The longitudinal collection of pain data with the inclusion of hospital data during periods of hospitalization is feasible and acceptable in patients with SCD over periods of 30 to 60 days. Long-term collection of pain diary data, while informative, is associated with higher rates of missing data. Novel metrics of pain have the potential to better describe intraindividual and interindividual variation in pain, inform studies of the transition from acute to chronic pain as well as contribute patient-reported end points of pain for interventional clinical trials of pain in SCD.
There was no mention of the American Osteopathic Association Guidelines for Osteopathic Manipulative Treatment (OMT) for Patients With Low Back Pain, 3 which strongly recommends OMT for patients with acute or chronic LBP. However, despite these limitations, this study clearly sheds light on the substandard care of LBP, raises concerns about what percentage of DOs comply with the American Osteopathic Association's guidelines, and brings into question how many patients have access to recommended care.
Furthermore, the level of safety and reproducibility reported in this study surpasses previous reports on MUA. A prospective randomized clinical trial comparing other manual therapies, arthroscopic release, and MUA is underway. 3
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