None listed
Conditions
Brief summary
Pilot study about effectiveness of LIFT OFF manipulation applied to T12-L1 for lumbar ROM and pain in subject with non-specific acute and subacute low back pain. Low back pain is painful manifestation with high incidence and prevalence mainly in the western world. Some guidelines suggest that the majority of patients have spontaneous recovery in the first months of onset but according to Itz CJ et al (review 2012) there is a large proportion of subjects who still experience pain after a year. It is therefore necessary to focus the research by targeting these patients in order to avoid the chronicity of low back disorders. There are several examples of studies that have compared rehabilitative and manipulative interventions, but so far we have not yet identified the most effective intervention. There are no more in-depth literature regarding the immediate effect of manipulation in LIFT OFF of the dorsolumbar hinge often involved in the painful manifestations of these subjects. The high-velocity low-amplitude (HVLA) manipulation on the dorsolumbar spine hinge, also called LIFT-OFF, consists of a mechanical stimulation at the facet joints T12-L1 in anteroposterior direction. This technique is often used by physical therapists and osteopaths but needs support to indicate it as an elective treatment for subjects with non-specific acute and subacute low back pain. A clinical case study described a patient with thoraco-lumbar hinge syndrome with low back and posterior iliac crests pain, confirming the possible implication.
Interventions
From TIDieR:
1. Lift off thrust on T12-L1;
2. T12-L1 crucial sensation and movement area in subject affected by low back pain. The target is to stimulate this area and to improve lumbar ROM and pain;
3. an electric cot for therapies (height adjustable) maximum width 65 cm; digital algometer to assess PPT
4. test and treatment: m-Scober test, fingertip-to-floor distance (FDD), NRS are given to subjects; after which each subject sits on the end of the cot with legs on the sides. The therapist stan
From TIDieR: 1. Lift off thrust on T12-L1; 2. T12-L1 crucial sensation and movement area in subject affected by low back pain. The target is to stimulate this area and to improve lumbar ROM and pain; 3. an electric cot for therapies (height adjustable) maximum width 65 cm; digital algometer to assess PPT 4. test and treatment: m-Scober test, fingertip-to-floor distance (FDD), NRS are given to subjects; after which each subject sits on the end of the cot with legs on the sides. The therapist stands behind him. The subject puts his open hands on the T12 area. The therapist's thorax makes contact with the subject's palms, his arms pass through patients arms, and his palms make contact with subject's thorax. The patient flexes forward his head and trunk, and at the end the therapist applies posterior-anterior impulse in a high velocity and low amplitude way; then the subject is reassessed with m-Scober test, fingertip-to-floor distance (FDD), NRS. 5. therapist: always a Physical Therapist with an upgrade in Osteopathy and at least 10 years experience 6. the valuator is blind concerning subject group and while he performs the assessment, he doesn't know the aim of the study. The therapist obviously is not blind and waits in other room during the assessment, he performs the manipulation one subject at a time. 7. each session is carried out in a Physical Therapist's private practice in Udine, Italy 8. the intervention is delivered only once if the manipulation is successful, a maximum of three times if the manipulation was not successful at the first or second attempt. The assessment is always carried out three times and an average of the three is calculated
Sponsors
Simone Milocco
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
non-specific acute and subacute low back pain
Exclusion criteria
- lumbar stabilization surgery - inflammatory/metabolic diseases (diabetes, ankylosing spondylitis, Paget's disease, sarcoidosis, arachnoiditis) - direct or indirect trauma that foresees risk of injury to the structural integrity - suspected tumors or suspected weight losses - disc herniations and irradiation (lasegue and braggard positives) - osteopathic treatment in the last 3 months
Outcome results
None listed