THE EFFECTS OF POSITIONING AND ADJUSTING ON THE Z JOINT

描述：（改编自研究者摘要）这是一份“证明 “概念”研究评价腰椎的作用机制， 操纵脊椎按摩疗法的一个基本假设是， 在关节突关节（Z关节）中发展， 结构.这种粘连被认为是减轻分离（间隙） 的Z关节。侧姿势调整被许多人认为是间隙的Z关节， 然而，脊柱前和后的Z关节没有可测量的差异 操纵曾经发表过。本研究的目的是 确定是否可以在L3-S1 Z关节间隙中测量差异， 在腰部区域的侧姿定位期间以及在腰部区域的侧姿定位之前和之后 腰侧姿势脊柱调整。具体而言，本研究将 通过测量评估L3/L4、L4/L5和L5/S1 Z关节的间隙 直接从Z关节的MRI扫描之前和期间定位， 侧面姿态调整和侧面姿态调整前后。开始 本研究将征集健康志愿者（32名女性和32名男性）。的 然后将志愿者随机分为四组：1）中立位置 然后是侧位姿势定位（躯干旋转到受试者的右侧），2） 中立位，然后侧位脊柱调整，然后中立 3）中立位后侧位脊柱调整 然后是侧姿势定位，以及4）中立位置，然后是 中立位（对照组）。将对受试者进行MRI扫描， 初始空档位置和最终位置（或者第二空档位置 位置或侧姿势定位）。每个主题的实验将是 在大约45分钟的时间内进行。三名独立 观察员将接受培训，直接从 核磁共振扫描测量将评估前后 上级和下部关节面之间的尺寸（间隙）。的 观察者将无法获得彼此的结果，而MRI扫描 将被编码，这样观察员将没有受试者信息， 关于任何扫描是治疗前还是治疗后的指示。数据将 分析以确定之前侧和期间侧之间是否存在差异 姿势定位扫描、操作前和操作后扫描以及 对照组这项“概念验证”研究的结果将用于 增加对腰侧姿势作用机制的了解 加强结构性改革如果试验结果显示Z型接头存在间隙， 在操纵之后，下一个合乎逻辑的步骤将是设计， 使用这些相同的方法进行更大规模的临床试验， 侧位调整对急性膝关节炎患者Z关节的影响 然后是慢性腰痛

DESCRIPTION: (adapted from Investigator's abstract) This is a "proof of concept" study evaluating the mechanism of action of lumbar spinal manipulation. A fundamental hypothesis of chiropractic is that adhesions develop in the zygapophysial joints (Z joints) following hypomobility of these structures. Such adhesions are thought to be alleviated by separation (gapping) of the Z joints. Side posture adjusting is thought by many to gap the Z joints, yet no measurable differences of the Z joints before and after spinal manipulation have ever been published. The purpose of this study is to determine if differences can be measured in the L3-S1 Z joint spaces before and during side posture positioning of the lumbar region and also before and after lumbar side posture spinal adjusting. More specifically, this study will evaluate gapping of the L3/L4, L4/L5, and L5/S1 Z joints by taking measurements directly from MRI scans of the Z joints before and during positioning for a side posture adjustment and before and after side posture adjusting. To begin this study, healthy volunteers (32 female and 32 male) will be solicited. The volunteers will then be randomized into one of four groups: 1) neutral position followed by side posture positioning (trunk rotated to the subject's right), 2) neutral position followed by side posture spinal adjusting followed by neutral positioning, 3) neutral position followed by side posture spinal adjusting followed by side posture positioning, and 4) neutral position followed by neutral position (control group). MRI scans will be taken with the subjects in the original neutral position and in the final position (either second neutral position or side posture positioning). The experiments for each subject will be conducted over approximately a forty-five minute period. Three independent observers will be trained to make measurements of the Z joints directly from the MRI scans. The measurements will evaluate the anterior-to-posterior dimensions (gap) between the superior and inferior articular facets. The observers will not have access to the results of one another, and the MRI scans will be coded so that the observers will have no subject information and no indication as to whether any scan is pre- or post-treatment. The data will be analyzed to determine if differences exist between the before and during side posture positioning scans, the pre- and post manipulation scans, and the control group. The results of this 'proof of concept" study will be used to increase understanding of the mechanism of action of the lumbar side posture adjustment. If the results of this trial demonstrate gapping of the Z joints following manipulation, the next logical step would be the design and implementation of larger clinical trials using these same methods to evaluate the effects of side posture adjusting on the Z joints of subjects with acute and then chronic low back pain.