Mechanical diagnosis and treatment (MDT) and Manual Therapy (MT) have both demonstrated efficacy in the management of CLBP. The use of a Point of Care (POC) design in this study will allow for comparison of these two treatment modalities in a clinical setting. The purpose of this study is to demonstrate the feasibility of recruiting, enrolling and collecting outcome data on CLBP patients utilizing the POC methodology.
20 new patients entering the chiropractic clinic who meet inclusion criteria including demonstrating a directional preference upon physical examination during their initial evaluation will be recruited. Patients will be queried as to interest and those interested will be consented. Patients will then be randomized utilizing a computer generated randomization chart to receive either MDT or MT delivered in a pragmatic manner. Outcomes will include: Pain (PEG), Quality of Life (PROMIS Global Health Survey (GHS)), psychosocial questions and Self Efficacy (2 Question). Outcomes will be collected at baseline, 4 weeks and 8 weeks post baseline.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Identification of directional preference.
Mechanically based treatment based on taking joint to end range and thrusting or soft tissue manipulation.
Rochester Outpatient Clinic (ROPC) of the Canandaigua VA Medical Center
Rochester, New York, United States
PROMIS Global Health Scale (GHS)
Change in Quality of Life Measure
Time frame: baseline, 4 week and 8 week (assessing change from baseline to 4 weeks and 8 weeks)
PEG (Pain/enjoyment of life/general activity)
Change in Pain
Time frame: baseline, 4 week and 8 week (assessing change from baseline to 4 weeks and 8 weeks)
Fear Avoidance
It's not really safe for a person with my back problem to be physically active (1-5 scale)
Time frame: baseline, 4 week and 8 week (assessing change from baseline to 4 weeks and 8 weeks)
Catastrophizing
I feel that my back pain is terrible and it's never going to get any better (1-5 scale)
Time frame: baseline, 4 week and 8 week (assessing change from baseline to 4 weeks and 8 weeks)
Behavioral Disengagement
Due to my chronic back pain, I no longer engage in activities that are enjoyable and pleasant (1-5 scale\_
Time frame: baseline, 4 week and 8 week (assessing change from baseline to 4 weeks and 8 weeks)
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