None listed
Conditions
Brief summary
Individuals with persistent post-concussion symptoms, such as headache or dizziness, are thought to be from a dysfunctional stress response. There are two components involved in regulating the human stress response, the autonomic nervous system and hypothalamic pituitary adrenal-axis. We have termed this the peripheral stress response. Manual therapy applied to the cervical spine is a common treatment technique performed by physiotherapists. Evidence has shown that cervical spine manual therapy can modulate the autonomic nervous system and hypothalamic pituitary adrenal-axis in isolation, and as a collective. This modulation can occur in either direction, either and increase or decrease. To date, no study has investigated the physiological response of cervical spine manual therapy on both components of a dysfunctional peripheral stress response, or whether there is a differential physiological response depending on the location of the cervical spine manual therapy in individuals with a dysfunctional peripheral stress response.
Interventions
Cervical spine mobilization manual therapy technique
-Parallel arm 1-Upper cervical spine mobilization applied to C0-1 and C1-2 for 3 lots of 2 minutes each, separated by a 30 second rest.
-Parallel arm 2-Lower cervical spine mobilization applied to C6-7 and C7-T1 for 3 lots of 2 minutes each, separated by a 30 second rest.
Each mobilization will be low frequency, mid-range, bilateral and alternating oscillations.
All interventions will be performed by the same operator (New Zealand registered p
Cervical spine mobilization manual therapy technique -Parallel arm 1-Upper cervical spine mobilization applied to C0-1 and C1-2 for 3 lots of 2 minutes each, separated by a 30 second rest. -Parallel arm 2-Lower cervical spine mobilization applied to C6-7 and C7-T1 for 3 lots of 2 minutes each, separated by a 30 second rest. Each mobilization will be low frequency, mid-range, bilateral and alternating oscillations. All interventions will be performed by the same operator (New Zealand registered physiotherapist with a Masters degree in orthopaedic manipulative therapy), face to face, and on an individual basis. Each participant will be randomised to either arm 1 (upper cervical mobilization) or arm 2 (lower cervical mobilization). Each intervention will be held in the same room at the School of Physiotherapy, University of Otago, Dunedin, New Zealand. This trial is performing a one-off intervention. If a participant does not attend their intervention session, their data will not be included. Therefore, monitoring adherence to the intervention is not applicable.
Sponsors
Gerard Farrell
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
Male
Age
19 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
Males with a diagnosis of persistent post-concussion symptoms aged between 19-35 years old who own an iPhone.
Exclusion criteria
Participants will be excluded if they are: -Asymptomatic. -Unable to refrain from external treatment (treatment session in person or online) or change in treatment (progression or modification of existing treatment) for three consecutive days, specifically days five to seven (out of eight), so the intervention can be performed, and salivary samples collected (primary outcome). -Confounding factors to the outcome measurements. These include; Serious medical or psychiatric disorder; co-morbid musculoskeletal or serious conditions which may confound treatment or anticipated recovery; NSAIDs use; recent steroid injections; currently have an endocrine, central nervous system, cardiovascular, or a mental health disorder; systemic glucocorticoid or cardioactive medication; serotonin-norepinephrine reuptake inhibitors; moderate to severe traumatic brain injury. Note, Participants prescribed with psychotropic medication for treatment of concussion-related symptoms (e.g., headache and migraine) will be permitted to be enrolled in the study provided they are not prescribed serotonin-norepinephrine reuptake inhibitors (e.g., desvenlafaxine, venlafaxine, duloxetine, etc.) given their impact on autonomic function. -Contra-indications to the intervention. If any precautions to manual therapy are present, participants will be excluded on a case-by-case basis.
Outcome results
None listed