The effect of manual therapy and exercise in patients with chronic low back pain: Double blind randomized controlled trial

Ülger, Özlem; Demirel, Aynur; Öz, Müzeyyen; Tamer, Seval

doi:10.3233/bmr-169673

Cited by 58 publications

(59 citation statements)

References 25 publications

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“…The qualitative analysis of the training volume revealed a range of 1 30,32,35,37,40,44,48,50,52,53,56,58,70 to 10 24,44,46,59,60 sets per exercise practiced with a mean of 3.2 ± 2.4 sets, while 28 22,25,28,[30][31][32][33][34][35][38][39][40][41]43,45,[49][50][51]53,54,56,58,63,[67][68][69][70][71] studies did not report any details on this aspect. In addition to this, only 23 22,25,28,[30][31]…”

Section: Study Quality and Risk Of Bias Within Studiesmentioning

confidence: 99%

Dose-response-relationship of stabilisation exercises in patients with chronic non-specific low back pain: a systematic review with meta-regression

Mueller

Niederer

2020

Sci Rep

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Stabilization exercise (SE) is evident for the management of chronic non-specific low back pain (LBP). The optimal dose-response-relationship for the utmost treatment success is, thus, still unknown. The purpose is to systematically review the dose-response-relationship of stabilisation exercises on pain and disability in patients with chronic non-specific LBP. A systematic review with meta-regression was conducted (Pubmed, Web of Knowledge, Cochrane). Eligibility criteria were RCTs on patients with chronic non-specific LBP, written in English/German and adopting a longitudinal core-specific/stabilising/motor control exercise intervention with at least one outcome for pain intensity and/or disability. Meta-regressions (dependent variable = effect sizes (Cohens d) of the interventions (for pain and for disability), independent variable = training characteristics (duration, frequency, time per session)), and controlled for (low) study quality (PEDro) and (low) sample sizes (n) were conducted to reveal the optimal dose required for therapy success. From the 3,415 studies initially selected, 50 studies (n = 2,786 LBP patients) were included. N = 1,239 patients received SE. Training duration was 7.0 ± 3.3 weeks, training frequency was 3.1 ± 1.8 sessions per week with a mean training time of 44.6 ± 18.0 min per session. The meta-regressions’ mean effect size was d = 1.80 (pain) and d = 1.70 (disability). Total R2 was 0.445 and 0.17. Moderate quality evidence (R2 = 0.231) revealed that a training duration of 20 to 30 min elicited the largest effect (both in pain and disability, logarithmic association). Low quality evidence (R2 = 0.125) revealed that training 3 to 5 times per week led to the largest effect of SE in patients with chronic non-specific LBP (inverted U-shaped association). In patients with non-specific chronic LBP, stabilization exercise with a training frequency of 3 to 5 times per week (Grade C) and a training time of 20 to 30 min per session (Grade A) elicited the largest effect on pain and disability.

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Section: Study Quality and Risk Of Bias Within Studiesmentioning

confidence: 99%

Dose-response-relationship of stabilisation exercises in patients with chronic non-specific low back pain: a systematic review with meta-regression

Mueller

Niederer

2020

Sci Rep

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“…Furthermore , when analyzed for a 50% change in ODI, there was 64.6% for the FM group and 40% for the SPT group (p ¼ 0.02). In a double-blind randomized controlled trial, Ulger et al (2017) studied the effects of manual therapy methods vs. spinal stabilization exercises on pain and quality of life in those with low back pain. Manual therapy procedures included soft tissue mobilization (e.g.…”

Section: Discussionmentioning

confidence: 99%

Fascial manipulation vs. standard physical therapy practice for low back pain diagnoses: A pragmatic study

Harper

Steinbeck

Aron

2019

Journal of Bodywork and Movement Therapies

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“…of action on pain and movement limitation. [6][7][8][9] For instance, mobilization intends to increase soft tissue extensibility and joint mobility using low velocity passive force to achieve pain modulation via reduced hyperexcitability of muscle spindles and endogenous pain inhibition in the central nervous system. 25) Manipulation applies a sudden thrust that intends to make cracking sound to induce cavitation of a joint to achieve improvement of joint mobility and pain modulation via intradiscal pressure changes.…”

Section: Spinal Mobilization and Manipulation Have Different Mechanismsmentioning

confidence: 99%

“…While in some studies, 4,8,9,30) Our trial has several strengths, including four different types of management, including homogenous groups and a rigorous design with emphasis on internal validity. We also had excellent engagement and follow-up rates.…”

Section: Spinal Mobilization and Manipulation Have Different Mechanismsmentioning

confidence: 99%

“…Pain relief is provided by conservative treatment, drugs administration including nonsteroid anti-inflammatory drugs, thermotherapy, and electrotherapy, and functional restoration of the spine is achieved through exercise. [4][5][6] Manual therapy, [7][8][9] reflex therapy, 10,11) and Kinesio Taping [12][13][14] techniques are some of the passive treatment methods for reducing pain and improving biomechanics of the lumbar region.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Physiotherapy Approaches in Low Back Pain: A Randomized Controlled Trial

2021

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Background: The purpose of this study was to compare the effectiveness of rehabilitation approaches in individuals with low back pain (LBP) on pain, spinal mobility, disability, and muscular strength. Methods: Ninety volunteers were included and divided into four groups depending on the rehabilitation approach. Group 1, soft tissue mobilization techniques and stabilization exercises (n=24; 11 females (F), 13 males (M); group 2, Kinesio Taping and stabilization exercises (n=24; 12F, 12M); group 3, stabilization exercises (n=22; 11F, 11M); and group 4, reflex therapy and stabilization exercises (n=20; 10F, 10M). Visual Analog Scale for pain intensity, an isokinetic evaluation for strength at 60°/s and a side-plank position test for trunk stabilization were measured before and assessed at the beginning, after a 4-week treatment and during 4 weeks of follow-up. The functional status was evaluated with the Oswestry Disability Index. Results: Individuals in all groups showed similar decrease in pain after the treatment and at 1-month follow-up, but there were no significant differences in pain levels between the groups (P<0.05). Conclusion: All therapeutic approaches were found to be effective in diminishing pain and thus helpful in increasing strength and stabilization in patients with LBP.

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The effect of manual therapy and exercise in patients with chronic low back pain: Double blind randomized controlled trial

Abstract: This study showed that SSE and manual therapy methods have the same effects on QoL, while the manual treatment is more effective on the pain and functional parameters in particular.

Cited by 58 publications

References 25 publications

Dose-response-relationship of stabilisation exercises in patients with chronic non-specific low back pain: a systematic review with meta-regression

Dose-response-relationship of stabilisation exercises in patients with chronic non-specific low back pain: a systematic review with meta-regression

Fascial manipulation vs. standard physical therapy practice for low back pain diagnoses: A pragmatic study

Comparison of Physiotherapy Approaches in Low Back Pain: A Randomized Controlled Trial

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