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

Taise Angeli Boff, Fernanda Pasinato, Ângela Jornada Ben, Judith E. Bosmans, Maurits van Tulder, Rodrigo Luiz Carregaro*

*Corresponding author for this work

Research output: Contribution to JournalArticle

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.

Original languageEnglish
Pages (from-to)71-80
Number of pages10
JournalPhysiotherapy (United Kingdom)
Volume107
Early online date18 Nov 2019
DOIs
Publication statusE-pub ahead of print - 18 Nov 2019

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Keywords

  • Disability
  • Low back pain
  • Manual therapy
  • Postural balance
  • Quality of life
  • Treatment outcome

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