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Trial registered on ANZCTR
Registration number
ACTRN12613000653763
Ethics application status
Not yet submitted
Date submitted
5/06/2013
Date registered
13/06/2013
Date last updated
13/06/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised controlled trial of chiropractic neck manipulation for improvement of neck pain, postural and dynamic balance, and cognition in the elderly: A feasibility study
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Scientific title
Efficacy of chiropractic neck manipulation compared to sham manipulation in decreasing scores on the Dizziness Handicap Inventory, Neck Disability Index and other measures of balance and cognition in the community dwelling elderly
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Secondary ID [1]
282625
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None
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Universal Trial Number (UTN)
U1111-1144-0406
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Non-specific dizziness
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Chronic neck pain
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Geriatric falls
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Condition category
Condition code
Musculoskeletal
289654
289654
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0
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Other muscular and skeletal disorders
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Neurological
289655
289655
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0
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Other neurological disorders
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Physical Medicine / Rehabilitation
289656
289656
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Chiropractic manipulation of the neck will be administered to the experimental group with or without massage. Chiropractic manipulation will consist of gentle application of manual high velocity low amplitude thrust procedures commonly practised by chiropractors. Treatment will be delivered twice a week over a period of 8 weeks. All treatment sessions will take 30 minutes each. The decision to include or exclude massage will depend on the clinical judgement of the treating investigator in determining whether hypertonicity exists in the muscles of the neck.
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Intervention code [1]
287291
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Treatment: Other
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Comparator / control treatment
The control group will be administered a sham manipulation procedure known as the Outcomes of Usual Chiropractic, Harm & Efficacy (OUCH) protocol as previously published (1). Briefly, this will involve the application of the practitioners hands to the participants neck as well as detuned ultrasound and the "sham" thrust of an Activator TM instrument set at zero. These treatments will be given twice a week over a period of eight weeks. Each sham treatment session will take 30 minutes.
Reference:
(1) Walker BF, Losco B, Clarke BR, Hebert J, French S, Stomski NJ. Outcomes of usual chiropractic, harm & efficacy, the ouch study: study protocol for a randomized controlled trial. Trials. 2011;12:235.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Dizziness Handicap Inventory (DHI)
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Assessment method [1]
289733
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Timepoint [1]
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One week following the completion of treatment regime.
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Secondary outcome [1]
303128
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Visual Analogue Scale for dizziness
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Assessment method [1]
303128
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Timepoint [1]
303128
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One week following the completion of the treatment phase
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Secondary outcome [2]
303129
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Neck Disability Index for neck pain
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Assessment method [2]
303129
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Timepoint [2]
303129
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One week following the completion of the treatment phase
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Secondary outcome [3]
303130
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Falls Efficacy Scale International for fear of falling
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Assessment method [3]
303130
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Timepoint [3]
303130
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One week following the completion of the treatment phase
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Secondary outcome [4]
303131
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Visual Analogue Scale for neck pain
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Assessment method [4]
303131
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Timepoint [4]
303131
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One week following the completion of the treatment phase
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Secondary outcome [5]
303132
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Visual Analogue Scale for low back pain
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Assessment method [5]
303132
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Timepoint [5]
303132
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One week following the completion of the treatment phase
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Secondary outcome [6]
303133
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Oswestry Disability Index for low back pain
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Assessment method [6]
303133
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Timepoint [6]
303133
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One week following the completion of the treatment phase
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Secondary outcome [7]
303134
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Visual Analogue Scale for tinnitus
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Assessment method [7]
303134
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Timepoint [7]
303134
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One week following the completion of the treatment phase
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Secondary outcome [8]
303135
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Centre of Pressure changes using a forceplate
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Assessment method [8]
303135
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Timepoint [8]
303135
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One week following the completion of the treatment phase
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Secondary outcome [9]
303136
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Range of Motion using a digital goniometer
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Assessment method [9]
303136
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Timepoint [9]
303136
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One week following the completion of the treatment phase
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Secondary outcome [10]
303137
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Tenderness over the cervical spine using a pressure algometer
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Assessment method [10]
303137
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Timepoint [10]
303137
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One week following the completion of the treatment phase
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Secondary outcome [11]
303138
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Montreal Cognitive Assessment and Stroop Tests for cognitive function
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Assessment method [11]
303138
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Timepoint [11]
303138
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One week following the completion of the treatment phase
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Secondary outcome [12]
303139
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Quality of Life as measured by the RAND-36 questionnaire
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Assessment method [12]
303139
0
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Timepoint [12]
303139
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One week following the completion of the treatment phase
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Secondary outcome [13]
303140
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Satisfaction with treatment using a five point scale.
