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