<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/NCT02983435</url>
  </required_header>
  <id_info>
    <org_study_id>rubens@unopar.br</org_study_id>
    <nct_id>NCT02983435</nct_id>
  </id_info>
  <brief_title>Osteopathic Treatment for Chronic Low Back Pain</brief_title>
  <acronym>OTCLBP</acronym>
  <official_title>Comparison Between Two Osteopathic Techniques for Chronic Low Back Pain Treatment: a Randomized Crossover Trial.</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Universidade Norte do Paraná</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Universidade Norte do Paraná</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      The relevance of this study is to determine the efficacy of two osteopathic techniques -&#xD;
      Thrust Technique and Muscle Energy Technique (MET) - in improving of neuromuscular component&#xD;
      of the trunk and clinical symptoms in adult workers with Chronic Low Back Pain (CLBP). Few&#xD;
      studies have investigated and compared the physiological responses of these techniques&#xD;
      quantitatively, and no published study has compared their effects in low back pain subjects&#xD;
      in terms of symptoms, postural balance and muscle activation. The main outcomes will be&#xD;
      computed by electromyography measurement so that to assess the trunk neuromuscular activation&#xD;
      pattern as well as by force platform parameters for determining of postural control. Clinical&#xD;
      symptoms such as pain intensity, perception of disability and fear and avoidance will also be&#xD;
      computed.&#xD;
&#xD;
      This is the first study to compare these two osteopathic techniques using the main biological&#xD;
      outcomes related to trunk neuromuscular function.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      The purpose of this study is to assess the efficacy of two osteopathic techniques (Thrust and&#xD;
      MET) on CLBP adult workers treatment.&#xD;
&#xD;
      A total of 15 male participants with chronic low back pain, volunteers, active workers aged&#xD;
      from 35 to 55 years (in aging process) will be recruited by convenience from the community&#xD;
      local. All participants will sign an informed consent form approved by the North of Parana&#xD;
      University Ethics Committee for Research on Human Subjects. The intervention will follow the&#xD;
      CONSORT recommendations for randomized controlled trials. All baseline testing and evaluation&#xD;
      will be performed by a blinded evaluator to the study intervention. The sample will be&#xD;
      randomized in two groups from crossover design: Group #1), which will receive the Thrust&#xD;
      technique applied at the level of dysfunction; and Group #2, which will receive the Muscle&#xD;
      Energy Technique, also applied at the level of dysfunction. The allocation will be printed in&#xD;
      cards by sequentially numbered in opaque envelopes.&#xD;
&#xD;
      The treatment (intervention) will occur in 2 phases of 3 weeks each one. The participants&#xD;
      will receive only one of techniques in each phase, and after one rest week (washout) they&#xD;
      will receive the other technique (crossover), totaling 7 weeks. In this study, both&#xD;
      techniques will be applied at the lumbar vertebral level that present the dysfunction which&#xD;
      will be diagnosed in the specific evaluation, performed by two specialized physiotherapists&#xD;
      in osteopathy. Before and after the manipulation (with Thrust or MET) all participants will&#xD;
      be evaluated in 2 tasks - bipedal without load and bipedal with load (10% of body mass) - on&#xD;
      the force platform. Parallel to the tasks, the recording of the measurements of EMG surface&#xD;
      will be computed to determine the pattern of the trunk neuromuscular activation in amplitude&#xD;
      of the RMS signal as well as muscle fatigue through the median frequency parameters.&#xD;
&#xD;
      Before performing the tasks on the force platform, a maximum voluntary isometric contraction&#xD;
      will be performed for the back (paravertebral) and abdominal (rectus) muscles in order to&#xD;
      normalize the signal EMG for determining of the level muscular activity during each task&#xD;
      (with or without load). After the intervention, the immediate and final revaluations will&#xD;
      include all the used measures in the initial evaluation, such as muscle activation of trunk&#xD;
