Manipulative therapy versus education programs in chronic low back pain.

摘要: Study Design. A randomized trial was conducted on a representative sample of patients with untreated low back pain lasting 7 weeks or longer, having more than 6 episodes in 12 months. Objectives. To contrast the effectiveness manipulation, manipulation mimic, and education program. Methodologic criticisms earlier studies were addressed. Summary Background Data. Published meta-analyses suggests clinical benefit from for acute patients. Data are inconclusive symptoms longer 1 month. Methods. total 1267 consecutive screened. Block randomization used to assign 209 qualifying treatment groups. Self-reported activity tolerance served as primary outcome measures. Patients assessed at enrollment, after 2 treatment, again without treatment. Multiple teams recruitment, randomization, assessment, data analysis independently sharing information. Treatments carefully described, monitored, balanced physician attention physical contact effects. Results. 81.3% subjects completed study. Confounding factors missing identified approximately 20% those completing final follow-up. Analysis remaining carried out. strong time effect under observed. Greater improvement noted manipulating group. Immediate relief continued accrue even last encounter end 2-week interval. Conclusion. Time is ally patient. In human terms, however, there appears be value according defined plan using exceeding weeks' duration