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The role of patients' expectation of appropriate initial manual therapy treatment in outcomes for patients with low back pain.

Publication ,  Journal Article
Donaldson, M; Learman, K; O'Halloran, B; Showalter, C; Cook, C
Published in: J Manipulative Physiol Ther
June 2013

OBJECTIVES: The purpose of this study was to compare the outcomes of patients with low back pain who had a matched, unmatched, or were indifferent with their pretreatment expectation/preference to the manual therapy thrust or nonthrust intervention. A secondary purpose was to explore baseline patient characteristics affiliated with a preference of manual therapy treatment type (thrust or nonthrust manipulation). METHODS: The study is a secondary analysis of a prospective randomized controlled trial that enrolled 149 patients with low back pain, from 16 distinct outpatient physical therapy practices within the United States. Patient's pretreatment expectations were identified before randomization. The intervention included manual therapy (thrust or nonthrust manipulation) with a standardized exercise program, which was carried out for 2 treatment sessions. Six outcomes captured the constructs of (a) disability, (b) pain perception, (c) care intensity, (d) fear avoidance behaviors, and (e) perception of extent of recovery. Descriptive statistics, analysis of variance (and Tukey, a post hoc test), Fisher exact test, and a multivariate logistic regression analysis were used for analysis. RESULTS: There were no statistical differences in any of the 6 dedicated outcomes measures between the matched, unmatched, and no preference groups. Therapist-determined patient "irritability" was associated with patient preference of nonthrust treatment, and higher body mass index was associated with patient preference of thrust treatment. CONCLUSIONS: This study shows that patients demonstrated no statistical difference in disability or pain outcome measures when matched, unmatched, or indifferent to the intervention.

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Published In

J Manipulative Physiol Ther

DOI

EISSN

1532-6586

Publication Date

June 2013

Volume

36

Issue

5

Start / End Page

276 / 283

Location

United States

Related Subject Headings

  • United States
  • Severity of Illness Index
  • Range of Motion, Articular
  • Prospective Studies
  • Patient Satisfaction
  • Outcome Assessment, Health Care
  • Orthopedics
  • Middle Aged
  • Manipulation, Spinal
  • Male
 

Citation

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Donaldson, M., Learman, K., O’Halloran, B., Showalter, C., & Cook, C. (2013). The role of patients' expectation of appropriate initial manual therapy treatment in outcomes for patients with low back pain. J Manipulative Physiol Ther, 36(5), 276–283. https://doi.org/10.1016/j.jmpt.2013.05.016
Donaldson, Megan, Kenneth Learman, Bryan O’Halloran, Christopher Showalter, and Chad Cook. “The role of patients' expectation of appropriate initial manual therapy treatment in outcomes for patients with low back pain.J Manipulative Physiol Ther 36, no. 5 (June 2013): 276–83. https://doi.org/10.1016/j.jmpt.2013.05.016.
Donaldson M, Learman K, O’Halloran B, Showalter C, Cook C. The role of patients' expectation of appropriate initial manual therapy treatment in outcomes for patients with low back pain. J Manipulative Physiol Ther. 2013 Jun;36(5):276–83.
Donaldson, Megan, et al. “The role of patients' expectation of appropriate initial manual therapy treatment in outcomes for patients with low back pain.J Manipulative Physiol Ther, vol. 36, no. 5, June 2013, pp. 276–83. Pubmed, doi:10.1016/j.jmpt.2013.05.016.
Donaldson M, Learman K, O’Halloran B, Showalter C, Cook C. The role of patients' expectation of appropriate initial manual therapy treatment in outcomes for patients with low back pain. J Manipulative Physiol Ther. 2013 Jun;36(5):276–283.
Journal cover image

Published In

J Manipulative Physiol Ther

DOI

EISSN

1532-6586

Publication Date

June 2013

Volume

36

Issue

5

Start / End Page

276 / 283

Location

United States

Related Subject Headings

  • United States
  • Severity of Illness Index
  • Range of Motion, Articular
  • Prospective Studies
  • Patient Satisfaction
  • Outcome Assessment, Health Care
  • Orthopedics
  • Middle Aged
  • Manipulation, Spinal
  • Male