitted_qc>
  <study_first_posted type="Estimate">October 10, 2014</study_first_posted>
  <last_update_submitted>January 25, 2019</last_update_submitted>
  <last_update_submitted_qc>January 25, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">January 29, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Michigan State University</investigator_affiliation>
    <investigator_full_name>Jacek Cholewicki</investigator_full_name>
    <investigator_title>Professor</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Low Back Pain</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02261246
org study id: NCCAM U19 AT006057 Project 2
secondary id: 5U19AT006057-02
nct id: NCT02261246
lead sponsor: 
collaborator: 
has dmc: Yes
The overall goal of this project is to develop sensitive and objective clinical research
      tools for the assessment of trunk motor control. In order to accomplish this goal, the
      investigators aim to quantify changes in trunk motor control before and after spinal
      manipulation treatment. The investigators hypothesize that trunk motor control will improve
      in the low back pain participants after 4-weeks of spinal manipulation treatment.
      Additionally, the investigators will compare position and force trunk motor control between
      healthy controls and low back pain patients. The investigators hypothesize that baseline
      tests of position and force trunk motor control will be better in healthy individuals than
      low back pain patients.
allocation: Randomized
intervention model: Crossover Assignment
primary purpose: Basic Science
masking: Triple (Care Provider, Investigator, Outcomes Assessor)
measure: Change from baseline to week 4 and from week 4 to 8 in trunk position tracking accuracy
time frame: Change from baseline to week 4 and from week 4 to 8
description: Participants will be in a seated position during the position tracking task and will wear a chest harness with an attached position sensor. The angular position of the trunk will be displayed on a monitor 1 meter in front of the participants and they will be asked to follow a moving target by moving their trunk. Accuracy will be determined by taking the difference between the target position signal and the actual trunk position (measured in degrees with string potentiometers).
measure: Change from baseline to week 4 and from week 4 to 8 in trunk force tracking accuracy
time frame: Change from baseline to week 4 and from week 4 to 8
description: Participants will be in a seated position and will be asked to generate force with their trunk against a fixed pad. The pad will be attached to a load cell that monitors how much force is being generated by their trunk. The force level will be displayed on a monitor 1 meter in front of the participants and they will be asked to follow a moving target by generating force with their trunk. Accuracy will be determined by taking the difference between target force signal and the actual trunk force (measured in Newtons with the load cell).
measure: Change from baseline to week 4 and from week 4 to 8 in trunk position stabilization accuracy
time frame: Change from baseline to week 4 and from week 4 to 8
description: Participants will be sitting in a seat mounted to a robotic platform (Mikrolar Hexapod Robot) and will wear a chest harness with an attached position sensor. The robotic platform will provide an angular perturbation to the participant about the lumbar spine in the sagittal plane while the participant is asked to maintain (stabilize) their trunk position in the upright posture. Accuracy will be determined by measuring the amount of trunk displacement (measured in degrees with string potentiometers) during the perturbation trial.
measure: Change from baseline to week 4 and from week 4 to 8 in trunk force stabilization accuracy
time frame: Change from baseline to week 4 and from week 4 to 8
description: Participants will be sitting in a seat mounted to a robotic platform (Mikrolar Hexapod Robot) and will be asked to generate force with their trunk against a fixed pad. The pad will be attached to a load cell that monitors how much force is being generated by their trunk. The robotic platform will provide an angular perturbation to the participant about the lumbar spine in the sagittal plane while the participant is asked to maintain (stabilize) a static force level (projected on a screen in front of them) with their trunk (10% of the average maximum trunk moment). Accuracy will be determined by measuring the difference between the target force level and the actual force level maintained (measured in Newtons with a load cell) during the perturbation trial.
