Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

A prospective randomised controlled trial of spinal manipulation and ultrasound in the treatment of chronic low back pain [with consumer summary]
Mohseni-Bandpei MA, Critchley J, Staunton T, Richardson B
Physiotherapy 2006 Mar;92(1):34-42
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: To assess the short- and long-term effectiveness of spinal manipulation therapy, and to identify the effect of manipulation on lumbar muscle endurance in patients with chronic low back pain (LBP). DESIGN: A randomised controlled trial comparing manipulation and exercise treatment with ultrasound and exercise treatment. SETTING: An outpatient physiotherapy department. PARTICIPANTS: One hundred and twenty patients with chronic LBP were allocated at random into the manipulation/exercise group or the ultrasound/exercise group. INTERVENTIONS: Both groups were given a programme of exercises. In addition, one group received spinal manipulation therapy and the other group received therapeutic ultrasound. MAIN OUTCOME MEASURES: Pain intensity, functional disability, lumbar movements and muscle endurance were measured shortly before treatment, at the end of the treatment programme and 6 months after randomisation using surface electromyography. RESULTS: Following treatment, the manipulation/exercise group showed a statistically significant improvement (p = 0.001) in pain intensity (mean 16.4 mm, 95% confidence interval (CI) 6.1 to 26.8), functional disability (mean 8%, 95% CI 2 to 13) and spinal mobility (flexion: mean 9.4 mm, 95% CI 5.5 to 13.4; extension: mean 3.4 mm, 95% CI 1.0 to 5.8). There was no significant difference (p = 0.068) between the two groups in the median frequency of surface electromyography (multifidus: mean 6.8 Hz, 95% CI 1.24 to 14.91; iliocostalis: mean 2.4 Hz, 95% CI 2.5 to 7.1), although a significant difference (p = 0.013) was found in the median frequency slope of surface electromyography in favour of spinal manipulation for multifidus alone (mean 0.3, 95% CI 0.1 to 0.5). A significant difference was also found between the two groups in favour of the manipulation/exercise group at 6-month follow-up. CONCLUSIONS: Although improvements were recorded in both groups, patients receiving manipulation/exercise showed a greater improvement compared with those receiving ultrasound/exercise at both the end of the treatment period and at 6-month follow-up.

Full text (sometimes free) may be available at these link(s):      help