title: A Prescriptively Selected Nonthrust Manipulation Versus a Therapist-Selected Nonthrust Manipulation for Treatment of Individuals With Low Back Pain: A Randomized Clinical Trial.
abstract: METHODS
  Randomized controlled trial.
  
  
  BACKGROUND
  Several studies that have investigated the effects of a therapist-selected versus a randomly assigned segmental approach have looked at immediate effects only for pain-related outcomes.
  
  
  OBJECTIVE
  To examine differences in outcomes following a therapist-selected nonthrust manipulation versus a prescriptively selected nonthrust manipulation in subjects with low back pain.
  
  
  METHODS
  Subjects with mechanically producible low back pain were randomly treated with nonthrust manipulation in a therapist-selected approach or a prescriptively selected approach. All subjects received a standardized home exercise program. Outcome measures included pain, disability, global rating of change, and patient acceptable symptom state. Analyses of covariance, chi-square tests, and Mann-Whitney U tests were used to determine differences between groups.
  
  
  RESULTS
  Sixty-three subjects were tracked for 6 months, during which subjects in both groups significantly improved. There were no differences between groups in pain, disability, or patient acceptable symptom state scores at 6 months. There was a significant difference in global rating of change scores favoring the therapist-selected manipulation group at 6 months.
  
  
  CONCLUSIONS
  This study measured long-term differences between a prescriptively selected nonthrust manipulation and a therapist-selected approach to nonthrust manipulation. In pain, disability, and patient acceptable symptom state there were no differences in outcomes, findings similar to studies of immediate effects. After 6 months, perceived well-being was significantly higher for those in the therapist-selected treatment group. The study was registered at ClinicalTrials.gov (NCT01940744).
  
  
  METHODS
  Therapy, level 1b.
authors.forename: Megan
authors.initials: M
authors.lastname: Donaldson
authors.forename: Shannon
authors.initials: S
authors.lastname: Petersen
authors.forename: Chad
authors.initials: C
authors.lastname: Cook
authors.forename: Ken
authors.initials: K
authors.lastname: Learman
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D020393:Manipulation, Spinal / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D016059:Range of Motion, Articular; D016896:Treatment Outcome
keywords: joint mobilization; low back pain; manual therapy; outcomes