Longitudinal Comparative Study on the Outcome of Inpatient Treatment of Low Back Pain with Manual Therapy vs Physical Therapy

Abstract

The effect of manual therapy (postisometric relaxation) versus physical therapy on the outcome in hospitalised patients with low back pain (n=95) was analysed before and after the first and the last procedure and at one year follow-up. The patients were randomly assigned to one of 4 groups. The first group (n=29) was treated by postisometric muscle relaxation (PR) of the low back muscles and iliopsoas. The second group (n=21) received average frequency sinuous modulated current therapy (AFSMC) and sham mobilisation of the spine. The third group (n=26) was treated by Perl’s traction therapy (PTT) and sham mobilisation of the spine as well. The fourth group (n=19) received only sham mobilisation of the spine and non-steroidal antiinflammatory dugs (NSAID) in case of need. The duration of the treatment was 20 days comprising 12 procedures for the therapeutic groups and 12 sham mobilisations for the control group (CO). Physical measurements consisted of self-assessment of the pain (visual analogue scale), lumbar spinal mobility, trunk muscle strength and integrated myoelectric activity of the low back muscles. Only the PR group showed significant improvement after the first procedure. At the end of the therapeutic course, each of the treatment groups had better results than the CO (p<0.05), although the results were comparatively better for the PR group than the AFSMC and PTT groups. At one year follow-up, the results were significantly better in the PR group in comparison with the rest of the groups. It could be concluded that PR possesses advantages not only at the beginning of the treatment, but also hasa long-term beneficial effect on physical measurements