A Comparison of Manual VS. Mechanical Chiropractic Manipulation Methods

手动与手动的比较。

• 批准号: 8290077
• 负责人: MICHAEL J SCHNEIDER
• 金额: $ 24.71万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8290077
• 关键词: Adherence; Advertising; Back; Belief; Chiropractic manipulation; Clinical; Clinical Trials; Clinical effectiveness; Effectiveness; Enrollment; Exercise; Expectancy; Frequencies; Fright; Future; Literature; Location; Low Back Pain; Mails; Manuals; Mechanics; Mediator of activation protein; Medical; Methods; Minority; Modeling; Outcome; Outcome Measure; Pain; Participant; Patients; Pharmaceutical Preparations; Procedures; Questionnaires; Randomized; Recruitment Activity; Reporting; Research; Review Literature; Sample Size; Spinal; Spinal Manipulation; Visit; chiropracty; comparative effectiveness; cost effective; design; disability; effective therapy; expectation; follow-up; instrument; interest; primary outcome; randomized trial; research study; secondary outcome; success; systematic review; treatment effect

This Study will be a small randomized trial (n=40 per group) comparing the clinical effectiveness of mechanical instrument assisted manipulation (MIAM) with traditional manual thrust manipulation (MTM) for the treatment of low back pain (LBP). Systematic reviews of the literature have described at least 42 randomized trials using spinal manipulation as a treatment for LBP, the majority of which utilized some variety of MTM but no high quality studies utilizing MIAM. This trial mil explore the differences in clinical effectiveness of these two manipulative methods for LBP. Eighty patients with a new onset of LBP within the past 12 weeks will be recruited and randomized into two groups; treatment with MTM or treatment with MIAM. ITie treatment frequency will be twice per week for 4 weeks (8 visits in total). Outcome measures will be gathered at 4,12, and 24 weeks. The primary outcome measure will be the Oswestry Disability Questionnaire (ODQ) score at 4-weeks. The secondary outcome measure will be the Numeric Pain Rating Scale (NPRS). Other secondary variables of interest will include treatment expectancy for each type of manipulation, fear-avoidance beliefs score, and presence of predictor variables from previously validated clinical prediction rules associated with manipulation and stabilization exercise successes. The primary analysis will be a generalized Imear regression model with 6-week ODQ score as the dependent variable and treatment group as the key independent variable; while controlling for baseline randomization variables and treatment expectation scores as covariates in the model. The secondary analysis will be a shnilar regression model using NPRS score as the dependent variable. The key aims of this study are; (1) to acquire infonnation that will be used to design a large clinical trial (ROl) on the comparative effectiveness of different types of spinal manipxUation and to determine its feasibility, and (2) to obtain parameter estimates of effect sizes and explore potential confounders or treatment effect mediators for the future larger trial.

这项研究将是一项小型随机试验（每组n = 40个），比较 机械仪器辅助操作（MIAM），并使用传统的手动推力操纵（MTM） 腰痛（LBP）的治疗。文献的系统评价至少描述了42 使用脊柱操纵作为LBP的随机试验，其中大多数利用了一些 MTM种类繁多，但没有使用迈阿密的高质量研究。该试验探索了临床的差异 LBP的这两种操纵方法的有效性。 过去12周内有80名LBP发作的患者将被招募并随机分为 两组；用MTM治疗或用迈姆治疗。 ITIE治疗频率每周两次 4周（总共8个访问）。结果指标将在4,12和24周收集。 主要结果度量将是4周的OSWESTRY残疾问卷（ODQ）得分。 次要结果度量将是数字疼痛评级量表（NPRS）。其他次要变量 兴趣将包括每种操纵类型的预期率，避免恐惧的信念得分和 与先前验证的临床预测规则相关的预测变量存在 操纵和稳定运动成功。 主要分析将是一个概括为6周ODQ评分的广义IMEAR回归模型 因变量和治疗组作为关键自变量；在控制基线的同时 随机变量和治疗期望得分作为模型中的协变量。次要分析 将是使用NPRS得分作为因变量的Shnilar回归模型。 这项研究的主要目的是： （1）获取将用于设计大型临床试验的信息 （ROL）关于不同类型的脊柱操作的比较有效性，并确定其 可行性，（2）获得效应大小的参数估计并探索潜在的混杂因素或治疗 对未来大型试验的效果调解人。

项目成果

The association of biomarkers with pain and function in acute and subacute low back pain: a secondary analysis of an RCT.

• DOI: 10.1186/s12891-022-06027-9
• 发表时间: 2022-12-05
• 期刊: BMC MUSCULOSKELETAL DISORDERS
• 影响因子: 2.3
• 作者: Tonelli Enrico, Valerio;Schneider, Michael;Haas, Mitchell;Vo, Nam;Huang, Wan;McFarland, Christine;Weber, Nick;Sowa, Gwendolyn
• 通讯作者: Sowa, Gwendolyn