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

Publication ,  Journal Article
Xia, T; Long, CR; Gudavalli, MR; Wilder, DG; Vining, RD; Rowell, RM; Reed, WR; DeVocht, JW; Goertz, CM; Owens, EF; Meeker, WC
Published in: Spine (Phila Pa 1976)
June 2016

STUDY DESIGN: A three-arm controlled trial with adaptive allocation. OBJECTIVES: 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. SUMMARY OF BACKGROUND DATA: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. LEVEL OF EVIDENCE: 2.

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Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

June 2016

Volume

41

Issue

12

Start / End Page

E702 / E709

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Single-Blind Method
  • Range of Motion, Articular
  • Prospective Studies
  • Pain Measurement
  • Orthopedics
  • Middle Aged
  • Manipulation, Spinal
  • Male
 

Citation

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Xia, T., Long, C. R., Gudavalli, M. R., Wilder, D. G., Vining, R. D., Rowell, R. M., … Meeker, W. C. (2016). 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 (Phila Pa 1976), 41(12), E702–E709. https://doi.org/10.1097/BRS.0000000000001373
Xia, Ting, Cynthia R. Long, Maruti R. Gudavalli, David G. Wilder, Robert D. Vining, Robert M. Rowell, William R. Reed, et al. “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 (Phila Pa 1976) 41, no. 12 (June 2016): E702–9. https://doi.org/10.1097/BRS.0000000000001373.
Xia T, Long CR, Gudavalli MR, Wilder DG, Vining RD, Rowell RM, et al. 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 (Phila Pa 1976). 2016 Jun;41(12):E702–9.
Xia, Ting, et al. “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 (Phila Pa 1976), vol. 41, no. 12, June 2016, pp. E702–09. Pubmed, doi:10.1097/BRS.0000000000001373.
Xia T, Long CR, Gudavalli MR, Wilder DG, Vining RD, Rowell RM, Reed WR, DeVocht JW, Goertz CM, Owens EF, Meeker WC. 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 (Phila Pa 1976). 2016 Jun;41(12):E702–E709.

Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

June 2016

Volume

41

Issue

12

Start / End Page

E702 / E709

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Single-Blind Method
  • Range of Motion, Articular
  • Prospective Studies
  • Pain Measurement
  • Orthopedics
  • Middle Aged
  • Manipulation, Spinal
  • Male