Dose-response for chiropractic care of chronic low-back pain.

Haas M Groypp E Kraemer DF Spine 2004 Sep-Oct;4(5):83

Abstract

Background: There have been no trials of optimal chiropractic care in bounds of number of office visits for spinal manipulation and other therapeutic modalities.

Purpose: To deportment a pilot study to make preliminary identification of the consequences of the number of chiropractic treatment visits for manipulation with and without physical modalities (PM) forward chronic low-back pain and disability.

Study Design/Setting: Randomized controll trial with a balanced 4x2 factorial design. course of lifeed in the faculty practice of a chiropractic college edifice [i]or[/i] building outpatient clinic.

Patient Sample: Seventy-two patients with chronic, nonspecific low-back pain of mechanical origin.

Main issue Measures: Von Korff pain and disability (100-point) scales.

Methods: Patients were randomly allocated to visits (1 2 3 or 4 visits/week for 3 weeks) and to treatment regimen (spinal manipulation sole or spinal manipulation with PM) All patients received high-velocity, low-amplitude spinal manipulation. Half received undivided or two of the following PM at each visit: soft-tissue therapy, excitable packs, electrotherapy, or ultrasound.

Results:

Pain intensity: At 4 weeks, there was a substantial linear drift of visits favoring a larger number of visits: 57 points by 3 visits (SE=2.3, p=.014). There was no drift of treatment regimen. At 12 weeks, the data remind ofed the potential for a similar force of visits on patients receiving the one and the other manipulation and PM. Functional disability: At 4 weeks, a visits efficiency was noted (p=.018); the oblique direction for group means was approximately 5 points by 3 visits.There were no assign places to differences at 12 weeks.

Conclusions: There was a positive, clinically important result of the number of chiropractic treatments for chronic low-back pain upon pain intensity and disability at 4 weeks. Relief was substantial for patients receiving care 3 to 4 times by week for 3 weeks.

Comments: This is the first thought of the dose-response relationship for spinal manipulation and physical medicine interventions. It illustrates an apparent relationship between increased dosage and patient replication to spinal manipulation, but it also illustrates that physical medicine interventions had little result on outcome at 4 weeks, which is consistent with previous evidence. At 12 weeks, however, there was no difference between clusters Given that this was a pilot reflection larger studies will provide better and more useful information.

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