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出境医 / 临床实验 / Comparing the Reciprocal Inhibition Method and Post-isometric Inhibition Method of Muscle Energy Technique on the Spinal Reflex Excitability in Healthy Subjects

Comparing the Reciprocal Inhibition Method and Post-isometric Inhibition Method of Muscle Energy Technique on the Spinal Reflex Excitability in Healthy Subjects

Study Description
Brief Summary:
This a cross-over study to compare the effect of two different muscle energy techniques (MET) including post-isometric inhibition and reciprocal inhibition on the spinal reflex excitability. The study contains two experimental groups, while one group will receive post-isometric inhibition MET in the first stage and reciprocal inhibition MET in the second stage, the other group will receive reciprocal inhibition MET in the first stage and post-isometric inhibition MET in the second stage.

Condition or disease Intervention/treatment Phase
Relaxation; Joint Limitation, Mobility Relaxation; Lumbosacral Other: Reciprocal Inhibition Muscle Energy Technique Other: Post-Isometric Inhibition Muscle Energy Technique Not Applicable

Detailed Description:

Reciprocal inhibition MET works based on the two mechanisms a) voluntary activation of agonist muscle that is simultaneously accompanied by the inhibition of the antagonist muscles or b) the activation of muscle spindle which causes a reflexive contraction in the agonist muscle (known as the stretch reflex) and relaxation of the antagonist muscles. By using this method, the activation of agonist muscles may inhibit or deactivate the antagonist muscles which may permit the therapist to introduce further ROM to the affected joint.

The other method of MET is post-isometric relaxation which works based on the two mechanisms including; 1) activation of Golgi Tendon Organs (GTO) that located between the muscle belly and its tendon and 2) presetting muscle spindles by muscle contraction witch project information to the spinal cord via afferent type II fibers and through a complex central control systems, the spindle is preset to adjust the tone of the muscle. It seems that moderate isometric contraction of muscle may preset the muscle spindle and cause a post-isometric relaxation within the agonist muscles which now can be stretched further, and this may permit the therapist to introduce further ROM to the affected joint and help to improve joint mobilization.

Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Comparing the Reciprocal Inhibition Method and Post-isometric Inhibition Method of Muscle Energy Technique on the Spinal Reflex Excitability in Healthy Subjects
Estimated Study Start Date : June 6, 2020
Estimated Primary Completion Date : August 15, 2020
Estimated Study Completion Date : September 30, 2020
Arms and Interventions
Arm Intervention/treatment
Experimental: Experimental RI-PI
They receive the Reciprocal Inhibition (RI) technique in the first stage and then the Post-isometric Inhibition (PI) technique in the second stage.
Other: Reciprocal Inhibition Muscle Energy Technique
In this technique, the subject will be asked to contract antagonist muscles against a moderate resistant force provided by the therapist to inhibit the contraction of the agonist muscle.

Other: Post-Isometric Inhibition Muscle Energy Technique
In this technique, the subject will be asked to contract agonist muscles against a moderate resistant force provided by the therapist to inhibit the contraction of the agonist muscle.

Experimental: Experimental PI-RI
They receive the Post-isometric Inhibition (PI) technique in the first stage and then the Reciprocal Inhibition (RI) technique in the second stage.
Other: Reciprocal Inhibition Muscle Energy Technique
In this technique, the subject will be asked to contract antagonist muscles against a moderate resistant force provided by the therapist to inhibit the contraction of the agonist muscle.

Other: Post-Isometric Inhibition Muscle Energy Technique
In this technique, the subject will be asked to contract agonist muscles against a moderate resistant force provided by the therapist to inhibit the contraction of the agonist muscle.

Outcome Measures
Primary Outcome Measures :
  1. Change in H Reflex Amplitude [ Time Frame: First measurement (Base-line), second measurement after 30 minutes (Pre-test), third measurement after 20 minutes (first post-test), forth measurement after 20 minutes (second post-test) ]
    H reflex or Hoffman's reflex is a refectory reaction of muscles after electrical stimulation of sensory fibers (Ia afferent from muscle spindles) in their innervated nerves (here is Tibial N),

  2. Change in M wave Amplitude [ Time Frame: First measurement (Base-line), second measurement after 30 minutes (Pre-test), third measurement after 20 minutes (first post-test), forth measurement after 20 minutes (second post-test) ]
    M- wave is a compound muscle action potential, which is produce by the electrical stimulation of motor nerve fibers (here is Tibial N)


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 30 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • without current low back pain

Exclusion Criteria:

  • Suffering from pain in the cervical, thoracic and lumbar spine,
  • Presenting signs of radiculopathy or peripheral neuropathy such as specific patterns of numbness and muscle weakness,
  • Any history or signs of joint instability, healing fractures, malignancy, open wounds, sutures, severe rheumatoid arthritis.
Contacts and Locations

Contacts
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Contact: Mohammad R Nourbakhsh 7068641766 reza.nourbakhsh@ung.edu

