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Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up.
Clin Rehabil. 2010 Jan; 24(1):26-36.CR

Abstract

OBJECTIVE

To compare spinal manipulation, back school and individual physiotherapy in the treatment of chronic low back pain.

DESIGN

Randomized trial, 12-month follow-up.

SETTING

Outpatient rehabilitation department.

PARTICIPANTS

210 patients with chronic, non-specific low back pain, 140/210 women, age 59 +/- 14 years.

INTERVENTIONS

Back school and individual physiotherapy scheduled 15 1-hour-sessions for 3 weeks. Back school included: group exercise, education/ ergonomics; individual physiotherapy: exercise, passive mobilization and soft-tissue treatment. Spinal manipulation, given according to Manual Medicine, scheduled 4 to 6 20'-sessions once-a-week.

OUTCOME

Roland Morris Disability Questionnaire (scoring 0-24) and Pain Rating Scale (scoring 0-6) were assessed at baseline, discharge 3, 6, and 12 months.

RESULTS

205 patients completed the study. At discharge, disability score decreased by 3.7 +/- 4.1 for back school, 4.4 +/- 3.7 for individual physiotherapy, 6.7 +/- 3.9 for manipulation; pain score reduction was 0.9 +/- 1.1, 1.1 +/- 1.0, 1.0 +/- 1.1, respectively. At 12 months, disability score reduction was 4.2 +/- 4.8 for back school, 4.0 +/- 5.1 for individual physiotherapy, 5.9 +/- 4.6 for manipulation; pain score reduction was 0.7 +/- 1.2, 0.4 +/- 1.3, and 1.5 +/- 1.1, respectively. Spinal manipulation was associated with higher functional improvement and long-term pain relief than back school or individual physiotherapy, but received more further treatment at follow-ups (P < 0.001); pain recurrences and drug intake were also reduced compared to back school (P < 0.05) or individual physiotherapy (P < 0.001).

CONCLUSIONS

Spinal manipulation provided better short and long-term functional improvement, and more pain relief in the follow-up than either back school or individual physiotherapy.

Authors+Show Affiliations

Fondazione Don Carlo Gnocchi, Scientific Institute, Florence, Italy. francescacecchi2002@libero.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20053720

Citation

Cecchi, Francesca, et al. "Spinal Manipulation Compared With Back School and With Individually Delivered Physiotherapy for the Treatment of Chronic Low Back Pain: a Randomized Trial With One-year Follow-up." Clinical Rehabilitation, vol. 24, no. 1, 2010, pp. 26-36.
Cecchi F, Molino-Lova R, Chiti M, et al. Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up. Clin Rehabil. 2010;24(1):26-36.
Cecchi, F., Molino-Lova, R., Chiti, M., Pasquini, G., Paperini, A., Conti, A. A., & Macchi, C. (2010). Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up. Clinical Rehabilitation, 24(1), 26-36. https://doi.org/10.1177/0269215509342328
Cecchi F, et al. Spinal Manipulation Compared With Back School and With Individually Delivered Physiotherapy for the Treatment of Chronic Low Back Pain: a Randomized Trial With One-year Follow-up. Clin Rehabil. 2010;24(1):26-36. PubMed PMID: 20053720.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up. AU - Cecchi,Francesca, AU - Molino-Lova,Raffaello, AU - Chiti,Massimiliano, AU - Pasquini,Guido, AU - Paperini,Anita, AU - Conti,Andrea A, AU - Macchi,Claudio, PY - 2010/1/8/entrez PY - 2010/1/8/pubmed PY - 2010/4/21/medline SP - 26 EP - 36 JF - Clinical rehabilitation JO - Clin Rehabil VL - 24 IS - 1 N2 - OBJECTIVE: To compare spinal manipulation, back school and individual physiotherapy in the treatment of chronic low back pain. DESIGN: Randomized trial, 12-month follow-up. SETTING: Outpatient rehabilitation department. PARTICIPANTS: 210 patients with chronic, non-specific low back pain, 140/210 women, age 59 +/- 14 years. INTERVENTIONS: Back school and individual physiotherapy scheduled 15 1-hour-sessions for 3 weeks. Back school included: group exercise, education/ ergonomics; individual physiotherapy: exercise, passive mobilization and soft-tissue treatment. Spinal manipulation, given according to Manual Medicine, scheduled 4 to 6 20'-sessions once-a-week. OUTCOME: Roland Morris Disability Questionnaire (scoring 0-24) and Pain Rating Scale (scoring 0-6) were assessed at baseline, discharge 3, 6, and 12 months. RESULTS: 205 patients completed the study. At discharge, disability score decreased by 3.7 +/- 4.1 for back school, 4.4 +/- 3.7 for individual physiotherapy, 6.7 +/- 3.9 for manipulation; pain score reduction was 0.9 +/- 1.1, 1.1 +/- 1.0, 1.0 +/- 1.1, respectively. At 12 months, disability score reduction was 4.2 +/- 4.8 for back school, 4.0 +/- 5.1 for individual physiotherapy, 5.9 +/- 4.6 for manipulation; pain score reduction was 0.7 +/- 1.2, 0.4 +/- 1.3, and 1.5 +/- 1.1, respectively. Spinal manipulation was associated with higher functional improvement and long-term pain relief than back school or individual physiotherapy, but received more further treatment at follow-ups (P < 0.001); pain recurrences and drug intake were also reduced compared to back school (P < 0.05) or individual physiotherapy (P < 0.001). CONCLUSIONS: Spinal manipulation provided better short and long-term functional improvement, and more pain relief in the follow-up than either back school or individual physiotherapy. SN - 1477-0873 UR - https://www.unboundmedicine.com/medline/citation/20053720/Spinal_manipulation_compared_with_back_school_and_with_individually_delivered_physiotherapy_for_the_treatment_of_chronic_low_back_pain:_a_randomized_trial_with_one_year_follow_up_ L2 - https://journals.sagepub.com/doi/10.1177/0269215509342328?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -