Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Manual therapy, and more specifically spinal manipulation, is a common treatment for low back pain, and scientific evidences of its efficacy and relevance have greatly increased over the past decades. However, the specific mechanisms underlying the clinical effects of spinal manipulation therapy remain uncertain. The main objective of this doctoral project is to determine how different dosages of spinal manipulation can modify physiological and clinical responses in both healthy participants and patients with chronic low back pain. Phase 1 consists of 3 independent studies. In each of the study, healthy participants, lying down in a prone position, will be randomly subjected to 4 different levels of a same spinal manipulation therapy biomechanical parameters delivered by an innovative tool developed by the Université du Québec à Trois-Rivières. This tool standardizes the delivery of spinal manipulation while limiting patient-doctor interactions. Phase 2 consists of comparing the responses of healthy control participants and patients presenting chronic low back pain. Participants will be submitted twice to four different levels of spinal manipulation dosage derived from phase one. Several functional and clinical outcomes, such as pain intensity, disability, muscle activity and range of motion will be assessed before and after each experimental session. One of the main contributions of this project will be to study mechanical, neurophysiological, functional and clinical responses to spinal manipulation while assessing the specific contribution of various spinal manipulation mechanical components. From a clinical perspective, it is believed that studying spinal manipulation dose-response relationship in an experimental paradigm where the treatment parameters are standardized will provide a solid basis for the design of improved clinical trials, and ultimately lead to improved low back pain patients' care.