      (EMG), balance (force platform), and clinical symptoms of pain (Visual Analogue Scale and&#xD;
      McGill Short Questionnaire), psychosomatic factors (Fear and Avoidance Believe Questionnaire)&#xD;
      and disability (Roland Morris Questionnaire).&#xD;
&#xD;
      For the analysis a two-way ANOVA will be used for each dependent variable to compare the two&#xD;
      groups (G1 versus G2) in both situations (pre and post-immediate, and after 15 days) in the&#xD;
      clinical measurements, postural balance and EMG. The size effect also will be computed to&#xD;
      determine the rate of the changes observed.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date>December 2016</start_date>
  <completion_date type="Actual">April 2017</completion_date>
  <primary_completion_date type="Actual">March 2017</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>Treatment</primary_purpose>
    <masking>Single (Investigator)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Electromyography measurement - Root Mean Square (RMS)</measure>
    <time_frame>Change from baseline muscular activation at 3 weeks, in both phases</time_frame>
    <description>EMG estimates, Root Mean Square: RMS (in microvolts unit: uV) will be computed to evaluate the back and abdominal activation during the functional task.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Electromyography measurement - Median Frequency (MF)</measure>
    <time_frame>Change from baseline muscular activation at 3 weeks, in both phases</time_frame>
    <description>EMG estimates, Median Frequency: MF (in Hertz: Hz) will be computed to evaluate the back and abdominal activation during the functional task.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Force platform measurement</measure>
    <time_frame>Change from baseline muscular activation at 3 weeks, in both phases</time_frame>
    <description>Force platform measurement during balance performance using centre of pressure measures to assess balance performance.</description>
  </secondary_outcome>
  <other_outcome>
    <measure>Visual Analogic Scale</measure>
    <time_frame>Change from baseline muscular activation at 3 weeks, in both phases</time_frame>
    <description>Pain intensity measurement using Visual Analogue Scale (score of 0 to 10 intensity; being 10 of poor score for VAS).</description>
  </other_outcome>
  <other_outcome>
    <measure>Short Version of Pain Questionnaire McGill</measure>
    <time_frame>Change from baseline muscular activation at 3 weeks, in both phases</time_frame>
    <description>Pain measurement using Short Version of Pain Questionnaire McGill (score 0 to 78; while higher score is determined by poor condition related to pain).</description>
  </other_outcome>
  <other_outcome>
    <measure>Disability questionnaire</measure>
    <time_frame>Change from baseline muscular activation at 3 weeks, in both phases</time_frame>
    <description>Disability measurement using Roland Morris questionnaire.</description>
  </other_outcome>
  <other_outcome>
    <measure>Fear-avoidance questionnaire</measure>
    <time_frame>Change from baseline muscular activation at 3 weeks, in both phases</time_frame>
    <description>Fear-avoidance model measurement using Waddell questionnaire related to work and physical activity.</description>
  </other_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">10</enrollment>
  <condition>Low Back Pain</condition>
  <condition>Osteopathic Manipulative Treatment</condition>
  <arm_group>
    <arm_group_label>G1 - Thrust manipulation</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>G1 - Thrust manipulation is an osteopathic technique. The Group 1 (G1) will receive the Thrust technique applied at the level of dysfunction. Subject in lateral decubitus, with one lower limb extended and the other in flexion, to the level of the targeted vertebra; upper trunk rotated back until the same vertebra; at the end of the range of movement will be applied the high speed and low amplitude impulse (Thrust).</description>
  </arm_group>
  <arm_group>
