title: Immediate changes in electroencephalography activity in individuals with nonspecific chronic low back pain after cranial osteopathic manipulative treatment: study protocol of a randomized, controlled crossover trial.
abstract: BACKGROUND
  Osteopathic medicine is based on a diagnostic and therapeutic system to treat tissue mobility/ motility dysfunctions in general, using different approaches (depending on the target tissue) known as osteopathic manipulative treatment. Among the available techniques those ones addressed to the cranial field are the most questioned because of the lack of scientific evidence; but the compression of the 4th ventricle technique has been largely studied in clinical trials. Studies have shown that the technique may affect both central and autonomous nervous system, modulating some reflexes (Traube-Hering baro signal), and modifying brain cortex electrical activity through central sensitization in subjects with chronic low back pain. Thus, investigators hypothesize that the compression of the 4th ventricle may modulate peak alpha frequency (eletroencephalographic assessment) and promote physical relaxation in subjects in vigil.
  
  
  METHODS
  A randomized, controlled crossover trial with blinded assessor was designed to test the hypothesis. A total of 81 participants will be assigned to three treatment conditions, with seven days of washout: (I) compression of the 4th ventricle; (II) sham compression of the fourth ventricle; (III) control (no intervention). The (I) power amplitude and the (II) frequencies of the dominant peak in the alpha band will be the primary outcome measures of the study. All participants will be recruited at the Outpatient Rehabilitation Service of the University Hospital of Brasília-University of Brasília. All the electroencephalographic exams will be conducted by a blinded assessor.
  
  
  CONCLUSIONS
  The investigators hypothesize that patients with chronic low back pain submitted to the technique would have the peak alpha frequency modulated and, thus, would experience physical relaxation.
  
  
  BACKGROUND
  NCT02111382.
authors.affiliation: College of Physical Therapy, University of Brasilia, Brasilia, DF, Brasil. wagnermartins@unb.com.
authors.forename: Wagner Rodrigues
authors.initials: WR
authors.lastname: Martins
authors.affiliation: Brazilian Institute of Osteopathic, Rio de Janeiro, RJ, Brazil. lrdiniz@gmail.com.
authors.forename: Leonardo Rios
authors.initials: LR
authors.lastname: Diniz
authors.affiliation: Brazilian Institute of Osteopathic, Rio de Janeiro, RJ, Brazil. juscelinocastro@gmail.com.
authors.forename: Juscelino Castro
authors.initials: JC
authors.lastname: Blasczyk
authors.affiliation: Brazilian Institute of Osteopathic, Rio de Janeiro, RJ, Brazil. Karinalagoa@gmail.com.
authors.forename: Karina Ferreira
authors.initials: KF
authors.lastname: Lagoa
authors.affiliation: College of Physical Therapy, University of Brasilia, Brasilia, DF, Brasil. srthomaz@yahoo.com.br.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Thomaz
authors.affiliation: Brazilian Institute of Osteopathic, Rio de Janeiro, RJ, Brazil. osteopatiamarcia@gmail.com.
authors.forename: Marcia Elisabeth
authors.initials: ME
authors.lastname: Rodrigues
authors.affiliation: Faculty of Physical Education, University of Brasilia, Brasilia, DF, Brazil. rjaco@unb.br.
authors.forename: Ricardo Jacó
authors.initials: RJ
authors.lastname: de Oliveira
authors.affiliation: College of Physical Therapy, University of Brasilia, Brasilia, DF, Brasil. anaclara@unb.br.
authors.forename: Ana Clara
authors.initials: AC
authors.lastname: Bonini-Rocha
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D018592:Cross-Over Studies; D004569:Electroencephalography; D005260:Female; D006257:Head / Q000033:anatomy & histology; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D026301:Manipulation, Osteopathic; D008875:Middle Aged; D010045:Outpatients; D055815:Young Adult