Logo image
Similar Effects of Thrust and Nonthrust Spinal Manipulation Found in Adults With Subacute and Chronic Low Back Pain: A Controlled Trial With Adaptive Allocation
Journal article   Open access   Peer reviewed

Similar Effects of Thrust and Nonthrust Spinal Manipulation Found in Adults With Subacute and Chronic Low Back Pain: A Controlled Trial With Adaptive Allocation

Ting Xia, Cynthia R Long, Maruti R Gudavalli, David G Wilder, Robert D Vining, Robert M Rowell, William R Reed, James W DeVocht, Christine M Goertz, Edward F Owens Jr, …
Spine (Philadelphia, Pa. 1976), Vol.41(12), pp.E702-E709
06/2016
DOI: 10.1097/BRS.0000000000001373
PMCID: PMC4902754
PMID: 26656041
url
http://doi.org/10.1097/BRS.0000000000001373View
Open Access

Abstract

A three-arm controlled trial with adaptive allocation. The aim of this study was to compare short-term effects of a side-lying, thrust spinal manipulation (SM) procedure and a nonthrust, flexion-distraction SM procedure in adults with subacute or chronic low back pain (LBP) over 2 weeks. SM has been recommended in recently published clinical guidelines for LBP management. Previous studies suggest that thrust and nonthrust SM procedures, though distinctly different in joint loading characteristics, have similar effects on patients with LBP. Participants were eligible if they were 21 to 54 years old, had LBP for at least 4 weeks, scored 6 or above on the Roland-Morris disability questionnaire, and met the diagnostic classification of 1, 2, or 3 according to the Quebec Task Force Classification for Spinal Disorders. Participants were allocated in a 3:3:2 ratio to four sessions of thrust or nonthrust SM procedures directed at the lower lumbar and pelvic regions, or to a 2-week wait list control. The primary outcome was LBP-related disability using Roland-Morris Disability Questionnaire and the secondary outcomes were LBP intensity using visual analog scale, Fear-Avoidance Beliefs Questionnaire, and the 36-Item Short Form Health Survey. The study was conducted at the Palmer Center for Chiropractic Research with care provided by experienced doctors of chiropractic. Clinicians and patients were not blinded to treatment group. Of 192 participants enrolled, the mean age was 40 years and 54% were male. Improvement in disability, LBP intensity, Fear-Avoidance Beliefs Questionnaire-work subscale, and 36-Item Short Form Health Survey-physical health summary measure for the two SM groups were significantly greater than the control group. No difference in any outcomes was observed between the two SM groups. Thrust and nonthrust SM procedures with distinctly different joint loading characteristics demonstrated similar effects in short-term LBP improvement and both were superior to a wait list control. 2.
Single-Blind Method Chronic Pain - therapy Chronic Pain - diagnosis Prospective Studies Humans Middle Aged Male Treatment Outcome Acute Pain - diagnosis Low Back Pain - therapy Low Back Pain - diagnosis Young Adult Acute Pain - therapy Manipulation, Spinal - methods Pain Measurement - methods Range of Motion, Articular - physiology Adult Female Lumbar Vertebrae - pathology

Details

Metrics

Logo image