of a study that investigated the
comparative effectiveness of early use of thrust manipulation (TM) and
nonthrust manipulation (NTM) in patients with mechanical low back pain (LBP)
suggest that there is no difference between early use of TM or NTM, and, secondarily,
that personal equipoise affects study outcome. Intra-group changes were
significant for both groups, say authors and APTA members Chad Cook, PT, PhD, MBA, FAAOMPT, Kenneth Learman, PT, PhD, OCS, COMT, Christopher Showalter, PT, OCS, FAAOMPT, Vincent Kabbaz, PT, and Bryan
O'Halloran, PT, OCS, SCS.
trial, patients aged 18 and older with mechanically reproducible LBP were
randomized into 2 treatment groups. The main outcome measures were the Oswestry
Disability Index (ODI) and a Numeric Pain Rating Scale, with secondary measures
of rate of recovery, total visits and days in care, and the work subscale of
the Fears Avoidance Beliefs Questionnaire work subscale.
of 149 subjects completed the trial and received care over an average of 35
days. There were no significant differences between TM and NTM at the second
visit follow-up or at discharge with any of the outcomes categories. Personal
equipoise was significantly associated with ODI and pain.
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