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A Mechanical Construction to Enhance the Stability and Safety of Lifting and Thrusting Manipulation of Acupuncture
Published on: January 10, 2025
Early use of thrust manipulation versus non-thrust manipulation: a randomized clinical trial
Chad Cook1, Kenneth Learman, Chris Showalter
1Division of Physical Therapy, Walsh University, 2020 East Maple Street, North Canton, OH 44720, USA. ccook@walsh.edu
Manual Therapy
|October 9, 2012
Summary
Early use of thrust manipulation (TM) and non-thrust manipulation (NTM) showed no significant differences in improving mechanical low back pain (LBP). Patient expectations, or personal equipoise, significantly impacted outcomes for both LBP disability and pain levels.
Area of Science:
- Orthopedics and Sports Medicine
- Physical Therapy and Rehabilitation
Background:
- Mechanical low back pain (LBP) is a prevalent condition requiring effective treatment strategies.
- Thrust manipulation (TM) and non-thrust manipulation (NTM) are common interventions for LBP, but their comparative early effectiveness is debated.
Purpose of the Study:
- To compare the early effectiveness of thrust manipulation (TM) versus non-thrust manipulation (NTM) in patients with mechanical low back pain (LBP).
- To assess the impact of patient expectations (personal equipoise) on treatment outcomes.
Main Methods:
- A randomized controlled trial involving 149 adult patients with mechanically reproducible LBP.
- Patients were randomized to receive either TM or NTM.
- Outcomes included Oswestry Disability Index (ODI), Numeric Pain Rating Scale (NPRS), Rate of Recovery, total visits, days in care, and FABQ-w, analyzed using a two-way mixed model MANCOVA controlling for patient expectations.
Main Results:
- No significant differences were found between TM and NTM groups at the second visit follow-up or at discharge for any outcome measures.
- Within-group changes were significant for both TM and NTM groups, indicating improvement over time.
- Personal equipoise was significantly associated with improvements in both ODI and NPRS.
Conclusions:
- Early application of TM or NTM yields comparable outcomes for mechanical LBP.
- Patient expectations (personal equipoise) play a significant role in the perceived effectiveness of LBP treatments.
- Further research may explore the mechanisms by which patient expectations influence LBP recovery.
