Manual
Therapy Research
|
| Paper
Title |
A
Randomized Trial of Combined Manipulation, Stabilizing Exercises, and
Physician Consultation Compared to Physician Consultation Alone for
Chronic Low Back Pain |
| Author(s) |
Niemistö,
L; Lahtinen-Suopanki, T; Rissanen, P; Lindgren, KA; Sarna, S; Hurri, H |
| Journal
Reference |
Spine
2003; 28(19):2185-2191 |
| Background
and Objective |
To
examine the effectiveness of combined manipulative treatment, stabilizing
exercises, and physician consultation compared with physician consultation
alone for chronic low back pain. Strong evidence exists that manual
therapy provides more effective short-term pain relief than does placebo
treatment in the management of chronic low back pain. The evidence for
long-term effect is lacking. |
| Methods |
Two
hundred four chronic low back pain patients, whose Oswestry disability
index was at least 16%, were randomly assigned to either a
manipulative-treatment group or a consultation group. All were clinically
examined, informed about their back pain, provided with an educational
booklet, and were given specific instructions based on the clinical
evaluation. The treatment included four sessions of manipulation and
stabilizing exercises aiming to correct the lumbopelvic rhythm.
Questionnaires inquired about pain intensity, self-rated disability,
mental depression, health-related quality of life, health care costs, and
production costs. |
| Results |
At
the baseline, the groups were comparable, except for the percentage of
employees (P = 0.01). At the 5- and 12-month follow-ups, the
manipulative-treatment group showed more significant reductions in pain
intensity (P < 0.001) and in self-rated disability (P = 0.002) than the
consultation group. However, we detected no significant difference between
the groups in health-related quality of life or in costs. |
| Authors'
Conclusions |
The
manipulative treatment with stabilizing exercises was more effective in
reducing pain intensity and disability than the physician consultation
alone. The present study showed that short, specific treatment programs
with proper patient information may alter the course of chronic low back
pain. |
| Clinical
Significance |
This
study demonstrates that an intervention including manipulation and spinal
stability exercises can have a positive effect on pain and disability
scores over those treated by a physician alone for chronic low back pain
at 5 and 12 months follow up after only 4 treatments. |
| NOTE:
The clinical significance review is the opinion of Dr Ken Mueller based
upon the information available at the time of posting. Unauthorized
use of the section on clinical significance is prohibited by Canadian
Copyright. The above research abstract is based on information
published in the journal Spine. For further information, please
refer to the original article utilizing the publication information
provided. May 31, 2006 |
