Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials

Licciardone, John C.; Brimhall, Angela K.; King, Linda

doi:10.1186/1471-2474-6-43

Cited by 233 publications

(138 citation statements)

References 46 publications

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“…Other studies have evaluated the efficacy of other forms of treatment to reduce lumbalgia, such as trunk exercises to prevent and treat low back pain, but approaches that use mobilizations and manipulations significantly reduce low back pain. 33,34 The results we obtained in reducing pain levels are similar to those found in the literature [35][36][37][38] and affirm that procedures that use joint manipulations have a rapid physiological effect on the body, promoting an overal reduction of muscular spasms of the spine and causing chemical, mechanical, and thermal changes resulting in a response reflex and causing analgesia at the site of the adjustment, consequently reducing the pain. [38][39][40][41] Manipulation of the spine causes changes in the musculoskeletal system.…”

Section: Discussionsupporting

confidence: 78%

Effectiveness of Chiropractic Adjustment in Lumbar Pain in Crossfit Practitioners

Moehlecke

Forgiarini

2017

Coluna/Columna

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Objective: To evaluate the efficacy of acute chiropractic adjustment in individuals who practice CrossFit with regard to complaints of low back pain and the joint range of motion in this region. Methods: A randomized clinical trial comprised of CrossFit practitioners from a box in Novo Hamburgo-RS, of both sexes and aged 18 to 40 years who had low back pain at the time of the study. The following tools were used: Semi-structured Anamnesis Questionnaire, Visual Analog Scale, McGill Pain Questionnaire, and SF-36 Quality of Life Questionnaire. Individuals in the control group answered the questionnaires before and after CrossFit training. The chiropractic group performed the same procedure, plus pre-training chiropractic adjustment and joint range of motion (ROM) before and after lumbar adjustment. Results: There was a significant increase in pain in the control group, and a significant decrease in pain in the chiropractic group, including one day after the chiropractic adjustment. In the chiropractic group, the joint ranges of motion had a significant increase in flexion and extension of the lumbar spine after chiropractic adjustment. Conclusion: The chiropractic group achieved a significant improvement in pain level and joint range of motion, suggesting that acute chiropractic adjustment was effective in reducing low back pain.Keywords: Physical exercise; Manipulation, chiropractic; Low back pain; Range of motion; articular. RESUMO

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Section: Discussionsupporting

confidence: 78%

Effectiveness of Chiropractic Adjustment in Lumbar Pain in Crossfit Practitioners

Moehlecke

Forgiarini

2017

Coluna/Columna

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“…Yet, we did not locate the website mentioned by Schwerla. Interestingly, neither did Licciardone [2] whose review Schwerla seems to hold in such high regard. It is clearly impossible for authors of systematic reviews to search thousands of websites to retrieve studies that usually are not peer reviewed and probably of poor quality.…”

Section: Sirmentioning

confidence: 96%

Response to Schwerla

Posadzki

Ernst

2012

Clin Rheumatol

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Sir,The letter by Schwerla [1] deserves a brief comment. We did conduct electronic searches in Google Scholar, ISI Web of Knowledge, The Journal of the American Osteopathic Association, among others. Yet, we did not locate the website mentioned by Schwerla. Interestingly, neither did Licciardone [2] whose review Schwerla seems to hold in such high regard. It is clearly impossible for authors of systematic reviews to search thousands of websites to retrieve studies that usually are not peer reviewed and probably of poor quality. We also reject the allegation that we have not invited others to contribute further trials; the European meeting mentioned by Schwerla is unlikely to host more than a fraction of leading experts in osteopathy which, after all, is largely a North American field. Considering these facts, we are confident that our overall findings are correct [3] and hope that independent organisations such as the Cochrane Collaboration might replicate them. This, in our view, would be more valuable than the wishful thinking of interested parties.It has recently been calculated that osteopaths (and chiropractors) are more likely to publish low-quality systematic reviews arriving at positive conclusions, and this trend is statistically significant [4]. Other researchers found insufficient evidence to support the effectiveness and biological plausibility of cranial osteopathy and craniosacral therapy [5,6]. To conclude, until independently replicated trials show that osteopaths generate clinically relevant improvements, researchers will remain sceptical.Disclosures None. References

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“…In that regard, the Ernst and Cantor study 2 noted above pre-dated the first and only known SRMA specifically addressing OMT, published by Licciardone and colleagues in 2005. 6 The overall findings of the latter study, which assessed the efficacy of OMT in treating low back pain, are presented as a forest plot in Figure 1. The subjects who received OMT experienced a greater reduction in low back pain compared with those subjects who did not receive OMT (mean effect size, −0.30; 95% confidence interval, −0.47 -−0.13; P=.001).…”

Section: Systematic Review and Meta-analysis Of Osteopathic Manipulatmentioning

confidence: 99%

Responding to the challenge of clinically relevant osteopathic research: Efficacy and beyond

Licciardone

2007

International Journal of Osteopathic Medicine

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The osteopathic profession has been challenged over the past decade to provide clinically relevant research. The conduct of evidence-based osteopathic research is imperative not only for scientific, economic, and professional reasons, but also to drive health care policy and clinical practice guidelines. This paper summarizes recent studies in response to the osteopathic research challenge, including clinical trials registered with ClinicalTrials.gov and a systematic review and meta-analysis of osteopathic manipulative treatment (OMT) for low back pain. The concept of the OMT responder is introduced and supported with preliminary data. Within the context of a pain processing model, consideration is given to genomic (e.g., the catechol-O-methyltransferase gene) and psychological (e.g., depression and somatization) factors that are associated with pain sensitivity and pain progression, and to the role that such factors may play in screening for OMT responders. While substantial progress has been made in osteopathic research, much more needs to be done. Keywordsosteopathy; osteopathic medicine; osteopathic manipulative treatment (OMT); low back pain; genomics; catechol-O-methyltransferase (COMT); pain processing The osteopathic research challengeIn a recent Journal editorial, Lucas and Moran raised critical questions regarding the relevancy of contemporary osteopathy research in the evolving healthcare environment. 1 Their ultimate challenge to the osteopathic profession was to provide the "numbers" supporting the clinical effectiveness of osteopathy, or osteopathic manipulative treatment (OMT) as it is better known in the United States. They aptly identified important consumers of the numbers, including researchers, universities, health insurers, government agencies, and the media, with the latter noted to exert considerable influence over public opinion and, potentially, policy. The recent media attention afforded the Ernst and Canter 2 systematic review of systematic reviews of spinal manipulation and its conclusion that "data do not demonstrate that spinal manipulation is an effective intervention for any condition," illustrates their point.The osteopathic profession in the United States has been similarly challenged in the past decade. In 1997, Goldstein editorialized that the profession should foster evidence-based osteopathic medicine. 3 In 1999, following publication of a major randomized controlled trial of OMT in the New England Journal of Medicine ,4 Howell commented that "the long-term Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Ong...

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Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials

Cited by 233 publications

References 46 publications

Effectiveness of Chiropractic Adjustment in Lumbar Pain in Crossfit Practitioners

Effectiveness of Chiropractic Adjustment in Lumbar Pain in Crossfit Practitioners

Response to Schwerla

Responding to the challenge of clinically relevant osteopathic research: Efficacy and beyond

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