Comparison of short-term response to two spinal manipulation techniques for patients with low back pain in a military beneficiary population.
OBJECTIVE
To determine whether military health care beneficiaries with low back pain (LBP) who are likely to respond successfully to spinal manipulation experience a difference in short-term clinical outcomes based on the manipulation technique that is used.


METHODS
Sixty patients with LBP identified as likely responders to manipulation underwent a standardized clinical examination and were randomized to receive a lumbopelvic (LP) or lumbar neutral gap (NG) manipulation technique. Outcome measures were a numeric pain rating scale and the modified Oswestry Disability Questionnaire.


RESULTS
Both the LP and NG groups experienced statistically significant reductions in pain and disability at 48 hours postmanipulation. The improvements seen in each group were small because of the short follow-up. There were no statistically significant or clinically meaningful differences in pain or disability between the two groups.


CONCLUSIONS
The two manipulation techniques used in this study were equally effective at reducing pain and disability when compared at 48 hours posttreatment. Clinicians may employ either technique for the treatment of LBP and can expect similar outcomes in those who satisfy the clinical prediction rule (CPR). Further research is required to determine whether differences exist at longer-term follow-up periods, after multiple treatment sessions, or in different clinical populations.
Sutlive
Thomas G
TG
U.S. Army-Baylor University Doctoral Program in Physical Therapy, 3151 Scott Road, Suite 1303, Fort Sam Houston, TX 78234, USA.
Mabry
Lance M
LM
Easterling
Emmanuel J
EJ
Durbin
Jose D
JD
Hanson
Stephen L
SL
Wainner
Robert S
RS
Childs
John D
JD
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation / Q000628:therapy*; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D008875:Middle Aged; D008887:Military Medicine; D008889:Military Personnel; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult