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Trial registered on ANZCTR


Trial ID
ACTRN12614000987662
Ethics application status
Approved
Date submitted
28/08/2014
Date registered
15/09/2014
Date last updated
22/01/2018
Type of registration
Retrospectively registered

Titles & IDs
Public title
Effect of chiropractic care on upper limb function
Scientific title
The effects of chiropractic care on upper limb force production, proprioception and spinal stretch reflexes in adults with a history of recurring spinal dysfunction
Secondary ID [1] 285133 0
NIL
Universal Trial Number (UTN)
U111111512164
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
subclinical spinal pain 292703 0
Condition category
Condition code
Alternative and Complementary Medicine 293012 293012 0 0
Other alternative and complementary medicine
Musculoskeletal 293311 293311 0 0
Other muscular and skeletal disorders
Physical Medicine / Rehabilitation 293312 293312 0 0
Other physical medicine / rehabilitation

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Full spine adjustments will be carried out during the experimental sessions. The entire spine and sacroiliac joints will be assessed for vertebral subluxations and adjusted by hand where deemed necessary by a registered chiropractor with at least ten years clinical experience. The vertebral subluxation indicators that will be used to assess the function
of the spine prior to and after each spinal adjustment intervention 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 known clinical indicators of spinal dysfunction (Fryer, Morris, & Gibbons, 2004; Hestboek & Leboeuf-Yde, 2000). These findings will be documented prior to and after each spinal adjustment intervention. The improvements in segmental function following spinal adjustments will also be recorded for each subject. The single spinal adjustment intervention session will take 10 minutes on average.
Intervention code [1] 289985 0
Treatment: Other
Comparator / control treatment
The control intervention will consist of passive and active movements of the subject’s head, spine and body that will be carried out by the same chiropractor who pre-checks the participants for vertebral subluxations and who performs the adjustments in the experimental intervention sessions. This control intervention will involve the participants being
moved into the adjustment setup positions where the chiropractor would normally apply a thrust to the spine to achieve the adjustments.
However, the experimenter will be particularly careful not to put pressure on any individual spinal segments. Loading a joint, as is done prior to spinal adjustments has been shown to alter paraspinal proprioceptive firing in anesthetised cats (Pickar & Wheeler, 2001), and
will therefore be carefully avoided by ending the movement prior to endrange-of-motion when passively moving the participants. No spinal adjustments will be performed during any control intervention. This control intervention is not intended to act as a sham adjustment but to act as a physiological control for possible changes occurring due to the cutaneous, muscular or vestibular input that will occur with the type of passive and active movements involved in preparing a patient for an adjustment. It also acts as a control for the effects of the stimulation necessary to collect the dependent measures of the study, and acts as a
control for the time required to carry out the adjustment intervention. The single control intervention session will take 10 minutes on average.
Control group
Active

Outcomes
Primary outcome [1] 292870 0
We will be measuring the following dependant measures from the deltoid muscle in the upper limb before and after
a single session of adjusting subluxations;

Maximum isometric force production using an isometric strain gauge.
Timepoint [1] 292870 0
Pre and Post of intervention or control session
Primary outcome [2] 292871 0
Spinal stretch reflex function will be assessed using electromyography
Timepoint [2] 292871 0
Pre and Post of intervention or control session
Secondary outcome [1] 309846 0
Median frequency data from surface electromyography
Timepoint [1] 309846 0
Pre and Post of intervention or control session
Secondary outcome [2] 309847 0
Proprioception in the form of a position sense task
Timepoint [2] 309847 0
Pre and Post of intervention or control session

Eligibility
Key inclusion criteria
Subjects will be eligible for inclusion if they are English speaking, aged 18-40,and have previously sought
chiropractic care, and have some history of recurring spinal dysfunction such as mild pain, ache, and/or stiffness
with or without a history of known trauma.
Minimum age
18 Years
Maximum age
40 Years
Gender
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Subjects will be ineligible to participate if they exhibit no evidence of
vertebral subluxations, have absolute contraindications to spinal
adjustments, have experienced previous
significant adverse reactions to chiropractic care, or they are suffering from a current lower limb disorder/dysfunction that would make them unable to carry out data recording sessions (e.g. sprain/strain/fracture),and if they have sought treatment for the subclinical pain symptoms.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Who is / are masked / blinded?



