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Trial registered on ANZCTR

Registration number
Ethics application status
Date submitted
Date registered
Date last updated
Type of registration
Retrospectively registered

Titles & IDs
Public title
Effects after the application of the first rib thrust technique in patients with whiplash syndrome.
Scientific title
The first rib thrust technique applied to patients suffering from whiplash disorder causing changes in muscle hardness and pressure pain theresholds.
Secondary ID [1] 273119 0
"Nil known"
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Whiplash disorder 270867 0
Muscle hardness 270868 0
Pressure pain thresholds 299416 0
Condition category
Condition code
Physical Medicine / Rehabilitation 279044 279044 0 0

Study type
Description of intervention(s) / exposure
Before the intervention, the practitioner will take preintervention measurement of the hardness of some muscles with a Myotonometer and the pressure pain thresholds with an algometer.
After the measurements,(40 minutes) the practitioner will apply a thrust technique to the first rib with the patient in seated position and the practitioner behind him. The technique has a duration of 90 seconds.The measurements will be taken again after the thrust technique, so the thrust technique will be applied only once to the patient.
Intervention code [1] 269456 0
Treatment: Other
Intervention code [2] 269457 0
Comparator / control treatment
The same intervention will be made to the control group, but they will receive a sham- manual technique: the therapist will simule the manipulative procedure but without taking up the tissue tension or performing any thrust action. This position will be mantained for 15 seconds.
Control group

Primary outcome [1] 279698 0
Changes in the hardness of the following muscles: masseter, stercleidomastoideus, scalenus, trapezius, biceps and triceps in relaxed and contracted position.
To perform these steps it will be used a Myotonometer (R). These will be the preintervention measurements. After the intervention the measurements will be repeated (postintervention measurements).
Timepoint [1] 279698 0
Preintervention measurements will be taken immediately prior to the intervention. Post intervention measurements will be taken immmediately post the intervention.
Secondary outcome [1] 294243 0
Changes in pressure pain theresholds on the following points: a point through the path of the trigeminus nerve, a point through the path of the median nerve, a point through the path of the cubital nerve, a point at the trapezius muscle, at the biceps muscle and at the triceps muscle. These will be preintervention measurements
These measurements will be taken with a surface algometer. After the intervention the measurements will be repeated (postintervention measurements).
Timepoint [1] 294243 0
Preintervention measurements will be taken immediately prior to the intervention. Post intervention measurements will be taken immmediately post the intervention.

Key inclusion criteria
1. Patients who are diagnosed of Whiplash grade I or II according to the Quebec Task Force.
2. .Patients who show a positive response to the cervical rotation lateral flexion test.
3. Patients who give written informed consent.
4. Man or woman over 18 and under 65 years old.
Minimum age
18 Years
Maximum age
65 Years
Both males and females
Can healthy volunteers participate?
Key exclusion criteria
`-Patients suffering from cervicalgia, if this one is not related to the whiplash syndrome.
-Patients who pretend to have suffered a whiplash.
-Patients who are not diagnosed as have had suffered a whiplash.
- Level III or more by the Quebec Task Force classification.
-Malformations or previous injuries.
-Contraindication to the first rib manipulation technique, such as fracture at any level of the cervical spine.
-Tumor, osteitis, risk of cerebral hemorrhage.
-Any kind of rheumatism.

Study design
Purpose of the study
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Every subject will choose a red ball or a green ball. If he chooses he green one , he will be recruited to the control group. The subject who chooses the red ball will be recruited to the tratment group.
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
randomization.com website
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?

Intervention assignment
Other design features
Not Applicable
Type of endpoint(s)
Statistical methods / analysis

Recruitment status
Date of first participant enrolment
Date of last participant enrolment
Date of last data collection
Sample size
Accrual to date
Recruitment outside Australia
Country [1] 3867 0
State/province [1] 3867 0

Funding & Sponsors
Funding source category [1] 269939 0
Name [1] 269939 0
University of Seville
Address [1] 269939 0
Physiotherapy, Nursing and Podology Center. Avicena St.
41009 Seville (Spain)
Country [1] 269939 0
Primary sponsor type
Marta Pena Salinas
Physiotherapy Department. University of Seville. Avicena St., 41009
Seville (Spain)
Secondary sponsor category [1] 268937 0
Name [1] 268937 0
University of Seville
Address [1] 268937 0
Avicena St. 41009- Seville (Spain)
Country [1] 268937 0

Ethics approval
Ethics application status
Ethics committee name [1] 271907 0
Ethics Committee, University of Seville.
Ethics committee address [1] 271907 0
Ethics committee country [1] 271907 0
Date submitted for ethics approval [1] 271907 0
Approval date [1] 271907 0
Ethics approval number [1] 271907 0

Brief summary
Muscles show several changes after a traumatic event, such a whiplash. We will focus our study into changes in the hardness of a number of muscles in patients suffering from a whiplash. We will use a device called Myotonometer for this purpose. We will also measure changes in pressure pain threshold in these patients with an algometer.
The measures will be taken before and after the intervention. The intervention will consist of a first rib manipulation technique.
Trial website
Trial related presentations / publications
Public notes

Principal investigator
Name 33204 0
Dr Marta Pena Salinas
Address 33204 0
Physiotherapy Department.
Avicena St, , 41009, Seville (Spain)
Country 33204 0
Phone 33204 0
Fax 33204 0
Email 33204 0
Contact person for public queries
Name 16451 0
Dr Marta Pena Salinas
Address 16451 0
Physiotherapy Department. University of Seville, Avicena St, Seville-41009 (Spain)
Country 16451 0
Phone 16451 0
+0034 636 287228
Fax 16451 0
Email 16451 0
Contact person for scientific queries
Name 7379 0
Dr Marta Pena Salinas
Address 7379 0
Berlin St 20, Seville, 41012-Spain
Country 7379 0
Phone 7379 0
+0034 636 287228
Fax 7379 0
Email 7379 0

No information has been provided regarding IPD availability
Summary results
Have study results been published in a peer-reviewed journal?
Other publications
Have study results been made publicly available in another format?
Results – basic reporting
Results – plain English summary