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Short-term effect of spinal manipulation on pain perception, spinal mobility, and full height recovery in male subjects with degenerative disc disease: a randomized controlled trial
Vieira-Pellenz F, Oliva-Pascual-Vaca A, Rodriguez-Blanco C, Heredia-Rizo AM, Ricard F, Almazan-Campos G
Archives of Physical Medicine and Rehabilitation 2014 Sep;95(9):1613-1619
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To evaluate the short-term effect on spinal mobility, pain perception, neural mechanosensitivity, and full height recovery after high-velocity low-amplitude (HVLA) spinal manipulation (SM) in the lumbosacral joint (L5 to S1). STUDY DESIGN: Randomized, double-blind, controlled clinical trial with evaluations at baseline and after intervention. SETTING: University-based physical therapy research clinic. PARTICIPANTS: Forty male subjects (n = 40) (mean age +/- SD 38 +/- 9.14 years) diagnosed with degenerative lumbar disease at L5 to S1 were randomly divided into two groups: the treatment group (TG) (n = 20) (39 +/- 9.12 years) and control group (CG) (n = 20) (37 +/- 9.31 years). All participants completed the intervention and follow-up evaluations. INTERVENTIONS: A single L5 to S1 SM technique (pull-move) was performed in the TG, whereas the CG received a single placebo intervention. MAIN OUTCOME MEASURES: Measures included assessing the subject's height using a stadiometer. The secondary outcome measures included perceived low back pain, evaluated using a visual analogue scale; neural mechanosensitivity, as assessed using the passive straight leg raise test (SLR); and amount of spinal mobility in flexion, as measured using the finger to floor distance test (FFD) RESULTS: The intra-group comparison indicated a significant improvement in all variables in the TG (p < 0.001). There were no changes in the CG, except for the FFD (p = 0.008). In the between-group comparison of the mean differences from pre- to post-intervention, there was statistical significance for all cases (p < 0.001). CONCLUSIONS: An HVLA SM in the lumbosacral joint performed on male subjects with degenerative disc disease immediately improves self-perceived pain, spinal mobility in flexion, hip flexion during the passive SLR, and subject's full height. Future studies should include female subjects and should evaluate the long-term results.

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