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Assessment method [13]
303140
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Timepoint [13]
303140
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One week following the completion of the treatment phase
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Eligibility
Key inclusion criteria
Neck pain and concommitant dizziness or unsteadiness of three months duration or longer, whether constant or intermittent.
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Minimum age
65
Years
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Maximum age
85
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Diagnosed vestibular pathology such as Meniere's disease or benign paroxysmal positional vertigo (BPPV); history or cerebrovascular accident or myocardial infarct; psychiatric disease; active inflammatory spondyloarthropathies; recent spinal trauma; osteomyelitis; spinal tumours; acute myelopathy; those who have had neck spinal manipulative therapy or neck massage in the last three months.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Group allocations will be concealed from the investigators by placing them in opaque consecutively numbers sealed envelopes. As participants become eligible for the study, envelopes will be opened by a research assistant not involved in the conduct of baseline or outcome measurements.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The subjects will be randomly assigned at the baseline appointment by using a permuted block randomisation protocol to one of two groups (n=20). The randomization schedule will be done by the study statistician before recruitment using a computer generated random list of numbers.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Data analysis will be performed using SPSS software for Windows (version 20). Results are expressed as mean (95% confidence intervals) or median (range) where appropriate. Student's t-test and chi-squared analysis will be used to compare continuous and categorical variables, respectively. Factors effecting final DHI scores will be evaluated with ANCOVA. Participant's age and baseline values for the corresponding dependent varibles will serve as co-variates in these analyses. Since this is a feasibility study a sample size calculation is unnecessary. This study will act as a pilot for the larger RCT planned for a subsequent stage where 44 subjects will be needed per group for 90% power in detecting a 20% change in the primary outcome measure (DHI), also factoring in a 30% rate of drop-out.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/07/2013
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Actual
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Date of last participant enrolment
Anticipated
30/09/2013
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
287403
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University
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Name [1]
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RMIT University
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Address [1]
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School of Health Sciences, RMIT University, Plenty Road, Bundoora VIC 3083 Australia
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Country [1]
287403
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Australia
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Primary sponsor type
Individual
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Name
Dr Michael Azari
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Address
Office 26A, Level 5, Building 201, School of Health Sciences, RMIT University, Plenty Road, Bundoora VIC 3083 Australia
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Country
Australia
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Secondary sponsor category [1]
286142
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None
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Name [1]
286142
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Address [1]
286142
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Country [1]
286142
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
289379
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Human Research Ethics Committee
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Ethics committee address [1]
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RMIT University Research and Innovation, City Campus GPO Box 2476 Melbourne 3001 VIC Australia
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Ethics committee country [1]
289379
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Australia
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Date submitted for ethics approval [1]
289379
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04/05/2012
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Approval date [1]
289379
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Ethics approval number [1]
289379
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HREC 29/13
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Summary
Brief summary
The primary focus of this study is dizziness in the community dwelling elderly. Neck pain and dysfunction can cause dizziness and may be an important under-investigated risk factor for falls in the elderly. Neck manipulation is known to be effective for neck pain. There is also preliminary evidence that physical treatments administered to the neck (including manipulation) may improve dizziness. This study will use clinical rigorous research methods to determine whether chiropractic manipulation can be used to successfully treat dizziness, thereby lowering the likelihood of falls in the elderly. Falls in the elderly are a significant public health problem in need of new and innovative management strategies.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Michael Azari
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Address
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Office 26A, Level 5, Building 201, RMIT University, Plenty Road, Bundoora VIC, 3083
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Country
40546
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Australia
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Phone
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+61 3 99257744
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Fax
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Email
40546
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[email protected]
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Contact person for public queries
Name
40547
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Michael Azari
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Address
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Office 26A, Level 5, Building 201, RMIT University, Plenty Road, Bundoora VIC, 3083
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Country
40547
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Australia
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Phone
40547
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+61 3 99257744
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Fax
40547
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Email
40547
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[email protected]
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Contact person for scientific queries
Name
40548
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Michael Azari
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Address
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Office 26A, Level 5, Building 201, RMIT University, Plenty Road, Bundoora VIC, 3083
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Country
40548
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Australia
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Phone
40548
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+61 3 99257744
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Fax
40548
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Email
40548
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Chiropractic treatment including instrument-assisted manipulation for non-specific dizziness and neck pain in community-dwelling older people: A feasibility randomised sham-controlled trial.
2018
https://dx.doi.org/10.1186/s12998-018-0183-1
N.B. These documents automatically identified may not have been verified by the study sponsor.
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