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Chronic Pain (Back / Neck)ARTNCT06603168

Autonomic Recalibration

A study testing Autonomic Recalibration Treatment in people with Chronic Pain (Back / Neck) and Autonomic Dysregulation, run by Edward Via Virginia College of Osteopathic Medicine at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this clinical trial is to learn if Autonomic Recalibration works to reduce sympathetic dominance to alleviate dysfunctional myofascial pain. The main questions it aims to answer are: How is the Autonomic Nervous System (ANS) affected during Autonomic Recalibration Treatment (ART)? How are myofascial tissue… Read more about this study

Who is it for?
Ages 21 to 80 years
What is being tested?
Autonomic Recalibration Treatment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteUnited States
Study dates
27 Apr 2023to 27 Feb 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • dysfunctional myofascial pain, i.e., ongoing pain not relevant to an acute perturbation (e.g., recent injury) or known underlying condition (e.g., cancer).

Who cannot join

  • known skin allergies to gel as found in common cosmetic or household products
  • can't make treatment appointments on two consecutive days
  • myofascial pain is deemed functional (normal response to acute injury or ongoing pathology)
  • lacking a COVID-19 vaccination and a booster shot.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Edward Via College of Osteopathic Medicine, Auburn Campus

    Auburn, Alabama, 36832

Other trials in United States

About this study

Official title: Autonomic Recalibration Approach to Myofascial Pain Elimination

The goal of this clinical trial is to learn if Autonomic Recalibration works to reduce sympathetic dominance to alleviate dysfunctional myofascial pain. The main questions it aims to answer are:

How is the Autonomic Nervous System (ANS) affected during Autonomic Recalibration Treatment (ART)? How are myofascial tissue properties impacted from ART?

Participants will:

Have 2 treatments of ART on consecutive days. Wear sensors to track HRV (heart rate variability) and GSR to verify autonomic recalibration.

Measure changes in range of motion by wearing a Rokoko motion capture suit. Measure changes in muscle stiffness through shear wave elastography.

Read the detailed description

Myofascial pain contributes to opioid misuse and opioid use disorder. Alternative non-drug therapies for myofascial pain, such as osteopathic manipulative treatment, are critical areas of research. An unexplored approach in osteopathic manipulative treatment is recruiting the regulatory assistance of the autonomic nervous system (ANS) to alleviate myofascial pain. Autonomic Recalibration Technique (ART) is a manual and behavioral approach that employs osteopathic principles in addressing the neurobiological mechanisms that regulate myofascial pain. Our central hypothesis is that ART utilizes ANS regulation to restore myofascial function and alleviate chronic myofascial pain. The scientific premise of this proposal is the need to document mechanistic evidence that the ANS can be recruited to alleviate and eliminate pain by employing osteopathic principles. While elements of this approach have been employed by various practitioners, including manual and integrative clinicians including osteopaths, the innovation is to combine a manual bottom-up approach to shut down sympathetic tone, and a top-down approach to address trauma-based triggers that propagate pain. If successful, these preclinical data will be used in future grants to propose a clinical trial of ART as an additional technique in osteopathic manipulative treatment to provide an alternative to surgical or drug treatment of chronic myofascial pain.

Being tested
Autonomic Recalibration Treatment
Keywords
chronic pain, autonomic nervous system, sympathetic dominance, myofascial pain, Sympathetic tone, dysfunctional pain, Primal Reflex Release Technique, shear wave elastography, heart rate variability, galvanic skin response, Rokoko, motion capture, range of motion, posture
Medical subject headings
Chronic Pain, Primary Dysautonomias

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Autonomic Recalibration TreatmentOther

    An initial history to r/o pathology and document a chief complaint relevant to pain is conducted. An initial head to toe assessment of withdrawal or startle reflex behavior in response to palpation is performed to identify trigger points and establish patterns of sympathetic dominance throughout the myofascial system. The pattern of sympathetic dominance (pattern of trigger point) is addressed during treatment by Primal Reflex Release Technique Protocol to inhibit somatic afferent feedback loops and rebalance the autonomic nervous system towards a state of parasympathetic dominance. The absence of a trigger point indicates that the treatment is complete.