Locations
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United States, Georgia
University of North Georgia Recruiting
Dahlonega, Georgia, United States, 30597
Contact: University of N Georgia    706-864-1766    reza.nourbakhsh@ung.edu   
Sponsors and Collaborators
University of North Georgia
Investigators
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Principal Investigator: Mohammad R Nourbakhsh Professor of Physical Therapy
Tracking Information
First Submitted Date  ICMJE June 5, 2019
First Posted Date  ICMJE June 10, 2019
Last Update Posted Date March 31, 2020
Estimated Study Start Date  ICMJE June 6, 2020
Estimated Primary Completion Date August 15, 2020   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 6, 2019)
  • Change in H Reflex Amplitude [ Time Frame: First measurement (Base-line), second measurement after 30 minutes (Pre-test), third measurement after 20 minutes (first post-test), forth measurement after 20 minutes (second post-test) ]
    H reflex or Hoffman's reflex is a refectory reaction of muscles after electrical stimulation of sensory fibers (Ia afferent from muscle spindles) in their innervated nerves (here is Tibial N),
  • Change in M wave Amplitude [ Time Frame: First measurement (Base-line), second measurement after 30 minutes (Pre-test), third measurement after 20 minutes (first post-test), forth measurement after 20 minutes (second post-test) ]
    M- wave is a compound muscle action potential, which is produce by the electrical stimulation of motor nerve fibers (here is Tibial N)
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE Not Provided
Original Secondary Outcome Measures  ICMJE Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Comparing the Reciprocal Inhibition Method and Post-isometric Inhibition Method of Muscle Energy Technique on the Spinal Reflex Excitability in Healthy Subjects
Official Title  ICMJE Comparing the Reciprocal Inhibition Method and Post-isometric Inhibition Method of Muscle Energy Technique on the Spinal Reflex Excitability in Healthy Subjects
Brief Summary This a cross-over study to compare the effect of two different muscle energy techniques (MET) including post-isometric inhibition and reciprocal inhibition on the spinal reflex excitability. The study contains two experimental groups, while one group will receive post-isometric inhibition MET in the first stage and reciprocal inhibition MET in the second stage, the other group will receive reciprocal inhibition MET in the first stage and post-isometric inhibition MET in the second stage.
Detailed Description

Reciprocal inhibition MET works based on the two mechanisms a) voluntary activation of agonist muscle that is simultaneously accompanied by the inhibition of the antagonist muscles or b) the activation of muscle spindle which causes a reflexive contraction in the agonist muscle (known as the stretch reflex) and relaxation of the antagonist muscles. By using this method, the activation of agonist muscles may inhibit or deactivate the antagonist muscles which may permit the therapist to introduce further ROM to the affected joint.

The other method of MET is post-isometric relaxation which works based on the two mechanisms including; 1) activation of Golgi Tendon Organs (GTO) that located between the muscle belly and its tendon and 2) presetting muscle spindles by muscle contraction witch project information to the spinal cord via afferent type II fibers and through a complex central control systems, the spindle is preset to adjust the tone of the muscle. It seems that moderate isometric contraction of muscle may preset the muscle spindle and cause a post-isometric relaxation within the agonist muscles which now can be stretched further, and this may permit the therapist to introduce further ROM to the affected joint and help to improve joint mobilization.

Study Type  ICMJE Interventional
Study Phase  ICMJE Not Applicable
Study Design  ICMJE Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Condition  ICMJE
  • Relaxation; Joint
  • Limitation, Mobility
  • Relaxation; Lumbosacral
Intervention  ICMJE
  • Other: Reciprocal Inhibition Muscle Energy Technique
    In this technique, the subject will be asked to contract antagonist muscles against a moderate resistant force provided by the therapist to inhibit the contraction of the agonist muscle.
  • Other: Post-Isometric Inhibition Muscle Energy Technique
    In this technique, the subject will be asked to contract agonist muscles against a moderate resistant force provided by the therapist to inhibit the contraction of the agonist muscle.
Study Arms  ICMJE
  • Experimental: Experimental RI-PI
    They receive the Reciprocal Inhibition (RI) technique in the first stage and then the Post-isometric Inhibition (PI) technique in the second stage.
    Interventions:
    • Other: Reciprocal Inhibition Muscle Energy Technique
    • Other: Post-Isometric Inhibition Muscle Energy Technique
  • Experimental: Experimental PI-RI
    They receive the Post-isometric Inhibition (PI) technique in the first stage and then the Reciprocal Inhibition (RI) technique in the second stage.
    Interventions:
    • Other: Reciprocal Inhibition Muscle Energy Technique
    • Other: Post-Isometric Inhibition Muscle Energy Technique
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: June 6, 2019)
30
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE September 30, 2020
Estimated Primary Completion Date August 15, 2020   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • without current low back pain

Exclusion Criteria:

  • Suffering from pain in the cervical, thoracic and lumbar spine,
  • Presenting signs of radiculopathy or peripheral neuropathy such as specific patterns of numbness and muscle weakness,
  • Any history or signs of joint instability, healing fractures, malignancy, open wounds, sutures, severe rheumatoid arthritis.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 30 Years   (Adult)
Accepts Healthy Volunteers  ICMJE Yes
Contacts  ICMJE
Contact: Mohammad R Nourbakhsh 7068641766 reza.nourbakhsh@ung.edu
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03980106
Other Study ID Numbers  ICMJE IRB 2019-026
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Plan Description: No Plan to share individual participant data to other researchers.
Responsible Party Mohammad(Reza) Nourbakhsh, University of North Georgia
Study Sponsor  ICMJE University of North Georgia
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Mohammad R Nourbakhsh Professor of Physical Therapy
PRS Account University of North Georgia
Verification Date March 2020

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP