ARTICLE
To assess the benefits and harms of spinal manipulative therapy (SMT) for the treatment of chronic low back pain this study did a ystematic review and meta-analysis of randomised controlled trials using Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature, and trial registries up to 4 May 2018, including reference lists of eligible trials and related reviews. Randomised controlled trials examining the effect of spinal manipulation or mobilisation in adults with chronic low back pain with or without referred pain. Studies that exclusively examined sciatica were excluded, as was grey literature. In this review, authors consider SMT to represent any hands-on treatment of the spine, including both mobilization and manipulation. Mobilizations use low grade velocity, small or large amplitude passive movement techniques within the patient’s range of motion and control, whereas manipulation uses a high velocity impulse or thrust applied to a synovial joint over a short amplitude at or near the end of the passive or physiological range of motion. The effect of SMT was compared with recommended therapies, non-recommended therapies, sham (placebo) SMT, and SMT as an adjuvant therapy. Main outcomes were pain and back specific functional status, examined as mean differences and standardised mean differences (SMD), respectively. Outcomes were examined at 1, 6, and 12 months. Quality of evidence was assessed using GRADE. A random effects model was used and statistical heterogeneity explored. Forty-seven randomized controlled trials including a total of 9211 participants were identified, who were on average middle aged (35-60 years). Most trials compared SMT with recommended therapies. Moderate quality evidence suggested that SMT has similar effects to other recommended therapies for short term pain relief and a small, clinically better improvement in function. High quality evidence suggested that compared with non-recommended therapies SMT results in small, not clinically better effects for short term pain relief and small to moderate clinically better improvement in function. In general, these results were similar for the intermediate and long term outcomes as were the effects of SMT as an adjuvant therapy. Evidence for sham SMT was low to very low quality; therefore these effects should be considered uncertain. The study concludes that SMT produces similar effects to recommended therapies for chronic low back pain, whereas SMT seems to be better than non-recommended interventions for improvement in function in the short term. Source: https://chiro.org/wordpress/2020/02/benefits-and-harms-of-spinal-manipulative-therapy-for-the-treatment-of-chronic-low-back-pain-systematic-review-and-meta-analysis-of-randomised-controlled-trials/
To assess the benefits and harms of spinal manipulative therapy (SMT) for the treatment of chronic low back pain this study did a ystematic review and meta-analysis of randomised controlled trials using Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature, and trial registries up to 4 May 2018, including reference lists of eligible trials and related reviews. Randomised controlled trials examining the effect of spinal manipulation or mobilisation in adults with chronic low back pain with or without referred pain. Studies that exclusively examined sciatica were excluded, as was grey literature.
Source: https://chiro.org/wordpress/2020/02/benefits-and-harms-of-spinal-manipulative-therapy-for-the-treatment-of-chronic-low-back-pain-systematic-review-and-meta-analysis-of-randomised-controlled-trials/