Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis.

摘要: BACKGROUND CONTEXT: Despite the many published randomized clinical trials (RCTs), a substantial number of reviews and several national guidelines, much controversy still remains regarding evidence for or against efficacy spinal manipulation low back pain neck pain. PURPOSE: To reassess manipulative therapy (SMT) mobilization (MOB) management (LBP) (NP), with special attention to applying more stringent criteria study admissibility into isolating effect SMT and/or MOB. STUDY DESIGN: RCTs including 10 subjects per group receiving MOB using patient-oriented primary outcome measures (eg, patient-rated pain, disability, global improve- ment recovery time). METHODS: Articles in English, Danish, Swedish, Norwegian Dutch reporting on were identified by comprehensive search computerized bibliographic literature data- bases up end 2002. Two reviewers independently abstracted data assessed quality according eight explicit criteria. A best synthesis incorporating explicit, detailed information about interventions was used evaluate treatment efficacy. The strength classification system that incorporated validity statistical significance results. Sixty-nine met selection reviewed assigned scores varying from 6 81 scale 0 100. Forty- three evidence. RESULTS: Acute LBP: There is moderate provides short-term relief than detuned diathermy, limited faster commonly physical strategy. Chronic has an similar efficacious prescrip- tion nonsteroidal anti-inflammatory drug, SMT/MOB effective short term when compared placebo general practitioner care, long therapy. better home exercise both term. superior sham chemonucleolysis disc herniation However, there also inferior after surgery. Mix acute chronic either outcomes other treatments, such as McKenzie therapy, medical therapists, soft tissue school.