A Randomized Controlled Clinical Trial of Stay-Active Care Versus Manual Therapy in Addition to Stay-Active Care: Functional Variables and Pain

Grunnesjö, Marie I; Bogefeldt, Johan P; Svärdsudd, Kurt; Blomberg, Stefan

doi:10.1016/j.jmpt.2004.06.001

Cited by 31 publications

(36 citation statements)

References 25 publications

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“…More recent trials have also supported efficacy of spinal manipulation. [11][12][13][14] Our practice-based, nonrandomized comparative study showed a clinically important advantage for chiropractic care over medical care for chronic patients and a marginal advantage for acute patients. 15 Early cost studies showed both lower [16][17][18] and higher [19][20][21] costs for chiropractic care than for other interventions.…”

mentioning

confidence: 99%

Cost-Effectiveness of Medical and Chiropractic Care for Acute and Chronic Low Back Pain

Haas

Sharma

Stano

2005

Journal of Manipulative and Physiological Therapeutics

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confidence: 99%

Cost-Effectiveness of Medical and Chiropractic Care for Acute and Chronic Low Back Pain

Haas

Sharma

Stano

2005

Journal of Manipulative and Physiological Therapeutics

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“…One possible reason for the difference in use of diagnostic imaging may be that training in manual therapy gave the GPs a basis, with a larger diagnostic and therapeutic toolbox, to continue the treatment further without resorting to diagnostic imaging, consistent with the favourable natural history of low back pain, the demonstrated effectiveness of the experimental treatment to decrease pain and disability and that the GPs saw their patients more often and could assign a larger number of diagnoses to them (9).…”

Section: Discussionmentioning

confidence: 99%

“…Study design, patient recruitment, therapists and therapy within the trial have been presented earlier (9). Briefly, a factorial study design was used with four treatment groups, two experimental and two reference groups.…”

Section: Study Populationmentioning

confidence: 99%

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Diagnostic Differences Between General Practitioners and Orthopaedic Surgeons in Low Back Pain Patients

Bogefeldt

Grunnesjö

Svärdsudd

et al. 2007

Upsala Journal of Medical Sciences

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Background. There is a growing consensus on low back pain treatment. However, whether this extends to diagnostic labelling is still largely unknown. The aim of this report was to compare the diagnostic assessment of low back pain patients between general practitioners trained in manual therapy and orthopaedic surgeons.Methods. Population-based randomized controlled trial in which 160 patients with acute or sub-acute low back pain were assessed and treated by general practitioners or orthopaedic surgeons. Information on diagnoses and use of diagnostic imaging was obtained from medical records and physician questionnaires covering the ten-week treatment period. The Quebec Task Force classification and free text analysis were used to group diagnostic labels.Results: At baseline there were no significant differences in medical history, findings at physical examination and distribution of the Quebec Task Force diagnostic classification between the patient groups, indicating that they were similar. However, there were significant differences in physicians' use of diagnostic labels for local pain and their characterisation of radiating pain. General practitioners used more terms from manual medicine and reported more pseudoradicular pain than orthopaedic surgeons, who used non-specific pain labels, reported more true radicular pain and used more x-ray examinations. Differences were found at all times from first visit to ten week follow-up.Conclusions: There were significant differences in diagnostic assessment and use of diagnostic radiology between general practitioners and orthopaedic surgeons.

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“…Eisenburg et al 29 Hurley et al 30 Haas et al 31 Teyhen et al 32 Brennan et al Roberts et al 13 Penttinen et al 18 Heymans et al 34 Kendrick et al 35 Yip et al 36 Frerick et al 37 Lee et al 38 Grunnesjo et al 39 Marshall et al 40 Gabis et al 41 Chiradejnant et al 42 5. Unable to classify due to inadequate information Tuzun et al 12 Kaapa et al…”

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confidence: 99%

A literature review reveals that trials evaluating treatment of non-specific low back pain use inconsistent criteria to identify serious pathologies and nerve root involvement

Williams

Hancock

Ferreira

et al. 2012

Journal of Manual & Manipulative Therapy

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Objectives:The broad aim of this study was to assess the homogeneity of patients included in trials of nonspecific low back pain (NSLBP). To do this, we investigated the consistency and clarity of criteria used to identify and exclude participants with serious pathologies and nerve root compromise in randomized controlled trials, investigating interventions for NSLBP. Methods: We searched Medline database for randomized controlled trials of low back pain (LBP). published between 2000 and 2009. We then randomly selected and screened trials for inclusion until we had 50 eligible trials. Data were extracted on the criteria used to identify cases of serious conditions (e.g. cancer, fracture) and nerve root involvement. Results: The majority of papers (35/50) explicitly excluded patients with serious pathology. However, the terminology used and examples given were highly variable. Nerve root involvement was an exclusion criterion in the majority but not all studies. The criteria used for excluding patients with nerve root involvement varied greatly between studies. The most common criteria were 'motor, sensory or reflex changes' (nine studies), followed by 'pain radiating below the knee' (five studies) and 'reduced straight leg raise which reproduces leg pain' (five studies). In half of the included studies, the criteria used, while alluding to nerve root involvement, were not explained adequately for us to determine the types of patients included or excluded. Discussion: The inconsistent and unclear criteria used to identify cases of serious pathology and nerve root compromise means that published trials of LBP likely include heterogeneous patient populations. This trait limits our ability to make comparisons across trials or pool studies. Standardization and consensus is important for future research.

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A Randomized Controlled Clinical Trial of Stay-Active Care Versus Manual Therapy in Addition to Stay-Active Care: Functional Variables and Pain

Cited by 31 publications

References 25 publications

Cost-Effectiveness of Medical and Chiropractic Care for Acute and Chronic Low Back Pain

Cost-Effectiveness of Medical and Chiropractic Care for Acute and Chronic Low Back Pain

Diagnostic Differences Between General Practitioners and Orthopaedic Surgeons in Low Back Pain Patients

A literature review reveals that trials evaluating treatment of non-specific low back pain use inconsistent criteria to identify serious pathologies and nerve root involvement

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