Cardiovascular Response to Two Manual Techniques for Neck Pain

NCT ID: NCT02198677

Last Updated: 2016-01-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-07-31

Study Completion Date

2016-07-31

Brief Summary

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The aim of the investigators study is to investigate whether posteriorly directed (AP) pressures and laterally directed (LAT) glides, cause blood pressure and heart rate elevation or lowering in patients with neck pain. The answer will advance the investigators understanding of why manual therapy works.

Detailed Description

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To be included in the study, these subjects with unilateral non-traumatic, non-chronic neck pain (operationally defined as neck pain with mobility deficits lasting less than 3 months) shall have numeric pain rating scale (NPRS) of between 0 and 5 out of 10 as the most painful neck movement even with passive scapular elevation, neck disability index (NDI) of between 16 and 50 out of 100%, resting systolic and diastolic blood pressure between 90/60 and 138/88, and resting heart rate between 60 and 90. Subjects are excluded if they are current smoker, over 50 years of age, has a history of fainting spells or loss of consciousness, is on blood thinners, is taking medications for or have a history of diabetes mellitus, neurologic or cardiovascular disease, has a history of spinal surgeries, and has neck pain classified or associated with headache, radiating pain, and movement coordination impairments. A convenience sample of subjects will be randomly allocated to 1 of 2 groups. Both Group 1: AP and Group 2: LAT will receive posterior pressures and lateral glides respectively to one hypomobile segment. Baseline NPRS, and NDI will be collected at the initial visit. Systolic blood pressure (SBP) and heart rate (HR) will be measured with a OMRON automatic monitor recording time points: (1) 5 minutes, and (2) 7 minutes after lying supine; (3) during the 1st set, (4) 5th set of one of the glides, (5) 2 minutes after time point #4, and (6) 4 minutes after time point #4. After time point #6, a global rating of change (GROC) will immediately be collected based on the most painful neck movement. A finger pulse oximeter will be placed on the subjects' index finger to constantly monitor their pulse rate for slowing heart rate or asystole. The primary author will perform one of the techniques on all subjects. After one visit, a follow-up NPRS, and NDI will be collected again.

Conditions

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Neck Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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AP

Anterior to posterior pressures 5x10 seconds per set with 10 seconds rest between each set

Group Type EXPERIMENTAL

Anterior to posterior pressures

Intervention Type PROCEDURE

Anterior to posterior pressures

Lateral glides

Lateral glides 5x10 seconds per set with 10 seconds rest between each set

Group Type EXPERIMENTAL

Lateral glide

Intervention Type PROCEDURE

Lateral glide

Interventions

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Anterior to posterior pressures

Anterior to posterior pressures

Intervention Type PROCEDURE

Lateral glide

Lateral glide

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Unilateral, non-traumatic, non-chronic mechanical neck pain
* Numeric pain rating scale between 0-5/10 as the most painful neck movement (with passive scapular elevation)
* Neck Disability Index between 16-50/100 percent
* Resting blood pressure between 90/60 and 138/88 mmHg
* Resting heart rate between 60 and 90 beats per minute

Exclusion Criteria

* Current smoker
* Under 18 years and over 50 years of age
* History of fainting spells or loss of consciousness
* Currently on blood thinners
* Taking medications for or have a history of diabetes mellitus, neurologic or cardiovascular disease
* History of spinal surgery
* Has neck pain classified or associated headache, arm pain, trauma/whiplash
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Azusa Pacific University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael Wong, DPT

Role: PRINCIPAL_INVESTIGATOR

Azusa Pacific University

Emmanuel Yung, DPT

Role: PRINCIPAL_INVESTIGATOR

Sacred Heart University

Locations

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Physical Therapy Department

Azusa, California, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Michael Wong, DPT

Role: CONTACT

909 379 5433

Facility Contacts

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Michael Wong, DPT

Role: primary

References

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Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, Sopky BJ, Godges JJ, Flynn TW; American Physical Therapy Association. Neck pain: Clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2008 Sep;38(9):A1-A34. doi: 10.2519/jospt.2008.0303. Epub 2008 Sep 1.

