Science In Brief

Chiropractic Litterature Review

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The Study: Regional lumbar motion and patient-rated outcomes: a secondary analysis of data from a randomized clinical trial.

The Facts:

  1. Let's start at the end and work backwards on this one.
  2. "Overall, changes in regional lumbar motion were poorly associated with patient-rated outcomes..."
  3. This paper looked at data from a randomized clinical trial.
  4. The study looked at chronic low back pain patients who were treated over a 12 week time period.
  5. The types of care they received were spinal manipulation (77 subjects), supervised exercise (62 subjects) and advice on home exercise (60 subjects).
  6. Range of motion was done at baseline and at 12 weeks.
  7. They used a sophisticated device (CA 6000 Spine Motion Analyzer) to measure the motion.
  8. The authors felt that "in general" the changes in "regional lumbar motion patterns" didn't really match the patient reported pains or function.
  9. "...the actual usefulness of regional lumbar measurements remains controversial..."

Take Home:

Lumbar motion changes don't necessarily correlate with pain and function.

Reviewer's Comments:

This is a large and complex article that I recommend for your reading. I wished to concentrate on the idea that just because motion improves it doesn't mean that pain will. Now I think that motion is important. But there is a problem in that our profession has become obsessed with trying to correlate every treatment to its immediate effect on spinal pain. Sorry, but that's not a good way to run a profession and this article helps to point that out.

Reviewer: Roger Coleman DC

Editor: Mark R. Payne DC

Reference: Mieritz RM, Bronfort G, Hartvigsen J. Regional lumbar motion and patient-rated outcomes: a secondary analysis of data from a randomized clinical trial. J Manipulative Physiol Ther 2014;37:628-40.

Link to Abstract: http://www.ncbi.nlm.nih.gov/pubmed/25455833

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