Tip Manipulation support?

[Bas Asselbergs]

Check this out:
http://www.ncbi.nlm.nih.gov/pubmed/2...?dopt=Abstract

Will you come to the same conclusion as I did?

[Jordan]

Is this your conclusion? People get better in the long-term when they are given more attention. Stated otherwise, people like a little grooming.

[zimney3pt]

potential form of the Hawthorne Effect?

[Bas Asselbergs]

Yes to both of you. Jordan, that was my first thought; then after a few minutes of thought (a massive effort), I did remember the Hawthorne effect. I tend to think in manual therapy studies, the"social grooming"-effect is the stronger influence.

I certainly do not think that this study in ANY way supports manipulation for chronic back patients; however, many who make a living doing this, will see it as a great support of their maintenance "method" or technique.

[Sheffphysio]

Shock horror, there is such thing as treatment affect.

How does this get funding?

How does it get published in a peer review journal???


Is so easy to make this a proper study. Three groups, one gets Manips for 12 months, one gets MFR for 12 months one gets "chat". The results will be the same, both treatment groups will get small benefit, does not matter which you do. Yawn.

Chiro's will use conformational bias and cherry picking data and jump all over this. What this study does show is that a months worth of manips is useless and does not prevent long term disability. I can see the future of the NHS vanish as all lower back pain patients need “maintenance” ever week forever after back injury!!!

[Jason Silvernail]

Clever.

From the "Results" section.

"Patients in second and third groups experienced significantly lower pain and disability scores than first group at the end of 1-month period (P = 0.0027 and 0.0029, respectively). "

Note the use of the word "significant" and P value is provided. This means there is statistical support for the statement and a commonly understood threshold has been reached.

"However, only the third group that was given spinal manipulations (SM) during the follow-up period showed more improvement in pain and disability scores at the 10-month evaluation. In the nonmaintained SMT group, however, the mean pain and disability scores returned back near to their pretreatment level."

Notice, no use of the word 'significant' and no P value. I wonder why?
Usually this is because the authors want to talk about a "trend" in the data that is not statistically significant. We shouldn't allow this in scientific papers because whatever trend you see that isn't statistically significant hasn't met the threshold for a difference and may very well be chance.

Haven't read the article so I can't say for sure, but the wording of the abstract sure is eye-catching for those who understand this particular statistical issue.

[Frédéric]

We discussed this article before, in march, when it was in the published before print version. Also Neil O'Connell at bim blogged about it ealier.

The sloppy methodology (poor choice of control groups for one) they used precludes us for drawing any conclusions as to the pertinence of prolonged SMT in CLBP. Prior knowledge in general about continuous use of passive therapies do allow us, to the contrary, to advise against it.

This study was designed to give the result it did. This way, they can now cite that study in future papers as if it was supporting evidence. This is borderline dishonesty imo.