Journal article
Similar Effects of Thrust and Nonthrust Spinal Manipulation Found in Adults With Subacute and Chronic Low Back Pain: A Controlled Trial With Adaptive Allocation
Spine (Philadelphia, Pa. 1976), Vol.41(12), pp.E702-E709
06/2016
DOI: 10.1097/BRS.0000000000001373
PMCID: PMC4902754
PMID: 26656041
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.
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Details
- Title: Subtitle
- Similar Effects of Thrust and Nonthrust Spinal Manipulation Found in Adults With Subacute and Chronic Low Back Pain: A Controlled Trial With Adaptive Allocation
- Creators
- Ting Xia - Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA †Department of Biomedical Engineering, University of Iowa, Iowa City, IA ‡Diagnosis & Radiology, Palmer College of Chiropractic, Davenport, IA §Dr. Sid E. Williams Center for Chiropractic Research, Life University, Marietta, GA ¶Palmer College of Chiropractic-West Campus, San Jose, CACynthia R LongMaruti R GudavalliDavid G WilderRobert D ViningRobert M RowellWilliam R ReedJames W DeVochtChristine M GoertzEdward F Owens JrWilliam C Meeker
- Resource Type
- Journal article
- Publication Details
- Spine (Philadelphia, Pa. 1976), Vol.41(12), pp.E702-E709
- DOI
- 10.1097/BRS.0000000000001373
- PMID
- 26656041
- PMCID
- PMC4902754
- NLM abbreviation
- Spine (Phila Pa 1976)
- ISSN
- 0362-2436
- eISSN
- 1528-1159
- Publisher
- Lippincott Williams & Wilkins; United States
- Grant note
- C06 RR015433 / NCRR NIH HHS U19 AT002006 / NCCIH NIH HHS
- Language
- English
- Date published
- 06/2016
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Occupational and Environmental Health; Epidemiology
- Record Identifier
- 9984064581302771
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