BACKGROUND: Chronic low back pain has been shown to be related to gestures, muscle and activity characteristics. Etiological factors include decreased or excessive lumbar lordosis, decreased abdominal muscle strength, imbalance of trunk flexors and extensors, and decreased lumbar mobility. Spinal manipulation or chiropractic surgery is a conservative treatment for spinal dysfunction and pain at abroad. OBJECTIVE(S): To assess the efficacy of spinal mechanical impulsive manipulation and conventional physiotherapy by subjective pain and dysfunction as well as range of motion and trunk muscle strength in the patients with chronic low back pain. METHOD(S): This was a prospective, randomized controlled clinical trial. Sixty subjects with an age of 18 to 65 years, who had a primary complaint of low back pain at least 6-week duration with or without radiating pain to the lower extremity were included, and randomized into trial (spinal mechanical impulsive manipulation) and control (conventional physiotherapy) groups. Treatment programs were performed twice weekly, for 4 weeks. The visual analogue scale scores, Roland-Morris dysfunction questionnaire, lumbar spinal range of motion and trunk muscle strength before and 1 month after treatment were detected. RESULTS AND CONCLUSION(S): (1) All subjects had a significant decrease in pain and disability after intervention (p < 0.05). The visual analogue scale score at 1 month after treatment in the trial group was significantly lower than those in the control group (p < 0.05). (2) Both groups showed significant improvements in lumbar flexion, extension, flexor and extensor strength after treatment (p < 0.05). The lumbar flexion range of motion and extensor muscle strength at 1 month after treatment were increased significantly in the trial group compared with the control group (p < 0.05). (3) Both groups showed significant improvements in trunk extensor strength after treatment (p < 0.05). The trunk extensor strength improvement at 1 month after treatment in the trial group was significantly superior to that in the control group (p < 0.05). (4) These results suggest that spinal mechanical impulsive manipulation is more effective in reducing pain and improving range of motion and trunk muscle strength in patients with low back pain compared with conventional physiotherapy.

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