    <arm_group_label>G2 - Muscle Energy</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>G2 - Muscle Energy is a manual therapy technique based in muscular contraction and stretching. The Group 2 (G2) will receive the Muscle Energy technique applied at the level of dysfunction. Subject in lateral decubitus, with the upper and lower trunk flexed until the target vertebra, and upper trunk rotated back to the level of the same vertebra; lumbar in lateral flexion (using the subject's feet) until the target vertebra. Following the command the subject will perform an isometric contraction of 3-5 seconds against the therapist's hand (pushing the hand towards the floor), repeated 3 times.</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>G1 - Thrust manipulation</intervention_name>
    <description>Osteopathic manipulation with Thrust technique. The Group 1 (G1) will receive the Thrust technique applied at the level of dysfunction. Subject in lateral decubitus, with one lower limb extended and the other in flexion, to the level of the targeted vertebra; upper trunk rotated back until the same vertebra; at the end of the range of movement will be applied the high speed and low amplitude impulse (Thrust).</description>
    <arm_group_label>G1 - Thrust manipulation</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>G2 - Muscle Energy</intervention_name>
    <description>Osteopathic manipulation with Muscle Energy technique. The Group 2 (G2) will receive the Muscle Energy technique applied at the level of dysfunction. Subject in lateral decubitus, with the upper and lower trunk flexed until the target vertebra, and upper trunk rotated back to the level of the same vertebra; lumbar in lateral flexion (using the subject's feet) until the target vertebra. Following the command the subject will perform an isometric contraction of 3-5 seconds against the therapist's hand (pushing the hand towards the floor), repeated 3 times.</description>
    <arm_group_label>G2 - Muscle Energy</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Chronic low back pain at least for three months.&#xD;
&#xD;
          -  Low back pain of unknown mechanical origin without irradiation to the lower limbs.&#xD;
&#xD;
          -  Workers with chronic low back pain at least three months.&#xD;
&#xD;
          -  Do not be participating in rehabilitation programs.&#xD;
&#xD;
          -  Do not have practiced regular physical activity in the past 3 months.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Manual therapy treatment in the past 90 days.&#xD;
&#xD;
          -  Discal herniation diagnosis.&#xD;
&#xD;
          -  Lumbar radiculopathy and / or nerve root compression.&#xD;
&#xD;
          -  Lumbar stenosis.&#xD;
&#xD;
          -  Lumbar surgery.&#xD;
&#xD;
          -  Nerve root entrapment.&#xD;
&#xD;
          -  Neurological and endocrine.&#xD;
&#xD;
          -  Osteoporosis.&#xD;
&#xD;
          -  Rheumatoid arthritis.&#xD;
&#xD;
          -  Spinal osteomyelitis.&#xD;
&#xD;
          -  Spondylolysis.&#xD;
&#xD;
          -  Spondylolisthesis.&#xD;
&#xD;
          -  Tumors.&#xD;
&#xD;
          -  Vertebral fracture.&#xD;
&#xD;
          -  No current sports or treatment in Physiotherapy, Pilates Method or Manual Therapy.&#xD;
      </textblock>
    </criteria>
    <gender>Male</gender>
    <minimum_age>35 Years</minimum_age>
    <maximum_age>55 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Rubens da Silva, PhD</last_name>
    <role>Study Director</role>
    <affiliation>Laboratory of Functional Assessment and Human Motor Performance (LAFUP)</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Laboratory of Functional Assessment and Human Motor Performance (LAFUP)</name>
      <address>
        <city>Londrina</city>
        <state>Parana</state>
        <zip>86041-120</zip>
        <country>Brazil</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Brazil</country>
  </location_countries>
  <reference>
    <citation>Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Ann Fam Med. 2013 Mar-Apr;11(2):122-9. doi: 10.1370/afm.1468.</citation>
    <PMID>23508598</PMID>
  </reference>
  <reference>
    <citation>Haas M, Vavrek D, Peterson D, Polissar N, Neradilek MB. Dose-response and efficacy of spinal manipulation for care of chronic low back pain: a randomized controlled trial. Spine J. 2014 Jul 1;14(7):1106-16. doi: 10.1016/j.spinee.2013.07.468. Epub 2013 Oct 16.</citation>
    <PMID>24139233</PMID>
  </reference>
  <reference>
    <citation>Wilder DG, Vining RD, Pohlman KA, Meeker WC, Xia T, Devocht JW, Gudavalli RM, Long CR, Owens EF, Goertz CM. Effect of spinal manipulation on sensorimotor functions in back pain patients: study protocol for a randomised controlled trial. Trials. 2011 Jun 28;12:161. doi: 10.1186/1745-6215-12-161.</citation>
