Does early change predict long-term (6 months) improvements in subjects who receive manual therapy for low back pain?


Journal Article

Early change is commonly assessed for manual therapy interventions and has been used to determine treatment appropriateness. However, current studies have only explored the relationship of between or within-session changes and short-/medium-term outcomes. The goal of this study was to determine whether pain changes after two weeks of pragmatic manual therapy could predict those participants with chronic low back pain who demonstrate continued improvements at 6-month follow-up. This study was a retrospective observational design. Univariate logistic regression analyses were performed using a 33% and a 50% pain change to predict improvement. Those who experienced a ≥33% pain reduction by 2 weeks had 6.98 (95% CI = 1.29, 37.53) times higher odds of 50% improvement on the GRoC and 4.74 (95% CI = 1.31, 17.17) times higher odds of 50% improvement on the ODI (at 6 months). Subjects who reported a ≥50% pain reduction at 2 weeks had 5.98 (95% CI = 1.56, 22.88) times higher odds of a 50% improvement in the GRoC and 3.99 (95% CI = 1.23, 12.88) times higher odds of a 50% improvement in the ODI (at 6 months). Future studies may investigate whether a change in plan of care is beneficial for patients who are not showing early improvement predictive of a good long-term outcome.

Full Text

Duke Authors

Cited Authors

  • Cook, C; Petersen, S; Donaldson, M; Wilhelm, M; Learman, K

Published Date

  • September 2017

Published In

Volume / Issue

  • 33 / 9

Start / End Page

  • 716 - 724

PubMed ID

  • 28727924

Pubmed Central ID

  • 28727924

Electronic International Standard Serial Number (EISSN)

  • 1532-5040

Digital Object Identifier (DOI)

  • 10.1080/09593985.2017.1345025


  • eng

Conference Location

  • England