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A randomized controlled clinical trial of stay-active care versus manual therapy in addition to stay-active care: functional variables and pain.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2004 (English)In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 27, no 7, 431-441 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES

To compare the effect of manual therapy in addition to the stay-active concept versus the stay-active concept only in low back pain patients.

STUDY DESIGN

A randomized, controlled trial during 10 weeks.

METHODS

One hundred sixty outpatients with acute or subacute low back pain were recruited from a geographically defined area. They were randomly allocated to a reference group treated with the stay-active concept and, in some cases, muscle stretching and an experimental group receiving manual therapy and, in some cases, steroid injections in addition to the stay-active concept. Pain and disability rating index were used as outcome measures.

RESULTS

At baseline, the experimental group had somewhat more pain, a higher disability rating index, and more herniated disks than the reference group. After 5 and 10 weeks, the experimental group had less pain and a lower disability rating index than the reference group.

CONCLUSIONS

The manual treatment concept used in this study in low back pain patients appears to reduce pain and disability rating better than the traditional stay-active concept.

Place, publisher, year, edition, pages
2004. Vol. 27, no 7, 431-441 p.
Keyword [en]
Low back pain, disability rating, manipulation, mobilization, stay-active care
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-79639DOI: 10.1016/j.jmpt.2004.06.001ISI: 000224327300001PubMedID: 15389174OAI: oai:DiVA.org:uu-79639DiVA: diva2:107552
Available from: 2007-03-21 Created: 2007-03-21 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Low Back Pain: With Special Reference to Manual Therapy, Outcome and its Prognosis
Open this publication in new window or tab >>Low Back Pain: With Special Reference to Manual Therapy, Outcome and its Prognosis
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objectives. To assess outcome of manual therapy in addition to stay-active care in sub-acute low back pain patients and to investigate the predictive power of pain drawing sketch variables for return to work.

Materials and methods. The study was designed as a randomised controlled trial with a factorial design, and included 160 patients with acute or sub-acute low back pain allocated to one of the four treatment groups during 10 weeks. Group 1 received stay-active care only, Group 2 the same treatment as in Group 1 + muscle stretching, Group 3 the same treatment as in Group 2 plus manual therapy, and Group 4 the same treatment as Group 3 plus steroid injections. Outcome included pain intensity, pain extension, functional and health related quality of life variables and return to work.

Results. Pain intensity and disability rating improved faster in Groups 3 and 4 than in Groups 1 and 2 (p<0.05 and p<0.05). Also health related quality of life was affected by the treatments given; the more treatment options the better the effect (trend across the groups p<0.05). Pain extension as described on a pain drawing sketch decreased in all groups across the study period. The pain modality ‘numbness’ was the most painful one among patients with no pain radiation. Pain radiation according to the pain drawing sketch was the strongest predictor for return to work (p=0.03, Wald χ2=4.56).

Conclusions. The manual therapy concept used in this study reduced pain intensity and disability rating better than the stay active concept. The effects on health related quality of life were greater the larger the number of treatment modalities available. Pain drawing information was significantly correlated with pain and functional variables. Pain radiation according to the pain drawing adds significant information to the prediction of return to work.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 79 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 691
Keyword
Low Back Pain, Manual therapy, Stay active care, Mobilisation, Manipulation, Pain drawing, Return to work, Prognosis, Disability rating, Pain
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
urn:nbn:se:uu:diva-156739 (URN)978-91-554-8122-3 (ISBN)
Public defence
2011-09-30, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskölds väg 20, Uppsala Science Park, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2011-09-09 Created: 2011-08-08 Last updated: 2011-11-03Bibliographically approved

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Publisher's full textPubMedhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=15389174&dopt=Citation

Authority records BETA

Grunnesjö, Marie I.Bogefeldt, Johan P.Svärdsudd, Kurt F.Blomberg, Stefan I. E.

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