None listed
Conditions
Brief summary
Health in early life has a profound impact on health and quality of life in later years. Up to 75% of adolescents have experienced back pain with children and adolescents more likely to have recurrent pain in adulthood that may develop into disabling psychological distress and illness behaviour. Chiropractors treat adolescents with low back pain primarily using various forms of spinal manipulation. However, there is no high quality evidence to support or refute the effectiveness of chiropractic, or other manual approaches, for back pain in adolescents. There is also no agreement on what is thought to be the “best” approach for chiropractors to care for adolescents with non-specific low back pain. Hence, we undertook a Delphi study to construct a best chiropractic practice guideline for adolescent low back pain which we intend to administer in a randomised controlled trial. The objectives of this study are to: examine the feasibility of implementing a protocol of best practice chiropractic care for adolescents with non-specific low back pain; and undertake a pilot study of a randomised trial of chiropractic care for non-specific low-back pain in adolescents to examine the feasibility of conducting a fully powered randomised trial.
Interventions
Chiropractic group: the chiropractic care protocol will be semi-standardised, involving both fixed components and any other treatment the chiropractors deem necessary. The fixed components have been derived from a Delphi study undertaken to identify elements of best chiropractic practice for adolescent low back pain, and comprise: spinal manipulation in the lumbo-pelvic area; mobilisation in the lumbo-pelvic area; advice to stay active; advice about modification of activities; and recommending b
Chiropractic group: the chiropractic care protocol will be semi-standardised, involving both fixed components and any other treatment the chiropractors deem necessary. The fixed components have been derived from a Delphi study undertaken to identify elements of best chiropractic practice for adolescent low back pain, and comprise: spinal manipulation in the lumbo-pelvic area; mobilisation in the lumbo-pelvic area; advice to stay active; advice about modification of activities; and recommending back-specific exercises and general exercise. The chiropractors will be encouraged to use all of the fixed components in each consultation, but may use their discretion whether they are used on a particular patient or not. Four treatments will provided to each participant. The initial consultation will include a detailed medical history assessment and will last for about one hour. The three subsequent treatments, spaced at weekly intervals, will last for about 20-30 minutes.
Sponsors
Murdoch University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
13 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
Young people will be eligible to participate in the pilot study if they meet the following criteria: aged between 13 and 17 years (inclusive) who have experienced non-specific low back pain once a week for at least 6 weeks; and have a NRS for low back pain of 3 out of 10 on the day that baseline measures are collected
Exclusion criteria
Young people will be excluded if they meet any of the following exclusion criteria: known pathology causing their low back pain (for example, fracture, spinal infection, neoplastic disorders); clinical signs and symptoms of a lumbar disc herniation; a history of spinal surgery; not fluent and/or literate in the English language; currently receiving care for low-back pain from any other healthcare provider; unable to consent to treatment. Young people will also be excluded if they have previously received manipulation, as previous experience of manipulation may affect successfully maintaining blinding. If eligible informed consent will be obtained.
Outcome results
None listed