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Study aim
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The aim of this study is to investigate the effect of lumbar spinal manipulation on the neurophysiology of the brain or neuroplasticity in neuronal surfaces in chronic non-specific low back pain patients with using a technique for measuring brain metabolites at the level of neurons by H- Check the MRS as a precise and preferred method.
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Design
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Sample size using Gx power software based on previous studies and the basis of Glx (Glu + Gln) metabolism and taking d = 0.06, α = 0.05 and β = 0.2 in each group 8 people were appointed. Depending on the possibility of removal and removal of samples at a rate of 20% in the treatment group of 10 people and at a rate of 45% in the treatment group, 15 are studied. Samples include non-specific chronic low back pain individuals aged 20 to 50 years. Samples are divided into two treatment and Quasi-treatment groups based on random allocation method. Patients and the H-MRS imaging operator and an examiner were not aware of the groups being studied.
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Settings and conduct
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Patients with low back pain referred to clinics and referrals are examined by a specialist physician and, if they are eligible, will be included in the study. Patients are randomly divided into two groups: test and control. Initially, demographic information, an intensity of pain was assessed by NRS and their functional ability according to the Oswestry Disability Index questionnaire, and then information related to the metabolic map of the brain was determined using the H-MRS technique. The first group had 3 sessions of lumbopelvic manipulation treatment, and patients in the second group undergo 3 sessions of spinal alignment similar to the lumbopelvic manipulation technique. Both groups are studied at the Faculty of Rehabilitation, Shiraz.
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Participants/Inclusion and exclusion criteria
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Inclusion criteria:
Patients include men and women with chronic non-specific low back pain for more than three months in the age range of 20 to 50 years, pain intensity in the waist region of at least 3, and a maximum of 7 units of the pain assessment unit by NRS (numerical rating scale), positive three Tests or more of the sacroiliac joint assessment tests (Distraction Test, Compression Test, Thigh Thrust Test, Gaenslen Test, FABER Test, and Sacral Thrust Test) have not been treated for the last three months, and will be included in the study.
Exclusion criteria:
Patients with chronic low back pain with specific neurologic origin and specific pathology (tumors and ...), patients with noregular and rheumatoid disorders, diabetes, patients with fractures of the ribs, vertebrae and pelvis, periosteum syndrome, abdominal aortic aneurysm, neoplasm , Neuropathy and radiculopathy, osteoporosis, fibromyalgia, pain in other areas of the body, injury and the use of ongoing drug therapy during the study, those who use antidepressants and anxiety drugs, as well as patients with non-specific chronic low back pain who underwent the last three months Treatments.
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Intervention groups
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The first group received 3 sessions of lumbopelvic spinal manipulation and the patients in the second group under 3 sessions of the spine position are similar to the manipulation of the lumbar and pelvis.
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Main outcome variables
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1. Severity of pain
2. Functional Ability
3. Metabolic map of the cortex