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Q In patients with low back pain (LBP), does a clinical prediction rule predict outcome of spinal manipulation?
Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Rheumatology ★★★★★☆☆
METHODS
Design:
a randomised controlled trial to validate a previously developed clinical prediction rule for predicting outcome of spinal manipulation.
Setting:
8 physical therapy clinics in 2 academic medical centres and outpatient practice settings in the US.
Patients:
131 patients who were 18–60 years of age (mean age 34 y, 58% men), had a primary symptom of LBP, were referred to physical therapy, and had an Oswestry Disability Questionnaire (ODQ) score ⩾30%. Exclusion criteria: serious spinal condition, nerve root compression, pregnancy, or previous surgery to the lumbosacral spine or pelvis. Patients were allocated to receive spinal manipulation plus exercise (n = 70) or exercise alone (n = 61) given by a physical therapist for 4 weeks.
Description of prediction guide:
the clinical prediction rule criteria were (1) LBP symptom duration <16 days, (2) no symptoms distal to …
Footnotes
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For correspondence: Dr J D Childs, Wilford Hall Medical Center, San Antonio, TX, USA. childsjdsbcglobal.net
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Source of funding: Foundation for Physical Therapy, Inc.