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Efficacy of spinal manipulation/mobilization therapy. A meta-analysis
Spine
|November 1, 1985
Summary
This meta-analysis found limited evidence supporting joint mobilization and manipulation for pain and physical activity limitations. Methodological quality significantly influenced results, with non-randomized studies showing greater efficacy.
Area of Science:
- Physical Therapy
- Rehabilitation Medicine
- Evidence-Based Practice
Background:
- Joint mobilization and manipulation are common manual therapies.
- Evidence regarding their efficacy for musculoskeletal conditions is mixed.
- Quantitative reviews are crucial for synthesizing research findings.
Purpose of the Study:
- To synthesize existing evidence on the efficacy of joint mobilization and manipulation.
- To evaluate the impact of study design on reported treatment effects.
- To familiarize readers with quantitative review methodologies.
Main Methods:
- A systematic literature search was conducted using Index Medicus.
- Studies were included based on prespecified criteria.
- A quantitative review (meta-analysis) was performed on nine selected studies.
Main Results:
- Studies not using random assignment were more likely to report positive outcomes.
- Treatment effects were larger when manual therapy was combined with other interventions.
- Immediate post-treatment measurements showed greater effects than delayed measurements.
- US-published studies reported less effectiveness compared to non-US studies.
Conclusions:
- The empirical support for spinal mobilization and manipulation for pain, flexibility, and physical activity impairment is limited.
- Methodological factors, such as randomization and publication location, appear to influence study outcomes.
- Further high-quality research is needed to clarify the true efficacy of these interventions.