Effect of Spinal Manipulation on Sensorimotor Functions in Back Pain Patients

In collaboration with the University of Iowa, the Palmer Center for Chiropractic Research
will pursue the following specific aim: To determine the effects of 2 weeks (4 applications @
2 per week) of HVLA-SM and LVVA-SM to the lumbo-pelvic region, compared to a control group
receiving light effleurage and a sham mechanically assisted adjustment, on sensorimotor
function as measured by: lumbo-pelvic repositioning ability, standing postural sway and
response to sudden trunk loading;

Inclusion Criteria:

- 21 to 65 years old

- Low back pain (LBP) score an 11 point numerical rating scale: (must be > 4 at the
Phone Screening OR Baseline 1 Visit) AND (must be > 2 at the Phone Screen, Baseline 1
AND Baseline 2 Visits)

- Acute (less than 7 days), sub-acute (7 days to 7 weeks), or chronic (more than 7
weeks) LBP matching classifications 1, 2, or 3 of the Quebec Task Force (QTF)
Classification system - QTF 1: Pain without radiation, QTF 2: Pain + radiation to
proximal extremity, QTF 3: Pain + radiation to distal extremity, QTF 7: Spinal
stenosis

- Written informed consent (ICD1, ICD2 and ICD3)

Exclusion Criteria:

- Ongoing treatment for low back pain by other health care providers - unwillingness to
postpone use of all other types of manual treatment for LBP except those provided in
the study (including chiropractic and osteopathic SM, physical therapy and massage)
for the duration of the study period.

- Co-morbidities Bleeding Disorders Bone and Joint Pathology Cauda Equina Syndrome
Contra-indication to spinal manipulation, in general Current or Pending Litigation
General Poor Health Inflammatory or Destructive tissue changes to the spine
Neuromuscular Diseases Obesity Osteoporosis Peripheral Neuropathies Spinal Surgery
Suspicion of drug or alcohol abuse Uncontrolled hypertension Vascular claudication

- Quebec Task Force (QTF) on Spinal Disorders QTF 4: Pain + radiation to upper/lower
limb with neurologic signs QTF 5: Presumptive compression of a spinal nerve root on a
simple roentgenogram QTF 6: Compression of a spinal nerve root confirmed by specific
imaging techniques QTF 8: Postsurgical status, 1-6 months after intervention QTF 9:
Postsurgical status, >6 months after intervention 9.1: Asymptomatic 9.2: Symptomatic
QTF 10: Chronic pain syndrome QTF 11: Other diagnoses

- Pregnant or nursing women

- Pacemaker

- Inability to read or verbally comprehend English

- Any Joint Replacement

- Use of spinal manipulation within the past 4 weeks. If participants are willing to
delay study enrollment until four weeks post spinal manipulative therapy, then we will
schedule accordingly until this criterion is met

- Sensitivity to tape used during the biomechanical assessments

- If the Study Clinician believes that diagnostic procedures other than x-rays or
dipstick urinalysis are necessary to diagnose a participant's condition, then the
participant will be excluded

- Beck Depression Inventory-II greater than or equal to 29

- Retention of legal advice and an open or pending case for a health-related condition