    <PMID>21708042</PMID>
  </reference>
  <reference>
    <citation>Cleland JA, Fritz JM, Childs JD, Kulig K. Comparison of the effectiveness of three manual physical therapy techniques in a subgroup of patients with low back pain who satisfy a clinical prediction rule: study protocol of a randomized clinical trial [NCT00257998]. BMC Musculoskelet Disord. 2006 Feb 10;7:11. doi: 10.1186/1471-2474-7-11.</citation>
    <PMID>16472379</PMID>
  </reference>
  <reference>
    <citation>da Silva RA Jr, Arsenault AB, Gravel D, Lariviere C, de Oliveira E Jr. Back muscle strength and fatigue in healthy and chronic low back pain subjects: a comparative study of 3 assessment protocols. Arch Phys Med Rehabil. 2005 Apr;86(4):722-9. doi: 10.1016/j.apmr.2004.08.007.</citation>
    <PMID>15827924</PMID>
  </reference>
  <reference>
    <citation>Lariviere C, Gagnon D, Loisel P. The comparison of trunk muscles EMG activation between subjects with and without chronic low back pain during flexion-extension and lateral bending tasks. J Electromyogr Kinesiol. 2000 Apr;10(2):79-91. doi: 10.1016/s1050-6411(99)00027-9.</citation>
    <PMID>10699556</PMID>
  </reference>
  <verification_date>September 2018</verification_date>
  <study_first_submitted>November 25, 2016</study_first_submitted>
  <study_first_submitted_qc>December 1, 2016</study_first_submitted_qc>
  <study_first_posted type="Estimate">December 6, 2016</study_first_posted>
  <last_update_submitted>September 5, 2018</last_update_submitted>
  <last_update_submitted_qc>September 5, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">September 7, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Universidade Norte do Paraná</investigator_affiliation>
    <investigator_full_name>Rubens Alexandre da Silva Jr</investigator_full_name>
    <investigator_title>Professor</investigator_title>
  </responsible_party>
  <keyword>Osteopathic Treatment</keyword>
  <keyword>Postural control</keyword>
  <keyword>Neuromuscular activation</keyword>
  <keyword>Physiotherapy</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Back Pain</mesh_term>
    <mesh_term>Low Back Pain</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- 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/NCT02983435
org study id: rubens@unopar.br
nct id: NCT02983435
lead sponsor: 
has dmc: Yes
The relevance of this study is to determine the efficacy of two osteopathic techniques -
      Thrust Technique and Muscle Energy Technique (MET) - in improving of neuromuscular component
      of the trunk and clinical symptoms in adult workers with Chronic Low Back Pain (CLBP). Few
      studies have investigated and compared the physiological responses of these techniques
      quantitatively, and no published study has compared their effects in low back pain subjects
      in terms of symptoms, postural balance and muscle activation. The main outcomes will be
      computed by electromyography measurement so that to assess the trunk neuromuscular activation
      pattern as well as by force platform parameters for determining of postural control. Clinical
      symptoms such as pain intensity, perception of disability and fear and avoidance will also be
      computed.

      This is the first study to compare these two osteopathic techniques using the main biological
      outcomes related to trunk neuromuscular function.
The purpose of this study is to assess the efficacy of two osteopathic techniques (Thrust and
      MET) on CLBP adult workers treatment.

      A total of 15 male participants with chronic low back pain, volunteers, active workers aged
      from 35 to 55 years (in aging process) will be recruited by convenience from the community
      local. All participants will sign an informed consent form approved by the North of Parana
      University Ethics Committee for Research on Human Subjects. The intervention will follow the
      CONSORT recommendations for randomized controlled trials. All baseline testing and evaluation
      will be performed by a blinded evaluator to the study intervention. The sample will be
      randomized in two groups from crossover design: Group #1), which will receive the Thrust
      technique applied at the level of dysfunction; and Group #2, which will receive the Muscle
      Energy Technique, also applied at the level of dysfunction. The allocation will be printed in
      cards by sequentially numbered in opaque envelopes.