Intervention assignment
Other design features
Phase
Not Applicable
Type of endpoint(s)
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment outside Australia
Country [1] 6316 0
New Zealand
State/province [1] 6316 0
Auckland

Funding & Sponsors
Funding source category [1] 289865 0
University
Name [1] 289865 0
NewZealand College of chiropractic
Address [1] 289865 0
6 Harrison road
Ellerslie
1060,Auckland
Country [1] 289865 0
New Zealand
Primary sponsor type
University
Name
NewZealand College of chiropractic
Address
6 Harrison road
Ellerslie
1060,Auckland
Country
New Zealand
Secondary sponsor category [1] 288546 0
None
Name [1] 288546 0
Address [1] 288546 0
Country [1] 288546 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 291587 0
Northern A Health and Disability Ethics Committee
Ethics committee address [1] 291587 0
Health and Disability Ethics Committees
Ministry of Health
C/- MEDSAFE, Level 6, Deloitte House
10 Brandon Street
PO Box 5013
Wellington
6011
Ethics committee country [1] 291587 0
New Zealand
Date submitted for ethics approval [1] 291587 0
16/12/2013
Approval date [1] 291587 0
20/03/2014
Ethics approval number [1] 291587 0
13/NTA/236

Summary
Brief summary
Over the past ten years a growing body of evidence has accumulated that suggests neural plastic changes occur following chiropractic adjustments (for recent review see Haavik & Murphy, 2012). Recently, due to ASRF funding, we presented the findings from eight subjects that demonstrated that a full spine chiropractic adjustment session resulted in an increase in the subjects’ ability to maximally voluntarily contract their lower limb muscle by almost 73% (Niazi et al. 2013). There was also a 50% increase in cortical drive and a shift in the H reflex curve. These exciting findings were not observed following the control intervention and are similar to those reported in a study that investigated the effects of three weeks of strength training (Vila-Cha, Falla, Correia, & Farina, 2012).
In this proposed study we plan to expand on these findings to investigate whether chiropractic care also influences upper limb muscle function and neurological control. This study could have significant implications for our understanding of the effects of chiropractic care on sports performance. If the findings corroborate our previous work it will add weight to the hypothesis that increased strength and the prevention of fatigue may occur following chiropractic adjustments, which will be an important consideration for athletes who are trying to achieve their optimum athletic performance. We will be measuring the following dependant measures from the deltoid muscle in the upper limb before and after a single session of adjusting subluxations;
Maximum isometric force production (to provide strength and fatigue measures)
Median frequency data from surface electromyography (another fatigue measure)
Proprioception in the form of a position sense task (functional performance measure)
Spinal stretch reflex function (for spinal cord excitability measure)
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 50490 0
Dr Imran Khan Niazi
Address 50490 0
New Zealand College of Chiropractic
6 Harrison Road, Ellerslie Auckland
1060
Country 50490 0
New Zealand
Phone 50490 0
+6495266789
Fax 50490 0
Email 50490 0
imran.niazi@nzchiro.co.nz
Contact person for public queries
Name 50491 0
Dr Heidi Haavik
Address 50491 0
New Zealand College of Chiropractic
6 Harrison Road, Ellerslie Auckland
1060
Country 50491 0
New Zealand
Phone 50491 0
+6495266789
Fax 50491 0
Email 50491 0
heidi.haavik@nzchiro.co.nz
Contact person for scientific queries
Name 50492 0
Dr Imran Khan Niazi
Address 50492 0
New Zealand College of Chiropractic
6 Harrison Road, Ellerslie Auckland
1060
Country 50492 0
New Zealand
Phone 50492 0
+6495266789
Fax 50492 0
Email 50492 0
imran.niazi@nzchiro.co.nz