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Does early change predict long-term (6 months) improvements in subjects who receive manual therapy for low back pain ?

COOK C; PETERSEN S; DONALDSON M; WILHELM M; LEARMAN K
PHYSIOTHER THEORY PRACT , 2017, vol. 33, n° 9, p. 716-724
Doc n°: 186366
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1080/09593985.2017.1345025
Descripteurs : CE51 - LOMBALGIE

Early change is commonly assessed for manual therapy interventions and has been
used to determine treatment appropriateness. However, current studies have only
explored the relationship of between or within-session changes and
short-/medium-term outcomes. The goal of this study was to determine whether pain
changes after two weeks of pragmatic manual therapy could predict those
participants with chronic low back pain who demonstrate continued improvements at
6-month follow-up. This study was a retrospective observational design.
Univariate logistic regression analyses were performed using a 33% and a 50% pain
change to predict improvement. Those who experienced a >/=33% pain reduction by 2
weeks had 6.98 (95% CI = 1.29, 37.53) times higher odds of 50% improvement on the
GRoC and 4.74 (95% CI = 1.31, 17.17) times higher odds of 50% improvement on the
ODI (at 6 months). Subjects who reported a >/=50% pain reduction at 2 weeks had
5.98 (95% CI = 1.56, 22.88) times higher odds of a 50% improvement in the GRoC
and 3.99 (95% CI = 1.23, 12.88) times higher odds of a 50% improvement in the ODI
(at 6 months). Future studies may investigate whether a change in plan of care is
beneficial for patients who are not showing early improvement predictive of a
good long-term outcome.

Langue : ANGLAIS

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