Spinal Manipulative Therapy for Chronic Lower Back Pain in Older Veterans

Autor: Paul E. Dougherty DC, Jurgis Karuza PhD, Andrew S. Dunn DC, MEd, MS, Dorian Savino MPA, Paul Katz MD
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Zdroj: Geriatric Orthopaedic Surgery & Rehabilitation, Vol 5 (2014)
Druh dokumentu: article
ISSN: 2151-4585
2151-4593
21514585
DOI: 10.1177/2151458514544956
Popis: Introduction: Chronic lower back pain (CLBP) is problematic in older veterans. Spinal manipulative therapy (SMT) is commonly utilized for CLBP in older adults, yet there are few randomized placebo-controlled trials evaluating SMT. Methods: The purpose of the study was to compare the effectiveness of SMT to a sham intervention on pain (Visual Analogue Scale, SF-36 pain subscale), disability (Oswestry Disability Index), and physical function (SF-36 subscale, Timed Up and Go) by performing a randomized placebo-controlled trial at 2 Veteran Affairs Clinics. Results: Older veterans (≥ 65 years of age) who were naive to chiropractic were recruited. A total of 136 were included in the study with 69 being randomly assigned to SMT and 67 to sham intervention. Patients were treated 2 times per week for 4 weeks assessing outcomes at baseline, 5, and 12 weeks postbaseline. Both groups demonstrated significant decrease in pain and disability at 5 and 12 weeks. At 12 weeks, there was no significant difference in pain and a statistically significant decline in disability scores in the SMT group when compared to the sham intervention group. There were no significant differences in adverse events between the groups. Conclusions: The SMT did not result in greater improvement in pain when compared to our sham intervention; however, SMT did demonstrate a slightly greater improvement in disability at 12 weeks. The fact that patients in both groups showed improvements suggests the presence of a nonspecific therapeutic effect.
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