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The Palmer Center for Chiropractic Research conducts studies at facilities on each Palmer campus, including the William and Jo Harris Building on the Davenport Campus.
William and Jo Harris Building

Publishing the detailed protocol of a controlled clinical trial (CCT) in a peer-reviewed journal is becoming the standard. Investigators at the Palmer Center for Chiropractic Research (PCCR) recently published the following protocol of a CCT conducted in the Palmer Research Clinic at the Davenport Campus. The research team involved members of the PCCR clinic and biomechanics cores, the Office of Data Management and Biostatistics and the Office of Clinical Studies in collaboration with the University of Iowa. The research study was funded by grant number 1U19AT004137 at the National Institutes of Health. The full article can be accessed at www.trialsjournal. com (Wilder et al. Trials 2011, 12:161). This article has been designated as “highly accessed,” indicating that it is among the most viewed articles on BioMed Central.

Effect of spinal manipulation on sensorimotor functions in back pain patients: study protocol for a randomised controlled trial

AUTHORS: David G. Wilder, PhD, Robert D. Vining, DC, Katherine A. Pohlman, DC, MS, William C. Meeker, DC, MPH, Ting Xia, PhD, James W. DeVocht, DC, PhD, R. Maruti Gudavalli, PhD, Cynthia R. Long, PhD, Edward F. Owens, MS, DC, Christine M. Goertz, DC, PhD  

Background

Low back pain (LBP) is a recognized public health problem, impacting up to 80 percent of U.S. adults at some point in their lives. Patients with LBP are utilizing integrative health care such as spinal manipulation (SM). SM is the therapeutic application of a load to specific body tissues or structures and can be divided into two broad categories: SM with a high-velocity low-amplitude load, or an impulse “thrust” (HVLA-SM), and SM with a lowvelocity variable-amplitude load (LVVA-SM). There is evidence that sensorimotor function in people with LBP is altered. This study evaluates the sensorimotor function in the lumbopelvic region, as measured by postural sway, response to sudden load and repositioning accuracy, following SM to the lumbar and pelvic region, when compared to a sham treatment.

Methods/Design

A total of 221 participants with acute, subacute or chronic low back pain were recruited from the Quad Cities area located in Iowa and Illinois. They were allocated through a minimization algorithm in a 1:1:1 ratio to receive either 13 HVLA-SM treatments over six weeks, 13 LVVA-SM treatments over six weeks, or two weeks of a sham treatment followed by four weeks of full spine “doctor’s choice” SM. Sensorimotor function tests were performed before and immediately after treatment at baseline, week two and week six. Self-report outcome assessments were also collected. The primary aims of this study are to: 1) determine immediate pre- to post-changes in sensorimotor function as measured by postural sway following delivery of a single HVLA-SM or LVVA-SM treatment when compared to a sham treatment; and 2) to determine changes from baseline to two weeks (four treatments) of HVLA-SM or LVVA-SM compared to a sham treatment. Secondary aims include changes in response to sudden loads and lumbar repositioning accuracy at these endpoints, estimating sensorimotor function in the SM groups after six weeks of treatment, and exploring if changes in sensorimotor function are associated with changes in self-report outcome assessments.

Discussion

This study may provide clues to the sensorimotor mechanisms that explain observed functional deficits associated with LBP, as well as the mechanism of action of SM.

Trial registration

This trial is registered in ClinicalTrials.gov, with the ID number of NCT00830596, registered on 27 January 2009. The first participant was allocated on 30 January 2009, and the final participant was allocated on 17 March 2011.

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