Spinal manipulative therapy (SMT) is a complementary therapy frequently used to treat low back pain (LBP). Current theories propose that SMT corrects abnormal lumbar intersegmental motion, but the detection and characterization of in vivo intersegmental motion are not well established. Thus, the effect of SMT on intersegmental motion is unknown.
The broad, long term objective of this study is to investigate the effect of SMT on lumbar intersegmental motion and to determine the relationship between the clinical effects of SMT and intersegmental motion changes.
The study has the following Specific Aims:
Develop an automated software application to quantify 2-D intersegmental kinematics in the lumbar spine from dynamic videofluoroscopic images.
Conduct dynamic in vitro spine testing to establish the accuracy and limitations of assessing 2-D intersegmental kinematics using the automated software application (Aim 1). Fluoroscopic images of in vitro lumbar motion will be obtained simultaneously with kinematic parameters from an optoelectric tracking system of known accuracy. Kinematic data from the automated software will be compared to the optoelectric tracking system data.
Conduct a pilot study to: a) assess the reliability of in vivo lumbar intersegmental kinematic parameters measured by the software application from videofluoroscopic images of active lumbar flexion, extension, and lateral bending (see Aim 1), and b) compare the software-derived intersegmental kinematic parameters in asymptomatic subjects and subjects with chronic low back pain, and define kinematic outcome measures for future spinal manipulative therapy studies.
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