measure: Change from baseline to week 4 and from week 4 to 8 in push stabilization accuracy
time frame: Change from baseline to week 4 and from week 4 to 8
description: Participants will be standing and will be asked to generate push force while holding onto a bar (arms along the body, elbows flexed at 90º). The bar will be attached to a load cell that monitors how much force is being applied with the hands. The robotic platform will provide a linear movement (perturbation) of the bar in the horizontal plane while the participant is asked to maintain (stabilize) a static force level (projected on a screen in front of them) with their hands (10% of the average maximum trunk moment). Accuracy will be determined by measuring the difference between the target force level and the actual force level maintained (measured in Newtons with a load cell) during the perturbation trial.
measure: Change from baseline to week 4 and from week 4 to 8 in pull stabilization accuracy
time frame: Change from baseline to week 4 and from week 4 to 8
description: Participants will be standing and will be asked to generate pull force while holding onto a bar (arms along the body, elbows flexed at 90º). The bar will be attached to a load cell that monitors how much force is being applied with the hands. The robotic platform will provide a linear movement (perturbation) of the bar in the horizontal plane while the participant is asked to maintain (stabilize) a static force level (projected on a screen in front of them) with their hands (10% of the average maximum trunk moment). Accuracy will be determined by measuring the difference between the target force level and the actual force level maintained (measured in Newtons with a load cell) during the perturbation trial.
measure: Change in Patient Reported Outcomes Measurement Information System (PROMIS)
time frame: The expected average is weekly for this outcome measure until the end of week 8
description: Assesses weekly changes in physical function, anxiety, depression, fatigue, sleep, satisfaction with social role, and pain with PROMIS-29 questionnaire.
measure: Change in concomitant medication
time frame: The expected average is weekly for this outcome measure until the end of week 8
description: Assesses weekly changes in the use of medication for treating neck pain, including the type of medication and the quantity of medication (i.e., number of pills) with a questionnaire.
measure: Change in back-related disability
time frame: The expected average is weekly for this outcome measure until the end of week 8
description: Assesses weekly changes in functional limitations related to back pain with the Modified Oswestry Disability questionnaire.
measure: Change in fear avoidance behavior
time frame: The expected average is weekly for this outcome measure until the end of week 8
description: Assesses weekly changes in fear avoidance behavior using the Fear Avoidance Belief questionnaire.
measure: Treatment effectiveness belief
time frame: This outcome measure will be assessed at baseline
description: Assesses the patient's belief in how effective the treatment will be prior to treatment using the Credibility Expectancy questionnaire.
arm group label: Immediate treatment
arm group type: Experimental
description: This arm receives spinal manipulation treatment shortly after enrollment
arm group label: Delayed treatment
arm group type: Experimental
description: This arm receives spinal manipulation treatment approximately 4 weeks after enrollment
arm group label: Healthy control (no low back pain)
arm group type: No Intervention
description: In this arm, healthy controls are tested at baseline.
intervention type: Procedure
intervention name: Spinal manipulation treatment
description: Up to 4 sessions of spinal manipulation treatment (once per week).
arm group label: Delayed treatment
arm group label: Immediate treatment
criteria: 
gender: All
minimum age: 21 Years
maximum age: 65 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Norman P Reeves, PhD
role: Principal Investigator
affiliation: Sumaq Life LLC
last name: Jacek Cholewicki, PhD
role: Principal Investigator
affiliation: Michigan State University
facility: 
facility: 
facility: 
country: United States
url: http://orthopedicresearch.msu.edu/
description: Website for Michigan State University Center for Orthopedic Research
url: http://nccam.nih.gov/
description: Website for the National Center for Complementary and Alternative Medicine (Sponsor)
citation: Reeves NP, Popovich JM Jr, Priess MC, Cholewicki J, Choi J, Radcliffe CJ. Reliability of assessing trunk motor control using position and force tracking and stabilization tasks. J Biomech. 2014 Jan 3;47(1):44-9. doi: 10.1016/j.jbiomech.2013.10.018. Epub 2013 Oct 22.
PMID: 24262851
responsible party type: Principal Investigator
investigator affiliation: Michigan State University
investigator full name: Jacek Cholewicki
investigator title: Professor
mesh term: Low Back Pain