Abstract
INTRODUCTION: Joint mobilisation and manipulation often results in immediate pain relief in people with neck pain. However, the biological mechanisms behind pain relief are largely unknown. There is preliminary evidence that joint mobilisation and manipulation lessens the upregulated neuroimmune responses in people with persistent neck pain.
METHODS AND ANALYSIS: This study protocol describes a randomised placebo-controlled trial to investigate whether joint mobilisation and manipulation influence neuroimmune responses in people with persistent neck pain. People with persistent neck pain (N=100) will be allocated, in a randomised and concealed manner, to the experimental or control group (ratio 3:1). Short-term (ie, baseline, immediately after and 2 hours after the intervention) neuroimmune responses will be assessed, such as inflammatory marker concentration following in vitro stimulation of whole blood cells, systemic inflammatory marker concentrations directly from blood samples, phenotypic analysis of peripheral blood mononuclear cells and serum cortisol. Participants assigned to the experimental group (N=75) will receive cervical mobilisations targeting the painful and/or restricted cervical segments and a distraction manipulation of the cervicothoracic junction. Participants assigned to the control group (N=25) will receive a placebo mobilisation and placebo manipulation. Using linear mixed models, the short-term neuroimmune responses will be compared (1) between people in the experimental and control group and (2) within the experimental group, between people who experience a good outcome and those with a poor outcome. Furthermore, the association between the short-term neuroimmune responses and pain relief following joint mobilisation and manipulation will be tested in the experimental group.
ETHICS AND DISSEMINATION: This trial is approved by the Medical Ethics Committee of Amsterdam University Medical Centre, location VUmc (Approval number: 2018.181).
TRIAL REGISTRATION NUMBER: NL6575 (trialregister.nl.
| Original language | English |
|---|---|
| Article number | e055748 |
| Pages (from-to) | 1-10 |
| Number of pages | 10 |
| Journal | BMJ Open |
| Volume | 12 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 8 Mar 2022 |
Bibliographical note
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Funding
Funding This study is funded by the Dutch Association for Manual Therapy (NVMT, grant ID. Top-down_2018) and by the Faculty of Behavioural and Movement Sciences (grant ID. Lab Fund_2019) of Vrije Universiteit Amsterdam. The MSG Science Network (https://www.msg-sciencenetwerk.nl/) (grant ID. N/A) will support participant recruitment. The funding sources have no role in the study design and will not have any roles in data collection, analysis and interpretation of the data, nor in the reporting of the results.
| Funders | Funder number |
|---|---|
| Dutch Association for Manual Therapy | |
| Faculty of Behavioural and Movement Sciences | |
| NVMT |