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Table 1 Study inclusion and exclusion criteria

From: Study protocol for patient response to spinal manipulation – a prospective observational clinical trial on physiological and patient-centered outcomes in patients with chronic low back pain

Inclusion criteria

Rationale

Source

Age ≥ 21 and ≤ 65

Chronic LBP not as common under age 21. Older adults not as likely to tolerate biomechanical tests

PS, BL1

Chronic low back pain matching QTF Classifications 1, 2, and 3

Low back pain, uncomplicated by known nerve root compression, neurological signs or prior surgery

CR

RMDQ ≥ 6

Disability high enough to prevent floor effect

PS

NRS Pain (Average within past 24 hours) ≥ 2 at PS and BL1 and BL2, and ≥ 4 at PS or BL1

Pain high enough to prevent floor effect

PS, BL1, BL2

Exclusion criteria

  

Additional diagnostic tests or urgent/emergent procedures needed beyond study exam procedures

Advanced diagnostic tests or other necessary evaluation(s) are outside study scope

CR

BMI ≥ 40

Unable to adequately perform manipulation procedures per study protocol

BL1

BDI II score ≥ 29

May interfere with protocol compliance and data collection

BL1

Compliance concerns

May compromise ability to comply with study protocols

CR

Co-morbidity requiring coincident clinical management

May interfere with study requirements, pose significant scheduling burden, or pose a safety risk

CR

Inability to read or verbally comprehend English

Proxy unavailable

BL1

Inflammatory or destructive tissue changes to the spine

Potential intolerance to biomechanical testing or treatment protocols

PS, CR

Joint replacement history

Potential intolerance to biomechanical testing or treatment protocols

PS, CR

Moving from area within 8 weeks

May interfere with ability to comply with study protocol

PS, BL1, BL2

Neuromuscular disease

Interference with biomechanical measurements

PS

No indication for SM at L1 – L5 or sacroiliac joint (s)

Spinal Manipulation is only treatment available

CR

Open or pending litigation for LBP or seeking/receiving disability compensation

May interfere with study compliance or data collection

PS, BL1

Pacemaker/Defibrillator

Safety due to potential electromagnetic fields produced by biomechanical testing equipment

PS, BL1

Peripheral arterial disease

Potential intolerance to biomechanical tests, potential need for referral, and interference with pain and disability measures

PS, CR

Pregnancy

Safety for biomechanical testing and may interfere with data collection

PS, BL1

QTF classification 4-11

Conditions sufficiently complicated to cause intolerance to biomechanical testing procedures or data collection

CR

Received SM within past 4 weeks

May interfere with data interpretation

BL1

Safety

Precaution for condition(s) posing a safety risk or intolerance for treatment or biomechanical tests (i.e., excessive bruising/bleeding and adhesive sensitivity)

CR

Suspicion of drug or alcohol abuse

May interfere with data collection, ability to comply with study protocol, and require referral

CR

Uncontrolled hypertension

May interfere with study protocols and require referral

CR

  1. BDI-II: Beck Depression Inventory; BL1: Baseline Visit 1; BL2: Baseline Visit 2; BMI: body mass index; CR: Case Review; L1 – L5: lumbar segment level 1 to 5. LBP: low back pain; NRS: numerical rating scale; PS: Phone Screen; QTF- Quebec Task Force; SM: Spinal Manipulation.