None listed
Conditions
Brief summary
Research shows that neck pain is a significant burden that affects 30-50% of the population every year. Research is also showing that neck pain affects the way people perform movements and perceive their body positions in space. In past studies, our lab group has shown that these effects can be attributed to differences in how individuals with neck pain process sensory information. The current study will examine whether there are differences in how individuals with and without neck pain perform rapid eye movements. These movements are of interest because their control relies on sensory processing in distinct brain regions, and any differences in control may highlight impacted brain regions in those experiencing neck pain. We also want to examine whether chiropractic treatment restores the ability of the brain to integrate eye and upper limb movement performance to levels more typical in healthy individuals. The purpose of the study is to: (1) assess whether SCNP leads to altered function in the brain regions responsible for VOR/COR; (2) determine if chiropractic care, compared with no treatment, is effective in enhancing the capacity for cerebellar plasticity, in individuals with a spinal dysfunction. It is hypothesized that individuals that receive treatment will see measurable changes in outcome measures compared to the control group.
Interventions
The intervention will consist of spinal adjustments which will be either high-velocity, low-amplitude thrusts to the spine or pelvic joints or instrument assisted adjustments as well as myofascial release of associated muscles. Treatment will be personalized to each individual in the treatment arm since individuals may have different areas of associated joint dysfunction and associated myofascial pain. These are standard adjustment techniques used by chiropractors. These adjustment techniques have also previously been used in studies that have investigated the neurophysiological effects of chiropractic care. The entire spine and both sacroiliac joints will be assessed for the presence of spinal dysfunction and adjusted where deemed clinically necessary by a chiropractor over an 8-week period. Associated myofascial pain will be treated by manual myofascial release of “trigger point” areas. The registered chiropractor has been practicing for over 31 years and has the expertise to be providing the intervention in this study. A second chiropractor, with five to ten years of experience, will be available should the primary chiropractor experience illness or injury. The subclinical neck pain (SCNP) treatment group will receive 8 weeks of chiropractic intervention since past work has suggested that 6 to 8 weeks are required to consolidate neural changes. The treatment frequency will be twice per week, tapering off if clinically indicated, at the discretion of the treating chiropractor. Each treatment session will be approximately 20 minutes in duration with the first session being at least 45 minutes, to acquire details about their medical history and perform a physical examination and assessment of areas of spinal dysfunction and associated myofascial findings. The clinical indicators that will be used to assess the function of the spine prior to and after each chiropractic adjustment session will include assessing for tenderness to palpation of the relevant joints, manually palpating for restricted intersegmental range of motion, assessing for palpable asymmetric intervertebral muscle tension, and any abnormal or blocked joint play and end-feel of the joints. All of these biomechanical characteristics are used by chiropractors as clinical indicators of joint dysfunction. Areas of myofascial pain that have local tenderness and refer pain on palpation will be treated by the chiropractor using manually applied trigger point therapy. The chiropractic care will be performed at Ontario Tech University, where the registered chiropractors administering the treatment practice. In order to monitor adherence to the intervention, the chiropractor will provide a report of the number of sessions attended. The healthy (non-SCNP) participants will undergo the outcome measures once, at baseline only. The baseline outcome measures will be compared between the SCNP and healthy groups, to compare neurophysiological differences between SCNP participants and the healthy participants.
Sponsors
Study design
Eligibility
Inclusion criteria
Healthy and neck pain participants must be males and females aged 18 – 35, who are attending Ontario Tech University. Neck pain participants are to have mild-to-moderate neck pain and/or neck stiffness for at least 6 months and not started any treatment in the past 4 weeks or not yet sought treatment, this population is known as subclinical neck pain. Healthy participants are to be free from chronic or recurrent neck, shoulder, or elbow pain and have full pain-free neck and shoulder range of motion for at least 3 months prior to data collection. All participants will be screened for these inclusion and exclusion criteria using the chronic pain grade scale questionnaire (see secondary outcome 3). Individuals must have a score between 1 and 3 (out 4) on the Chronic Pain Grade Scale Questionnaire for time periods when they do experience neck pain, and a history of recurrent neck pain to be eligible for the SCNP group. Healthy participants must have a score of less than 1 on the Chronic Pain Grade scale. Because participants are “subclinical”, not all participants will have a progressed to the point where their pain has led to disability; therefore, to ensure we capture a range of SCNP participants, we plan to include participants’ who scored 1 to 3 on the Chronic Pain Grade scale questionnaire, and/or >30mm for intensity of pain on the visual analog scale. Right-handed individuals will be tested due to known differences in cortical excitability and sensorimotor processing between dominant and non-dominant limbs. Participants who score > +40 on the Edinburgh Handedness Inventory (Deemed right-handed) will be included in this study. Participants that are deemed ambidextrous, but have a strong inclination for right-hand dominance will also be included in the study. The SCNP participants will also screened by a registered chiropractor to ensure that they have a spinal joint dysfunction(s).
Exclusion criteria
SCNP participants (control or intervention group) must not have any contraindications to spinal adjustments, such as spinal instability, recurrent dizziness or vertigo, hypertension or upper limb radiculopathy. Participants cannot have any neurological conditions that are known to impact neural function and/or neural processing (e.g. multiple sclerosis, stroke, Parkinson’s etc.). All participants will be screened for these inclusion and exclusion criteria using a safety screening checklist. Left-handed participants will be excluded from the study (I.e. < -40 on the Edinburgh Handedness Inventory) due to known differences in neural processing in these individuals.