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  • New in the Literature: Early Use of Thrust Manipulation (Man Ther. 2012 October 2. [Epub ahead of print])

    Results 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.

    For this 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.

    A total 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.


    • Is the sterngth of this study greater than that of the clinical prediction rule promoted by the study in Annal of Internal Medicine 2004; 141: 920-928, Childs, Fritz, Flynn ?

      Posted by Scott Wallace on 10/19/2012 2:55 PM

    • Did nonthrust manipulation include Muscle energy or strain counterstrain techniques? Also who did the thrust manipulation and with what level of training.

      Posted by Louie Molen on 10/19/2012 3:53 PM

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