Format

Send to:

Choose Destination
See comment in PubMed Commons below
Spine J. 2015 Apr 1;15(4):570-6. doi: 10.1016/j.spinee.2014.10.016. Epub 2014 Oct 22.

Clinician proficiency in delivering manual treatment for neck pain within specified force ranges.

Author information

  • 1Palmer Center for Chiropractic Research, Palmer College of Chiropractic, 741 Brady Street, Davenport, IA 52803, USA. Electronic address: Gudavalli_r@palmer.edu.
  • 2Palmer Center for Chiropractic Research, Palmer College of Chiropractic, 741 Brady Street, Davenport, IA 52803, USA.
  • 3Department of Orthopaedic Surgery & Rehab, Loyola University Stritch School of Medicine, 2160 S. First Avenue, Maywood, IL 06153, USA.

Abstract

BACKGROUND CONTEXT:

Neck pain is a common musculoskeletal complaint responsive to manual therapies. Doctors of chiropractic commonly use manual cervical distraction, a mobilization procedure, to treat neck pain patients. However, it is unknown if clinicians can consistently apply standardized cervical traction forces, a critical step toward identifying an optimal therapeutic dose.

PURPOSE:

To assess clinicians' proficiency in delivering manually applied traction forces within specified ranges to neck pain patients.

STUDY DESIGN:

An observational study nested within a randomized clinical trial.

SAMPLE:

Two research clinicians provided study interventions to 48 participants with neck pain.

OUTCOME MEASURES:

Clinician proficiency in delivering cervical traction forces within three specified ranges (low force, less than 20 N; medium force, 21-50 N; and high force 51-100 N).

METHODS:

Participants were randomly allocated to three force-based treatment groups. Participants received five manual cervical distraction treatments over 2 weeks while lying prone on a treatment table instrumented with force sensors. Two clinicians delivered manual traction forces according to treatment groups. Clinicians treated participants first without real-time visual feedback displaying traction force and then with visual feedback. Peak traction force data were extracted and descriptively analyzed.

RESULTS:

Clinicians delivered manual cervical distraction treatments within the prescribed traction force ranges 75% of the time without visual feedback and 97% of the time with visual feedback.

CONCLUSIONS:

This study demonstrates that doctors of chiropractic can successfully deliver prescribed traction forces while treating neck pain patients, enabling the capability to conduct force-based dose response clinical studies.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01765751.

Copyright © 2015 Elsevier Inc. All rights reserved.

KEYWORDS:

Biomechanics; Chiropractic; Clinician training; Dose; Manual therapy; Mobilization; Neck pain; Traction forces

PMID:
25452013
[PubMed - indexed for MEDLINE]
PMCID:
PMC4375060
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Write to the Help Desk