      The treatment (intervention) will occur in 2 phases of 3 weeks each one. The participants
      will receive only one of techniques in each phase, and after one rest week (washout) they
      will receive the other technique (crossover), totaling 7 weeks. In this study, both
      techniques will be applied at the lumbar vertebral level that present the dysfunction which
      will be diagnosed in the specific evaluation, performed by two specialized physiotherapists
      in osteopathy. Before and after the manipulation (with Thrust or MET) all participants will
      be evaluated in 2 tasks - bipedal without load and bipedal with load (10% of body mass) - on
      the force platform. Parallel to the tasks, the recording of the measurements of EMG surface
      will be computed to determine the pattern of the trunk neuromuscular activation in amplitude
      of the RMS signal as well as muscle fatigue through the median frequency parameters.

      Before performing the tasks on the force platform, a maximum voluntary isometric contraction
      will be performed for the back (paravertebral) and abdominal (rectus) muscles in order to
      normalize the signal EMG for determining of the level muscular activity during each task
      (with or without load). After the intervention, the immediate and final revaluations will
      include all the used measures in the initial evaluation, such as muscle activation of trunk
      (EMG), balance (force platform), and clinical symptoms of pain (Visual Analogue Scale and
      McGill Short Questionnaire), psychosomatic factors (Fear and Avoidance Believe Questionnaire)
      and disability (Roland Morris Questionnaire).

      For the analysis a two-way ANOVA will be used for each dependent variable to compare the two
      groups (G1 versus G2) in both situations (pre and post-immediate, and after 15 days) in the
      clinical measurements, postural balance and EMG. The size effect also will be computed to
      determine the rate of the changes observed.
allocation: Randomized
intervention model: Crossover Assignment
primary purpose: Treatment
masking: Single (Investigator)
measure: Electromyography measurement - Root Mean Square (RMS)
time frame: Change from baseline muscular activation at 3 weeks, in both phases
description: EMG estimates, Root Mean Square: RMS (in microvolts unit: uV) will be computed to evaluate the back and abdominal activation during the functional task.
measure: Electromyography measurement - Median Frequency (MF)
time frame: Change from baseline muscular activation at 3 weeks, in both phases
description: EMG estimates, Median Frequency: MF (in Hertz: Hz) will be computed to evaluate the back and abdominal activation during the functional task.
measure: Force platform measurement
time frame: Change from baseline muscular activation at 3 weeks, in both phases
description: Force platform measurement during balance performance using centre of pressure measures to assess balance performance.
measure: Visual Analogic Scale
time frame: Change from baseline muscular activation at 3 weeks, in both phases
description: Pain intensity measurement using Visual Analogue Scale (score of 0 to 10 intensity; being 10 of poor score for VAS).
measure: Short Version of Pain Questionnaire McGill
time frame: Change from baseline muscular activation at 3 weeks, in both phases
description: Pain measurement using Short Version of Pain Questionnaire McGill (score 0 to 78; while higher score is determined by poor condition related to pain).
measure: Disability questionnaire
time frame: Change from baseline muscular activation at 3 weeks, in both phases
description: Disability measurement using Roland Morris questionnaire.
measure: Fear-avoidance questionnaire
time frame: Change from baseline muscular activation at 3 weeks, in both phases
description: Fear-avoidance model measurement using Waddell questionnaire related to work and physical activity.
arm group label: G1 - Thrust manipulation
arm group type: Experimental
description: G1 - Thrust manipulation is an osteopathic technique. The Group 1 (G1) will receive the Thrust technique applied at the level of dysfunction. Subject in lateral decubitus, with one lower limb extended and the other in flexion, to the level of the targeted vertebra; upper trunk rotated back until the same vertebra; at the end of the range of movement will be applied the high speed and low amplitude impulse (Thrust).
arm group label: G2 - Muscle Energy
arm group type: Active Comparator
description: G2 - Muscle Energy is a manual therapy technique based in muscular contraction and stretching. The Group 2 (G2) will receive the Muscle Energy technique applied at the level of dysfunction. Subject in lateral decubitus, with the upper and lower trunk flexed until the target vertebra, and upper trunk rotated back to the level of the same vertebra; lumbar in lateral flexion (using the subject's feet) until the target vertebra. Following the command the subject will perform an isometric contraction of 3-5 seconds against the therapist's hand (pushing the hand towards the floor), repeated 3 times.
