How Does Manual Therapy Improve Low Back Pain for Soldiers?
| Status: | Completed |
|---|---|
| Conditions: | Back Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | 17 - 35 |
| Updated: | 4/2/2016 |
| Start Date: | October 2006 |
| End Date: | October 2007 |
| Contact: | des Anges Cruser, Ph.D., MPA |
| Email: | dcruser@hsc.unt.edu |
| Phone: | 817-735-2009 |
Manual Manipulative Therapy for Back Pain in Active Duty Military Personnel
Musculoskeletal injuries including low back pain (LBP) are a major problem in military
personnel. These injuries can result from training exercises, job duties, or recreational
activities. However incurred, many of these injuries can result in limited duty in work or
training, and can decrease military readiness.
The National Osteopathic Research Center (ORC) will examine the effectiveness of a specific
set of Osteopathic Manipulative Treatment interventions referred to as Manual/Manipulative
Therapy (M/MT) to reduce pain and improve functioning in young active duty military
personnel.
The broad overall goal of this proposed research project is to determine the feasibility of
conducting a larger clinical trial of Manual/Manipulative Therapy (M/MT) in restoring full
performance in military personnel in the operational environment. A second goal is to
estimate the treatment effect size of M/MT in this population.
The following two hypotheses will guide the data study:
- Hypothesis 1: Subjects receiving manual/manipulative therapy for low back pain will
report less pain at two and four weeks than subjects in the control group.
- Hypothesis 2: Subjects receiving manual/manipulative therapy for low back pain will
achieve greater functioning at two and four weeks than subjects in the control group.
personnel. These injuries can result from training exercises, job duties, or recreational
activities. However incurred, many of these injuries can result in limited duty in work or
training, and can decrease military readiness.
The National Osteopathic Research Center (ORC) will examine the effectiveness of a specific
set of Osteopathic Manipulative Treatment interventions referred to as Manual/Manipulative
Therapy (M/MT) to reduce pain and improve functioning in young active duty military
personnel.
The broad overall goal of this proposed research project is to determine the feasibility of
conducting a larger clinical trial of Manual/Manipulative Therapy (M/MT) in restoring full
performance in military personnel in the operational environment. A second goal is to
estimate the treatment effect size of M/MT in this population.
The following two hypotheses will guide the data study:
- Hypothesis 1: Subjects receiving manual/manipulative therapy for low back pain will
report less pain at two and four weeks than subjects in the control group.
- Hypothesis 2: Subjects receiving manual/manipulative therapy for low back pain will
achieve greater functioning at two and four weeks than subjects in the control group.
Musculoskeletal injuries are among the most common injuries in the military, and cause more
soldiers to miss time from active duty than any other health condition.These injuries
account for up to 20% of all clinic visits at Fort Sam Houston.Of these visits, up to 36%
are back-related, resulting in lost duty time, lost training time, and a negative impact on
military preparedness. It is of interest to the military to refine interventions that would
effectively and efficiently treat back related injuries.
Osteopathic manipulative treatment (OMT) has been studied as a treatment for low back pain
in both chronic and subacute presentations in a variety of situations. OMT has been found
effective in decreasing medication use for back pain and improving pain and functioning.In a
study on low back pain in the Navy, use of OMT significantly reduced time on light duty and
sick-in-quarters time.
The National Osteopathic Research Center (ORC) proposes to examine the efficacy of a
specific set of OMT interventions referred to in this proposal as Manual/Manipulative
Therapy (M/MT) to reduce pain and improve functioning in young active duty military
personnel.
The site for this study is the Madiagan Amry Medical Center at Fort Lewis, WA. We will
sample the active duty personnel who present at the outpatient clinics at the Hospital with
a complaint of low back pain. Osteopathic physicians will provide the M/MT.
