Effectiveness of spinal manipulation and myofascial release compared with spinal manipulation alone on health-related outcomes in individuals with non-specific low back pain: randomized controlled trial. Issue Volume 107:Issue (2020) (June 2020)

• Record Type: Journal Article
• Authors: Boff, Taise Angeli; Pasinato, Fernanda; Ben, Ângela Jornada; Bosmans, Judith E.; van Tulder, Maurits; Carregaro, Rodrigo Luiz
• Is Part Of: Physiotherapy. Volume 107:Issue (2020)
• Page Start: 71
• Page End: 80
• Publication Date: 2020-06
• Subjects: Manual therapy -- Treatment outcome -- Low back pain -- Disability -- Quality of life -- Postural balance; Physical therapy -- Periodicals; Therapeutics, Physiological -- Periodicals; 615.8205
• DOI: 10.1016/j.physio.2019.11.002
• Languages: English
• ISSNs: 0031-9406

Abstract

Abstract: Objective: To investigate the effectiveness of spinal manipulation combined with myofascial release compared with spinal manipulation alone, in individuals with chronic non-specific low back pain (CNLBP). Design: Randomized controlled trial with three months follow-up. Setting: Rehabilitation clinic. Participants: Seventy-two individuals (between 18 and 50 years of age; CNLBP ≥12 consecutive weeks) were enrolled and randomly allocated to one of two groups: (1) Spinal manipulation and myofascial release – SMMRG; n = 36) or (2) Spinal manipulation alone (SMG; n = 36). Interventions: Combined spinal manipulation (characterized by high velocity/low amplitude thrusts) of the sacroiliac and lumbar spine and myofascial release of lumbar and sacroiliac muscles vs manipulation of the sacroiliac and lumbar spine alone, twice a week, for three weeks. Main outcome measures: Assessments were performed at baseline, three weeks post intervention and three months follow-up. Primary outcomes were pain intensity and disability. Secondary outcomes were quality of life, pressure pain-threshold and dynamic balance. Results: No significant differences were found between SMMRG vs SMG in pain intensity and disability post intervention and at follow-up. We found an overall significant difference between-groups for CNLBP disability (SMG-SMMRG: mean difference of 5.0; 95% confidence interval of difference 9.9; −0.1), though this effect was not clinically important and was not sustained at follow-up. Conclusions: We demonstrated that spinal manipulation combined with myofascial release was not more effective compared to spinal manipulation alone for patients with CNLBP. Clinical trial registration number: NCT03113292.