Reference Type BACKGROUND
PMID: 18758050 (View on PubMed)

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977 Mar;33(1):159-74.

Reference Type BACKGROUND
PMID: 843571 (View on PubMed)

Bruehl S, Dengler-Crish CM, Smith CA, Walker LS. Hypoalgesia related to elevated resting blood pressure is absent in adolescents and young adults with a history of functional abdominal pain. Pain. 2010 Apr;149(1):57-63. doi: 10.1016/j.pain.2010.01.009. Epub 2010 Feb 1.

Reference Type RESULT
PMID: 20122805 (View on PubMed)

Hurwitz EL, Morgenstern H, Vassilaki M, Chiang LM. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine (Phila Pa 1976). 2005 Jul 1;30(13):1477-84. doi: 10.1097/01.brs.0000167821.39373.c1.

Reference Type RESULT
PMID: 15990659 (View on PubMed)

Knutson GA. Significant changes in systolic blood pressure post vectored upper cervical adjustment vs resting control groups: a possible effect of the cervicosympathetic and/or pressor reflex. J Manipulative Physiol Ther. 2001 Feb;24(2):101-9. doi: 10.1067/mmt.2001.112564.

Reference Type RESULT
PMID: 11208222 (View on PubMed)

Krediet CT, Jardine DL, Wieling W. Dissection of carotid sinus hypersensitivity: the timing of vagal and vasodepressor effects and the effect of body position. Clin Sci (Lond). 2011 Nov;121(9):389-96. doi: 10.1042/CS20100607.

Reference Type RESULT
PMID: 21595633 (View on PubMed)

Lidegaard O, Lokkegaard E, Jensen A, Skovlund CW, Keiding N. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med. 2012 Jun 14;366(24):2257-66. doi: 10.1056/NEJMoa1111840.

Reference Type RESULT
PMID: 22693997 (View on PubMed)

Lidegaard O, Nielsen LH, Skovlund CW, Skjeldestad FE, Lokkegaard E. Risk of venous thromboembolism from use of oral contraceptives containing different progestogens and oestrogen doses: Danish cohort study, 2001-9. BMJ. 2011 Oct 25;343:d6423. doi: 10.1136/bmj.d6423.

Reference Type RESULT
PMID: 22027398 (View on PubMed)

McGuiness J, Vicenzino B, Wright A. Influence of a cervical mobilization technique on respiratory and cardiovascular function. Man Ther. 1997 Nov;2(4):216-220. doi: 10.1054/math.1997.0302.

Reference Type RESULT
PMID: 11440535 (View on PubMed)

Puentedura EJ, Cleland JA, Landers MR, Mintken PE, Louw A, Fernandez-de-Las-Penas C. Development of a clinical prediction rule to identify patients with neck pain likely to benefit from thrust joint manipulation to the cervical spine. J Orthop Sports Phys Ther. 2012 Jul;42(7):577-92. doi: 10.2519/jospt.2012.4243. Epub 2012 May 14.

Reference Type RESULT
PMID: 22585595 (View on PubMed)

Van Dillen LR, McDonnell MK, Susco TM, Sahrmann SA. The immediate effect of passive scapular elevation on symptoms with active neck rotation in patients with neck pain. Clin J Pain. 2007 Oct;23(8):641-7. doi: 10.1097/AJP.0b013e318125c5b6.

Reference Type RESULT
PMID: 17885341 (View on PubMed)

Egwu MO. Relative therapeutic efficacy of some vertebral mobilization techniques in the management of unilateral cervical spondylosis: a comparative study. Journal of Physical Therapy and Science. 2008;20:103-8.

Reference Type RESULT

Other Identifiers

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AP vs LAT

Identifier Type: -

Identifier Source: org_study_id

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