Efficacy of Osteopathic Manipulative Medicine (OMM) and Phototherapy for Patients With Chronic Lower Back Pain

NCT ID: NCT01765777

Last Updated: 2024-08-06

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 48 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-06-30
• Study Completion Date: 2025-12-31

Brief Summary

The purpose of the research study entitled "Efficacy of Osteopathic Manipulative Medicine (OMM) and Phototherapy for Patients with Chronic Lower Back Pain" is to investigate the hypothesis that combined treatment with both osteopathic manipulative medicine (OMM) and phototherapy will provide greater pain relief for patients with chronic lower back pain, as compared with standard medical management or either treatment alone.

Detailed Description

The research has demonstrated separately that phototherapy and osteopathic manipulative medicine (OMM) are effective in reducing chronic low back pain, However there has not been any research to evaluate whether the interaction of the two treatment approaches together can provide enhanced pain relief. In A Meta-analysis of the Efficacy of Phototherapy in Tissue Repair, Fulop et.al.(1) from the Department of Physical Therapy, School of Health Professions, New York Institute of Technology (NYIT) concluded that "phototherapy is a highly effective form of treatment for tissue repair, with stronger supporting evidence resulting from experimental animal studies than human studies" (Fulop, p. 695, 699). Further review of the literature by Fulop et. al. (2) focused on the question of pain relief in relation to phototherapy, and the conclusion was that pain from various etiologies can be effectively relieved by phototherapy. The U.S. Food and Drug Administration has cleared biostimulation lasers (a.k.a. low level laser therapy [LLLT], cold lasers, soft lasers, or laser acupuncture devices) for marketing as "adjunctive devices for the temporary relief of pain" (3). Thus, both health practitioners and the lay public have access to and may potentially obtain and use phototherapy devices manufactured by various companies. Other research protocols by Gur, A et. al. (4) and Djavid, GE et. al. (5) evaluated patients with chronic low back pain in relation to the combined effectiveness of low level laser therapy and exercise. These studies showed positive results with the combined approaches.

Osteopathic physicians utilize an approach to the treatment of patients called osteopathic manipulative medicine (OMM). The osteopathic physician will diagnose somatic dysfunction, and then treat the dysfunctions found with one or more of several OMM treatment approaches. The American Osteopathic Association (AOA) published in 2009 the "Guidelines for Osteopathic Manipulative Treatment (OMT) for Patients with Low Back Pain." These guidelines are available both through the AOA and the Agency for Healthcare Research and Quality (AHRQ), National Guideline Clearinghouse (6). This guideline (6) specifically addresses the "efficacy of osteopathic manipulation treatment in reducing low back pain" (p. 2). A review of the literature was performed, and after selection a total of "six trials, involving eight osteopathic manipulative treatment (OMT) vs control treatment comparisons, were included" in the meta-analysis (p. 2-3). The major recommendation stated in the guideline is that "osteopathic manipulative treatment (OMT) be utilized by osteopathic physicians for musculoskeletal causes of back pain, i.e., to treat the diagnoses of somatic dysfunctions related to the low back pain" (p.4). In addition, the meta-analysis performed did show that OMT for patients with low back pain led to statistically significant reduction in pain (p. 5). Thus, the potential for a complementary approach to patient care in cases of chronic low back pain exists. Yet, no studies to date have specifically evaluated this particular hypothesis regarding OMT and phototherapy for patients with chronic low back pain. The purpose of this research is to evaluate this question of enhanced combined efficacy for the overall benefit of patients.

Conditions

Chronic Lower Back Pain

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Control Group

Subjects in this arm continue with standard medical care

Group Type: NO_INTERVENTION

No interventions assigned to this group

Osteopathic Manipulative Medicine Group

Subjects in this arm will receive an OMM intervention.

Group Type: EXPERIMENTAL

Osteopathic Manipulative Medicine

Intervention Type: PROCEDURE

Phototherapy Group

Subjects in this arm will receive a phototherapy intervention.

Group Type: EXPERIMENTAL

Phototherapy

Intervention Type: PROCEDURE

OMM and Phototherapy Group

Subjects in this arm will receive both the OMM and phototherapy interventions.

Group Type: EXPERIMENTAL

Osteopathic Manipulative Medicine

Intervention Type: PROCEDURE

Phototherapy

Intervention Type: PROCEDURE

Interventions

Osteopathic Manipulative Medicine

Intervention Type: PROCEDURE

Phototherapy

Intervention Type: PROCEDURE

Other Intervention Names

OMM,OMT; Low level laser therapy; LLLT

Eligibility Criteria

Inclusion Criteria

• Age range: 18 - 65 years old
• Subjects with constant or intermittent nonspecific lower back pain for a minimum of three (3) months duration.

Exclusion Criteria

• Prospective subjects with a diagnosis of the following potential underlying causes of lower back pain: ankylosing spondylitis, cancer or a history of a histologically demonstrated malignant carcinoma, cauda equine syndrome, herniated disc, spinal fracture, or spinal osteomyelitis.
• Prospective subjects who have undergone surgery of the lower back in the preceding three (3) months.
• Prospective subjects who have received worker's compensation in the preceding three (3) months, or are involved in litigation involving concerns of lower back.
• Prospective subjects who are pregnant.
• Prospective subjects who have been a patient receiving any osteopathic manipulative medicine (OMM) treatment at the clinical trial site in the previous three (3) months, or on greater than three (3) occasions in the preceding year.
• Prospective subjects who have ever been an employee at the clinical trial site.
• Prospective subjects who have received spinal manipulation in the previous three (3) months, or on greater than three (3) occasions in the preceding year.
• Prospective subjects who are currently involved in a physical therapy rehabilitation program.
• Prospective subjects who have photosensitivity.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

New York Institute of Technology

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Patricia S Kooyman, D.O.

Role: PRINCIPAL_INVESTIGATOR

New York Institute of Technology

Locations

New York Institute of Technology

Old Westbury, New York, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Patricia S Kooyman, D.O.

Role: CONTACT

pkooyman@nyit.edu

516-686-1309

Peter Douris, PT,DPT, EdD

Role: CONTACT

pdouris@nyit.edu

516-686-7688

Facility Contacts

Hallie Zwibel, D.O

Role: primary

hzwibel@nyit.edu

516-686-3771

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Other Identifiers

BHS-740

Identifier Type: -

Identifier Source: org_study_id