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Physiotherapy Theory and Practice
An International Journal of Physical Therapy
Volume 33, 2017 - Issue 9
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Descriptive Report

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

, PT, PhD, FAAOMPT, , PT, DScPT, FAAOMPT, , PT, PhD, FAAOMPT, , PT, DPT & , PT, PhD, FAAOMPT
Pages 716-724 | Received 20 Dec 2015, Accepted 21 Aug 2016, Published online: 20 Jul 2017
 

ABSTRACT

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.

Declaration of interest

The authors report no conflicts of interest.

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