Study groups in NCT06603168
Study groupRoleWhat they receive
Autonomic Recalibration TreatmentExperimentalParticipant receives Autonomic Recalibration Treatment. Measurements: Pre/post shear wave elastography Pre/post myonometry Pre/post motion capture HRV/GSR during ART Pre/post pain ratings Pre/post trigger point log
Receives: Other: Autonomic Recalibration Treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain Intensity (NRS Pain Scale)

    0-10 Pain Rating. 0=no pain to 10=pain as intense as you can imagine

    Measured: Pre/Post for each day of treatment. 2 days total.

  2. Heart Rate Variability

    Changes in HRV (ms) pre/post and Day 1/Day 2.

    Measured: Pre/Post for each day of treatment. 2 days total.

  3. Galvanic Skin Response (GSR)

    Comparison of GSR peak counts pre/post and Day 1/Day 2.

    Measured: Pre/Post for each day of treatment. 2 days total.

  4. Muscle Stiffness using Shear Wave Elastography

    Changes in muscle stiffness (kPa) measured by Ultrasound.

    Measured: Pre/Post for each day of treatment. 2 days total.

  5. Nociceptive Trigger Points

    Log of reported trigger points during nociceptive start exam. Taken Pre, Middle, and Post ART on Day 1 and Day 2.

    Measured: Pre/Middle/Post for each day of treatment. 2 days total.

  6. Changes in mobility

    Posture/mobility changes using multivariate morphometric analysis.

    Measured: Pre/Post for each day of treatment. 2 days total.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Sep 2024
  2. Study start27 Apr 2023
  3. Primary completion24 Aug 2023
  4. Study completion27 Feb 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
This pilot study design is a pretest-posttest cohort study.
Masking
None (open label)
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06603168
Sponsor's protocol ID
2022-058
Acronym
ART
Status last verified
Sep 2024
First submitted
17 Sep 2024
Last updated
19 Sep 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Volkow ND, McLellan TA, Cotto JH, Karithanom M, Weiss SR. Characteristics of opioid prescriptions in 2009. JAMA. 2011 Apr 6;305(13):1299-301. doi: 10.1001/jama.2011.401. No abstract available.

    PubMed 21467282
  • Vattigunta S, Weiner S, Nayar SK, Jenkins S, Srikumaran U. Opioid consumption following orthopedic shoulder surgery: a retrospective analysis. J Shoulder Elbow Surg. 2021 Jul;30(7S):S153-S158. doi: 10.1016/j.jse.2021.04.005. Epub 2021 Apr 21.

    PubMed 33892118
  • Turo D, Otto P, Hossain M, Gebreab T, Armstrong K, Rosenberger WF, Shao H, Shah JP, Gerber LH, Sikdar S. Novel Use of Ultrasound Elastography to Quantify Muscle Tissue Changes After Dry Needling of Myofascial Trigger Points in Patients With Chronic Myofascial Pain. J Ultrasound Med. 2015 Dec;34(12):2149-61. doi: 10.7863/ultra.14.08033. Epub 2015 Oct 21.

    PubMed 26491094
  • Reddan MC, Wager TD. Modeling Pain Using fMRI: From Regions to Biomarkers. Neurosci Bull. 2018 Feb;34(1):208-215. doi: 10.1007/s12264-017-0150-1. Epub 2017 Jun 23.

    PubMed 28646349
  • Park G, Kim CW, Park SB, Kim MJ, Jang SH. Reliability and usefulness of the pressure pain threshold measurement in patients with myofascial pain. Ann Rehabil Med. 2011 Jun;35(3):412-7. doi: 10.5535/arm.2011.35.3.412. Epub 2011 Jun 30.