intervention type: Other
intervention name: G1 - Thrust manipulation
description: Osteopathic manipulation with Thrust technique. The Group 1 (G1) will receive the Thrust technique applied at the level of dysfunction. Subject in lateral decubitus, with one lower limb extended and the other in flexion, to the level of the targeted vertebra; upper trunk rotated back until the same vertebra; at the end of the range of movement will be applied the high speed and low amplitude impulse (Thrust).
arm group label: G1 - Thrust manipulation
intervention type: Other
intervention name: G2 - Muscle Energy
description: Osteopathic manipulation with Muscle Energy technique. The Group 2 (G2) will receive the Muscle Energy technique applied at the level of dysfunction. Subject in lateral decubitus, with the upper and lower trunk flexed until the target vertebra, and upper trunk rotated back to the level of the same vertebra; lumbar in lateral flexion (using the subject's feet) until the target vertebra. Following the command the subject will perform an isometric contraction of 3-5 seconds against the therapist's hand (pushing the hand towards the floor), repeated 3 times.
arm group label: G2 - Muscle Energy
criteria: 
gender: Male
minimum age: 35 Years
maximum age: 55 Years
healthy volunteers: No
last name: Rubens da Silva, PhD
role: Study Director
affiliation: Laboratory of Functional Assessment and Human Motor Performance (LAFUP)
facility: 
country: Brazil
citation: Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP. Osteopathic manual treatment and ultrasound therapy for chronic low back pain: a randomized controlled trial. Ann Fam Med. 2013 Mar-Apr;11(2):122-9. doi: 10.1370/afm.1468.
PMID: 23508598
citation: Haas M, Vavrek D, Peterson D, Polissar N, Neradilek MB. Dose-response and efficacy of spinal manipulation for care of chronic low back pain: a randomized controlled trial. Spine J. 2014 Jul 1;14(7):1106-16. doi: 10.1016/j.spinee.2013.07.468. Epub 2013 Oct 16.
PMID: 24139233
citation: Wilder DG, Vining RD, Pohlman KA, Meeker WC, Xia T, Devocht JW, Gudavalli RM, Long CR, Owens EF, Goertz CM. Effect of spinal manipulation on sensorimotor functions in back pain patients: study protocol for a randomised controlled trial. Trials. 2011 Jun 28;12:161. doi: 10.1186/1745-6215-12-161.
PMID: 21708042
citation: Cleland JA, Fritz JM, Childs JD, Kulig K. Comparison of the effectiveness of three manual physical therapy techniques in a subgroup of patients with low back pain who satisfy a clinical prediction rule: study protocol of a randomized clinical trial [NCT00257998]. BMC Musculoskelet Disord. 2006 Feb 10;7:11. doi: 10.1186/1471-2474-7-11.
PMID: 16472379
citation: da Silva RA Jr, Arsenault AB, Gravel D, Lariviere C, de Oliveira E Jr. Back muscle strength and fatigue in healthy and chronic low back pain subjects: a comparative study of 3 assessment protocols. Arch Phys Med Rehabil. 2005 Apr;86(4):722-9. doi: 10.1016/j.apmr.2004.08.007.
PMID: 15827924
citation: Lariviere C, Gagnon D, Loisel P. The comparison of trunk muscles EMG activation between subjects with and without chronic low back pain during flexion-extension and lateral bending tasks. J Electromyogr Kinesiol. 2000 Apr;10(2):79-91. doi: 10.1016/s1050-6411(99)00027-9.
PMID: 10699556
responsible party type: Principal Investigator
investigator affiliation: Universidade Norte do Paraná
investigator full name: Rubens Alexandre da Silva Jr
investigator title: Professor
mesh term: Back Pain
mesh term: Low Back Pain
sharing ipd: No