Z Joint Changes in Low Back Pain Following Adjusting

调整后腰痛的 Z 关节变化

基本信息

批准号：
7810838
负责人：
Gregory D Cramer
金额：
$ 46.54万
依托单位：
NATIONAL UNIVERSITY OF HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-30 至 2011-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7810838
关键词：
Acoustics Acute Address Biology Characteristics Chiropractic manipulation Clinical Clinical Research Clinical Trials Computers Contracts Control Groups Data Data Analyses Equipment Exhibits Exposure to Facet joint structure Faculty Feasibility Studies Goals Hand Hearing Hour Human Resources Image Individual Investigation Joints Lead Left Low Back Pain MRI Scans Magnetic Resonance Imaging Manipulative Therapies Manuals Measurement Measures Mentors Methods Movement National Center for Complementary and Alternative Medicine Occupations Outcome Outcomes Research Pain Patients Positioning Attribute Posture Principal Investigator Printing Progress Reports Radiology Specialty Randomized Reader Reading Recovery Recruitment Activity Research Research Design Research Personnel Role Side Spinal Spinal Manipulation Strategic Planning Students Technology Testing Therapeutic Training Work base clinical practice cost design functional disability graduate student healthy volunteer instrument morphometry parent grant parent project patient population programs public health relevance radiologist skills sound spine bone structure

项目摘要

DESCRIPTION (provided by applicant): The objectives of the parent grant are to quantify the therapeutic opening (gapping) of the L4/L5 and L5/S1 zygapophysial (Z) joint space following side posture positioning and side posture spinal manipulative therapy (SMT; a.k.a., adjusting) in subjects with acute low back pain. In addition, the parent grant is assessing the relationships among pain, functional impairment, and Z joint gapping. This competitive revision uniquely combines technologies from the fields of acoustics and MRI imaging to deepen the research of the parent grant by allowing further investigation of one of the mechanisms of action of SMT, namely the relationship between cavitation (audible release) and Z joint gapping following SMT. In addition, if cavitation is found to correlate with Z joint gapping, cavitation could be used as a simple, inexpensive, and quantified standard for SMT administered in clinical trials and possibly in clinical practice. The specific aims of this study are to correlate cavitation (audible release) that occurs (1) during SMT and (2) during side posture positioning, with gapping of the L3-S1 Z joints in 40 healthy subjects. The collaborating investigators will use established methods, combined with those tested in a feasibility study, to complete the research. Gapping will be calculated from the difference of Z joint space measurements made from MRI scans taken before and after SMT (adjusting group) or before and after lumbar side posture positioning (control group). The vertebral level and side of cavitation will be determined during the adjustment or side posture positioning by using data received from one linear array and two triangular arrays of accelerometers. Data analysis will determine the relationship between cavitation and gapping by comparing Z joints that: cavitate following adjusting, do not cavitate following adjusting, cavitate following side posture positioning, and do not cavitate following side posture positioning. Further work will be conducted to assess the intensity and unique acoustic characteristics of cavitations and other Z joint sounds of healthy subjects. This research is consistent with the NCCAM Strategic Plan to deepen understanding of manual therapies by helping to determine the significance of cavitation to joint movement during spinal adjusting. If a positive relationship is found, cavitation could possibly be used to identify patients who would respond optimally to high velocity low amplitude adjusting. If a negative relationship is found then cavitation would not be used as an indicator of joint movement during spinal adjusting. Consequently, regardless of the outcome, this research will deepen the understanding of SMT and manual therapies. PUBLIC HEALTH RELEVANCE: This project will deepen the research of the parent grant by further investigating one of the mechanisms of action of spinal manipulative therapy (SMT, or spinal adjusting), that is the relationship between cavitation (audible release) and gapping (separation) of the zygapophysial joint (Z joint) spaces following SMT. Although cavitation and gapping are thought to be related, there has been no evidence to support this hypothesis. If a positive relationship is found, cavitation could be used to identify patients who would respond optimally to high velocity low amplitude SMT, whereas no or a negative relationship would provide evidence that cavitation is not a suitable indicator of joint movement during spinal adjusting.

描述（由申请人提供）：父母赠款的目标是量化L4/L5和L5/S1 zygapophysial（Z）的治疗性开口（差距），侧面姿势定位和侧面姿势脊柱操纵治疗（SMT; a.k.a.，调整）的侧面姿势姿势姿势。此外，父母赠款正在评估疼痛，功能障碍和Z关节间隙之间的关系。这项竞争性修订独特地结合了来自声学领域和MRI成像领域的技术，通过允许进一步研究SMT的作用机理之一，即空化（Audible Release）与SMT后Z关节间隙之间的关系，从而加深了父母赠款的研究。此外，如果发现空化与Z关节间隙相关，则可以将空化作为在临床试验中和临床实践中使用的简单，廉价且量化的SMT标准。这项研究的具体目的是将在SMT和（2）侧姿势定位期间发生（1）发生的空化（可听见释放）相关联，在40名健康受试者中L3-S1 Z关节的间隙散布。合作的研究人员将使用既定方法，并结合在可行性研究中测试的方法来完成研究。差距将根据SMT之前和之后进行的MRI扫描的Z关节空间测量的差异（调整组）或腰部侧姿势定位（对照组）进行。通过使用从一个线性阵列和两个三角阵列的加速度计，将在调整或侧面姿势定位期间确定椎骨水平和空化的侧面。数据分析将通过比较z关节来确定空化和间隙之间的关系：z接头：调整后的腔体，不要进行调整后，cavitate下侧姿势定位，并且不要在侧面姿势下定位。将进行进一步的工作，以评估健康受试者的空洞和其他Z关节声音的强度和独特的声学特征。这项研究与NCCAM战略计划一致，可以通过帮助确定气膜对脊柱调节过程中的联合运动的重要性来加深对手动疗法的了解。如果发现正相关关系，则可以使用空化来识别对高速度低振幅调节最佳反应的患者。如果发现负相关关系，则在脊柱调节过程中，气氮将不会用作关节运动的指标。因此，无论结果如何，这项研究都将加深对SMT和手动疗法的理解。公共卫生相关性：该项目将通过进一步研究脊柱操纵疗法（SMT或脊柱调节）的一种作用机制，即对zygapophysial（z关节）（z关节）的关系之间的关系，从而加深了父母赠款的研究。尽管被认为是相关的空化和间隙，但没有证据支持这一假设。如果发现正相关关系，则可以使用空化来识别那些对高速度低振幅SMT最佳反应的患者，而没有或负相关的关系可以提供证据表明空化不是脊柱调节过程中关节运动的适当指标。