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Outcomes for chronic neck and low back pain patients after manipulation under anesthesia: a prospective cohort study

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Structural and chiropractic

J Manipulative Physiol Ther.2014 Jul-Aug;37(6):377-82.

Authors:

C K Peterson, B K Humphreys, R Vollenweider, M Kressig, R Nussbaumer

Abstract.

Background: The purpose of this study was to investigate outcomes of chronic patients unresponsive to previous spinal manipulative therapy subsequently treated with manipulation under anesthesia (MUA). Methods: A prospective outcome cohort study was performed on 30 patients who had not improved with previous treatment and who underwent a single MUA by a doctor of chiropractic. The numeric rating scale for pain (NRS) and Bournemouth Questionnaire (BQ) were collected at 2 weeks and 1 day before MUA. At 2 and 4 weeks after MUA, the Patient's Global Impression of Change, NRS, and BQ were collected. The intraclass correlation coefficient evaluated stability before treatment. Percentage of patients "improved" was calculated at 2 and 4 weeks. Wilcoxon test compared pretreatment NRS and BQ scores with posttreatment scores. Mann-Whitney U test compared individual questions on the BQ between improved and not improved patients. Logistic regression compared BQ questions to "improvement." Results: Good stability of NRS and BQ scores before MUA (intraclass correlation coefficient=0.46-0.95) was found. At 2 weeks, 52% of the patients reported improvement with 45.5% improved at 4 weeks. Significant reductions in NRS scores at 4 weeks (P=.01) and BQ scores at 2 (P=.008) and 4 weeks (P=.001) were reported. Anxiety/stress levels were significantly different at 2 and 4 weeks between improved and not improved patients (P=.007). None of the BQ questions were predictive of improvement. Conclusion: Approximately half of patients previously unresponsive to conservative treatment reported clinically relevant improvement at 2 and 4 weeks post-MUA.

Publication Date: 

2014 Jul-Aug

OEID: 

5510

Peterson, KC., Humphreys, KB., Vollenweider, R., Kressig, M., Nussbaumer, R. (2014) 'Outcomes for chronic neck and low back pain patients after manipulation under anesthesia: a prospective cohort study', J Manipulative Physiol Ther.2014 Jul-Aug;37(6):377-82.

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