Effectiveness of Four Conservative Treatments for Subacute Low Back Pain

Hsieh, Chang-Yu J.; Adams, Alan H.; Tobis, Jerome S.; Hong, Chang‐Zern; Danielson, Clark D.; Platt, Katherine J.; Hoehler, Fred K.; Reinsch, Sibylle; Rubel, Arthur J.

doi:10.1097/00007632-200206010-00003

Cited by 111 publications

(77 citation statements)

References 21 publications

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“…The 6 case studies were given a ranking of 4 in the CEBM scale (Table 2) and received no score on the PEDro scale (Table 1). Ethical approval was confirmed in only 5 studies (Enebo, 6 Hanten and Chandler, 7 Hseih et al, 8 Kuhar et al, 9 and LeBauer et al 10 ); 1 study 8 reported participant incentives of money or free chiropractic treatments (or both). Only 1 of the 6 case studies reported that participants gave informed consent.…”

Section: Resultsmentioning

confidence: 99%

“…Hsieh et al 8 conducted a high-quality study, ranked at level 1b on the Levels of Evidence scale and earning 7 of 10 points on the PEDro scale. The 1b rating reflects a study that was well designed, with a sufficient number of participants and adequate long-term follow-up.…”

Section: Experimental Studiesmentioning

confidence: 99%

“…From these studies, [7][8][9]12 it is clear that the results are mixed. Although no negative outcomes were reported, the overall quality of the experimental studies was not high, which indicates that more research is required to determine the effectiveness of MFR.…”

Section: Experimental Studiesmentioning

confidence: 99%

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Myofascial Release as a Treatment for Orthopaedic Conditions: A Systematic Review

McKenney

Elder

et al. 2013

Journal of Athletic Training

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Objective: To critically analyze published literature to determine the effectiveness of myofascial release therapy as a treatment for orthopaedic conditions.Data Sources: We searched the following electronic databases: MEDLINE, CINAHL, Academic Search Premier, Cochrane Library, and Physiotherapy Evidence Database (PEDro), with key words myofascial release, myofascial release therapy, myofascial release treatment, musculoskeletal, and orthopedic. No date limitations were applied to the searches.Study Selection: Articles were selected based upon the use of the term myofascial release in the abstract or key words. Final selection was made by applying the inclusion and exclusion criteria to the full text. Studies were included if they were English-language, peer-reviewed studies on myofascial release for an orthopaedic condition in adult patients. Ten studies were eligible.Data Extraction: Data collected were number of participants, condition being treated, treatment used, control group, outcome measures and results. Studies were analyzed using the PEDro scale and the Center for Evidence-Based Medicine's Levels of Evidence Scale.Data Synthesis: Study scores on the PEDro scale ranged from 6 of 10 to 8 of 10. Based on the Levels of Evidence Scale, the case studies (n ¼ 6) were of lower quality, with a rank of 4. Three of the 4 remaining studies were rated at 2b, and the final study was rated at 1b.Conclusions: The quality of studies was mixed, ranging from higher-quality experimental to lower-quality case studies. Overall, the studies had positive outcomes with myofascial release, but because of the low quality, few conclusions could be drawn. The studies in this review may serve as a good foundation for future randomized controlled trials.Key Words: manual therapy, musculoskeletal conditions, randomized controlled trials Key PointsThe quality and results of studies on myofascial release as a treatment for orthopaedic conditions were mixed. Experimental studies tended to be of higher quality than case studies. Randomized controlled trials are needed to determine if myofascial release is an effective treatment for orthopaedic conditions.

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Section: Resultsmentioning

confidence: 99%

Section: Experimental Studiesmentioning

confidence: 99%

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Myofascial Release as a Treatment for Orthopaedic Conditions: A Systematic Review

McKenney

Elder

et al. 2013

Journal of Athletic Training

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“…For example, therapists are often selected to participate in clinical research studies based on having more years of clinical experience or greater experience with manual physical therapy, without any further attempt to insure that the chosen therapists actually achieve better outcomes when caring for patients. 1,20,22,36,38 This is done based on the assumption that increased years of experience marks an expert therapist, and that these individuals will, consequently, deliver superior patient care. Our results did not support this premise.…”

Section: Discussionmentioning

confidence: 99%

“…5,11,17 The presumed importance of experience with manipulative interventions is evidenced by studies of manipulation that require a certain level of experience for the practitioners administering the manipulation interventions. 1,20,22,36 Exercise interventions, including spinal stabilization programs, have also been shown to improve clinical outcomes in patients with LBP. 21,38 The expertise of the therapist has been suggested to play an important role in the success with stabilization exercise interventions, 37 although it does not appear that as much attention has been focused on therapist-related factors and their influence on the outcomes of exercise interventions.…”

mentioning

confidence: 99%

The Influence of Experience and Specialty Certifications on Clinical Outcomes for Patients With Low Back Pain Treated Within a Standardized Physical Therapy Management Program

Whitman

Fritz

Childs

2004

J Orthop Sports Phys Ther

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Study Design: Secondary analysis of a randomized trial. Objectives: To examine the influence of experience and specialty certification on outcomes for patients with low back pain receiving a standardized manipulation or stabilization exercise intervention program. Background: Little research has examined the impact of therapist-related factors on the outcomes of clinical care for patients with low back pain. It is assumed that therapists with more clinical experience or specialty certification will achieve better clinical outcomes; however, few studies have examined this hypothesis. Methods and Measures: One hundred thirty-one participants in a randomized trial were included (70 randomized to receive manipulation, 61 stabilization). All subjects completed an Oswestry Disability Questionnaire at baseline, and after 1 and 4 weeks of treatment. Therapists were categorized based on total years of experience, years of experience with manual therapy, and specialty certification status. Two-way repeated-measures analyses of covariance were performed within each intervention group to examine the effects of the therapist characteristics on outcomes. Hierarchical linear regression models were used to examine the relative effects of therapist characteristics and intervention on clinical outcomes. Results: Thirteen therapists participated (average 6.0 years of experience [standard deviation, 4.0], 4 (30.8%) with specialty certification). A significant interaction between time and specialty certification status (P = .04) was detected for subjects receiving the manipulation intervention. No significant interactions were detected in the stabilization group. The regression models found that the intervention group significantly contributed to explaining clinical outcomes, but that therapist characteristics did not. Professions, Mail Code G-9, 3333 Regis Blvd, Denver, CO 80221-1099. E-mail: jwhitman@regis.edu Conclusions: With the standardized protocol utilized in this study, it appears that the therapist-related factors of increased experience and specialty certification status do not result in an improvement in patients' disability associated with low back pain.

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Back schools for non-specific low-back pain.

Heymans

Tulder²,

Esmail

et al. 2004

Cochrane Database of Systematic Reviews

145

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Effectiveness of Four Conservative Treatments for Subacute Low Back Pain

Abstract: For subacute low back pain, combined joint manipulation and myofascial therapy was as effective as joint manipulation or myofascial therapy alone. Additionally, back school was as effective as three manual treatments.

Cited by 111 publications

References 21 publications

Myofascial Release as a Treatment for Orthopaedic Conditions: A Systematic Review

Myofascial Release as a Treatment for Orthopaedic Conditions: A Systematic Review

The Influence of Experience and Specialty Certifications on Clinical Outcomes for Patients With Low Back Pain Treated Within a Standardized Physical Therapy Management Program

Back schools for non-specific low-back pain.

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