Manual Therapy
Volume 10, Issue 1 , Pages 61-67, February 2005

A descriptive study of the usage of spinal manipulative therapy techniques within a randomized clinical trial in acute low back pain☆

  • Deirdre A. Hurley

      Affiliations

    • School of Physiotherapy, University College Dublin, Republic of Ireland
    • Corresponding Author InformationCorresponding author. Tel.: +353-18034310; fax: +353-18303550.
    • ,
  • Suzanne M. McDonough

      Affiliations

    • Rehabilitation Sciences Research Group, University of Ulster, Northern Ireland
    • ,
  • G. David Baxter

      Affiliations

    • Rehabilitation Sciences Research Group, University of Ulster, Northern Ireland
    • ,
  • Martin Dempster

      Affiliations

    • School of Psychology, Queen's University, Northern Ireland
    • ,
  • Ann P. Moore

      Affiliations

    • Clinical Research Unit for Healthcare Professions, University of Brighton, UK

Received 12 February 2004; received in revised form 27 June 2004; accepted 27 July 2004.

Abstract 

The majority of randomized clinical trials (RCTs) of spinal manipulative therapy have not adequately defined the terms ‘mobilization’ and ‘manipulation’, nor distinguished between these terms in reporting the trial interventions. The purpose of this study was to describe the spinal manipulative therapy techniques utilized within a RCT of manipulative therapy (MT; n=80), interferential therapy (IFT; n=80), and a combination of both (CT; n=80) for people with acute low back pain (LBP). Spinal manipulative therapy was defined as any ‘mobilization’ (low velocity manual force without a thrust) or ‘manipulation’ (high velocity thrust) techniques of the spine described by Maitland and Cyriax.

The 16 physiotherapists, all members of the Society of Orthopaedic Medicine, utilized three spinal manipulative therapy patterns in the RCT: Maitland Mobilization (40.4%, n=59), Maitland Mobilization/Cyriax Manipulation (40.4%, n=59) and Cyriax Manipulation (19.1%, n=28). There was a significant difference between the MT and CT groups in their usage of spinal manipulative therapy techniques (χ2=9.178; df=2; P=0.01); subjects randomized to the CT group received three times more Cyriax Manipulation (29.2%, n=21/72) than those randomized to the MT group (9.5%, n=7/74; df=1; P=0.003).

The use of mobilization techniques within the trial was comparable with their usage by the general population of physiotherapists in Britain and Ireland for LBP management. However, the usage of manipulation techniques was considerably higher than reported in physiotherapy surveys and may reflect the postgraduate training of trial therapists.

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☆ This study was presented at the International Forum VI for Primary Care Research on Low Back Pain, Linköping, Sweden 22–24 May 2003.

PII: S1356-689X(04)00074-8

doi:10.1016/j.math.2004.07.008

Manual Therapy
Volume 10, Issue 1 , Pages 61-67, February 2005

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