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Publication: Annals of Internal Medicine, 2014: 161: 381 - 391. doi: 10.7326/M14-0006
Authors: Bronfort G, Hondras MA, Schulz CA, et al
Although, BRLP has a poorer prognosis (long-term outcome) than low back pain (LBP) alone very few studies have been done in terms of effective care. Compared to LBP, BRLP also has more pain severity, results in more time of work and poorer quality of life.
Concerns have been growing with respect to the adverse effects of current treatment of medication and surgery.
The Purpose of the Study
The study was to done to compare outcomes in people treated with a combination of spinal manipulation (SMT) in conjunction with home exercise and advice (HEA) and those given HEA alone.
group 1: participants received SMT and HEA
group 2: participants were given HEA alone
|rigorous method in a real-life treatment setting||the clinician was unable to be 'blinded' to the treatment given|
|participants of over 65 years were incluced, leading to greater generalisation||the study does not provide conclusions for the effectiveness of SMT alone|
1. Primary outcomes:
2. Secondary outcomes (other benefits):
More improvement was noted by the participants of the SMT with HEA group for the following factors:
3. Use of medication:
56% of participants of the SMT with HEA group were still taking medication at 12 weeks, compared to 63% of the HEA alone group.
4. Outcomes at 52 weeks:
Outcomes were more likely to be sustained for the participants from the SMT with HEA group for global improvement and general satisfaction.
SMT and HEA is a safe and effective approach in the first 12 weeks of injury in subacute and chronic BRLP patients.
Glossary of Terms
chronic: a disease process or illness lasting 3 months or more, often affecting quality of life
prognosis: prospect of recovery from a disease process
RCT: the NICE definition: A study in which a number of similar people are randomly assigned to 2 (or more) groups to test a specific drug or treatment. One group (the experimental group) receives the treatment being tested, the other (the comparison or control group) receives an alternative treatment, a dummy treatment (placebo) or no treatment at all. The groups are followed up to see how effective the experimental treatment was. Outcomes are measured at specific times and any difference in response between the groups is assessed statistically. This method is also used to reduce bias.
subacute: recent onset of symptoms (as opposed to acute, meaning a very sudden and very recent onset of symptoms)