According to the authors of an article published online in Manual Therapy, their study is the first to show an association of within/between-session changes with disability scores at discharge in patients who were treated with manual therapy for low back pain, and the first to define the extent of change necessary for prognosis of an outcome. A within/between-session change should be considered as a complimentary artifact along with other examination findings during clinical decision making, they add.
This randomized controlled trial involved 100 participants who demonstrated a positive response to manual therapy during an initial assessment. Within- and between-session findings (within/between session) were defined as a change in pain report from baseline to after the second physical therapy visit. Within/between-session changes were analyzed for associations between pain change scores at discharge, rate of recovery, and a 50% reduction of the Oswestry disability index (ODI) by discharge. The results suggest there is a significant association between a within/between-session change after the second physical therapy visit and discharge outcomes for pain and ODI in this sample of patients who received a manual therapy intervention. A 2-point change or greater on an 11-point scale is associated with functional recovery at discharge and accurately described the outcome in 67% of the cases, say the authors.
APTA member Chad E. Cook, PT, PhD, MBA, FAAOMPT, is lead author of the article. APTA members Christopher Showalter, PT, OCS, FAAOMPT, Vincent Kabbaz, PT, and Bryan O'Halloran, PT, OCS, SCS, are coauthors.