    PubMed 22506152
  • Oliveira-Campelo NM, de Melo CA, Alburquerque-Sendin F, Machado JP. Short- and medium-term effects of manual therapy on cervical active range of motion and pressure pain sensitivity in latent myofascial pain of the upper trapezius muscle: a randomized controlled trial. J Manipulative Physiol Ther. 2013 Jun;36(5):300-9. doi: 10.1016/j.jmpt.2013.04.008. Epub 2013 Jun 12.

    PubMed 23769263
  • Morikawa Y, Takamoto K, Nishimaru H, Taguchi T, Urakawa S, Sakai S, Ono T, Nishijo H. Compression at Myofascial Trigger Point on Chronic Neck Pain Provides Pain Relief through the Prefrontal Cortex and Autonomic Nervous System: A Pilot Study. Front Neurosci. 2017 Apr 11;11:186. doi: 10.3389/fnins.2017.00186. eCollection 2017.

    PubMed 28442987
  • Menendez ME, Ring D, Bateman BT. Preoperative Opioid Misuse is Associated With Increased Morbidity and Mortality After Elective Orthopaedic Surgery. Clin Orthop Relat Res. 2015 Jul;473(7):2402-12. doi: 10.1007/s11999-015-4173-5. Epub 2015 Feb 19.

    PubMed 25694266
  • Mejia-Mejia E, Budidha K, Abay TY, May JM, Kyriacou PA. Heart Rate Variability (HRV) and Pulse Rate Variability (PRV) for the Assessment of Autonomic Responses. Front Physiol. 2020 Jul 23;11:779. doi: 10.3389/fphys.2020.00779. eCollection 2020.

    PubMed 32792970
  • Malliaras P, Rathi S, Burstein F, Watt L, Ridgway J, King C, Warren N. 'Physio's not going to repair a torn tendon': patient decision-making related to surgery for rotator cuff related shoulder pain. Disabil Rehabil. 2022 Jul;44(14):3686-3693. doi: 10.1080/09638288.2021.1879945. Epub 2021 Feb 12.

    PubMed 33577359
  • Maher RM, Hayes DM, Shinohara M. Quantification of dry needling and posture effects on myofascial trigger points using ultrasound shear-wave elastography. Arch Phys Med Rehabil. 2013 Nov;94(11):2146-50. doi: 10.1016/j.apmr.2013.04.021. Epub 2013 May 14.

    PubMed 23684553
  • Lok UW, Huang C, Zhou C, Yang L, Ling W, Tang S, Gong P, Madson TJ, Jensen MA, Gay RE, Chen S. Quantitative Shear Wave Speed Assessment for Muscles With the Diagnosis of Taut Bands and/or Myofascial Trigger Points Using Probe Oscillation Shear Wave Elastography: A Pilot Study. J Ultrasound Med. 2022 Apr;41(4):845-854. doi: 10.1002/jum.15764. Epub 2021 Jun 4.

    PubMed 34085301
  • Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points. Anesthesiol Clin. 2007 Dec;25(4):841-51, vii-iii. doi: 10.1016/j.anclin.2007.07.003.

    PubMed 18054148
  • Lamine H, Bennour S, Laribi M, Romdhane L, Zaghloul S. Evaluation of Calibrated Kinect Gait Kinematics Using a Vicon Motion Capture System. Comput Methods Biomech Biomed Engin. 2017 Oct;20(sup1):111-112. doi: 10.1080/10255842.2017.1382886. No abstract available.

    PubMed 29088586
  • Kunz M, Scharmann S, Hemmeter U, Schepelmann K, Lautenbacher S. The facial expression of pain in patients with dementia. Pain. 2007 Dec 15;133(1-3):221-8. doi: 10.1016/j.pain.2007.09.007. Epub 2007 Oct 18.

    PubMed 17949906

Questions about this trial

What is this clinical trial studying?

A study testing Autonomic Recalibration Treatment in people with Chronic Pain (Back / Neck) and Autonomic Dysregulation, run by Edward Via Virginia College of Osteopathic Medicine at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain Intensity (NRS Pain Scale) (time frame: Pre/Post for each day of treatment. 2 days total.). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06603168, which also lists 33 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Sep 2024.

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