Enough subjects will be enrolled and randomized in the study for a total of 100 to complete
the trial in two groups: a treatment group receiving M/MT plus standard care (SC), and a
control group receiving SC only. Standard care may include medications, back care education
and exercise instructions, and/or limited duty. M/MT sessions will last approximately 15-20
minutes, and will be provided up to twice a week for up to four weeks. Standard care will be
provided as needed.
Outcomes to be measured are pain and functionality. Pain measures include a Visual Analog
Scale (VAS) and medication use. Function will be measured by the Back Pain Functional Scale
(BPFS), Roland-Morris Questionnaire (RMQ), and time on modified duty. The VAS and duty
status will be recorded at each visit. All other outcomes will be assessed at two and four
weeks.
At the initial visit, we will also collect demographic data, medical history, information on
quality of life using the SF-36, and subject treatment expectation. A subject satisfaction
survey and a measure of overall improvement will be completed at two and four weeks.
The broad overall goal of this proposed research project is to determine the feasibility of
conducting a larger clinical trial of Manual/Manipulative Therapy (M/MT) in restoring full
performance in military personnel in the operational environment. A second goal is to
estimate the treatment effect size of M/MT in this population.
soldiers to miss time from active duty than any other health condition.These injuries
account for up to 20% of all clinic visits at Fort Sam Houston.Of these visits, up to 36%
are back-related, resulting in lost duty time, lost training time, and a negative impact on
military preparedness. It is of interest to the military to refine interventions that would
effectively and efficiently treat back related injuries.
Osteopathic manipulative treatment (OMT) has been studied as a treatment for low back pain
in both chronic and subacute presentations in a variety of situations. OMT has been found
effective in decreasing medication use for back pain and improving pain and functioning.In a
study on low back pain in the Navy, use of OMT significantly reduced time on light duty and
sick-in-quarters time.
The National Osteopathic Research Center (ORC) proposes to examine the efficacy of a
specific set of OMT interventions referred to in this proposal as Manual/Manipulative
Therapy (M/MT) to reduce pain and improve functioning in young active duty military
personnel.
The site for this study is the Madiagan Amry Medical Center at Fort Lewis, WA. We will
sample the active duty personnel who present at the outpatient clinics at the Hospital with
a complaint of low back pain. Osteopathic physicians will provide the M/MT.
Enough subjects will be enrolled and randomized in the study for a total of 100 to complete
the trial in two groups: a treatment group receiving M/MT plus standard care (SC), and a
control group receiving SC only. Standard care may include medications, back care education
and exercise instructions, and/or limited duty. M/MT sessions will last approximately 15-20
minutes, and will be provided up to twice a week for up to four weeks. Standard care will be
provided as needed.
Outcomes to be measured are pain and functionality. Pain measures include a Visual Analog
Scale (VAS) and medication use. Function will be measured by the Back Pain Functional Scale
(BPFS), Roland-Morris Questionnaire (RMQ), and time on modified duty. The VAS and duty
status will be recorded at each visit. All other outcomes will be assessed at two and four
weeks.
At the initial visit, we will also collect demographic data, medical history, information on
quality of life using the SF-36, and subject treatment expectation. A subject satisfaction
survey and a measure of overall improvement will be completed at two and four weeks.
The broad overall goal of this proposed research project is to determine the feasibility of
conducting a larger clinical trial of Manual/Manipulative Therapy (M/MT) in restoring full
performance in military personnel in the operational environment. A second goal is to
estimate the treatment effect size of M/MT in this population.
Inclusion Criteria:
- Active duty military personnel
- Male and Female
- Age range 17-35
- Present with a new episode of low back pain (may be acute or new episode of chronic)
Exclusion Criteria:
- Pregnancy
- Any serious neurological, rheumatological, or orthopedic conditions such as
spondylolysis, spondylolithesis,fracture, nerve impingement, tumors, or infections.
- Prior manipulative treatment for this episode LBP.
- Leg pain worse than back pain indicating possible radiculopathy.
- Clinical evidence of a leg length discrepancy greater than 13mm.
- Inability to give informed consent.
- Inability to follow course of care for four weeks.
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