No differences in outcomes in people with low back pain who met the clinical prediction rule for lumbar spine manipulation when a pragmatic non-thrust manipulation was used as the comparator

Purpose: To investigate differences in pain and disability between patients treated with thrust manipulation (TM) and those treated with non-thrust manipulation (NTM) in a group of patients with mechanical low back pain (LBP) who had a within-session response to an initial assessment and met the clinical prediction rule (CPR). Methods: Data from 71 patients who met the CPR were extracted from a database of patients in a larger randomized controlled trial comparing TM and NTM. Treatment of the first two visits involved either TM or NTM (depending on allocation) and a standardized home exercise programme. Data analysis included descriptive statistics and a two-way ANOVA examining within-and between-groups effects for pain and disability, as well as total visits, total days in care, and rate of recovery. Results: No between-group differences in pain or disability were found for NTM versus TM groups (p ¼ 0.55), but within-subjects effects were noted for both groups (p = 0.001). Conclusions: This secondary analysis suggests that patients who satisfy the CPR benefit as much from NTM as from TM.

Duke Scholars

Author Chad E. Cook Orthopaedic Surgery, Physical Therapy