Journal article
Predictors of instantaneous relief from spinal manipulation for non-specific low back pain: A Delphi study
Chiropractic & Manual Therapies, Vol.28, Article number: 39
2020
Abstract
Background
There is some evidence and anecdotal reports that high-velocity low-amplitude (HVLA) spinal manipulation therapy (SMT) for non-specific low back pain (NSLBP) may immediately reduce pain in some patients. The mechanism for such a change remains unclear and the evidence is conflicting. The aim of this study was to seek consensus among a sample of expert manual therapists as to the possible clinical predictors that could help identify patients who are most likely to receive instant relief from NSLBP with SMT intervention.
Methods
Thirty-seven expert chiropractors and manipulative physiotherapists from around the world were invited to participate in a three round online Delphi questionnaire during the second half of 2018. Participants were provided with a list of 55 potential signs and symptoms as well as offering them the option of suggesting other factors in the first round. The variables were rated using a 4-point Likert likelihood scale and a threshold of 75% agreement was required for any item to progress to the next round.
Results
Of these 37 experts, 19 agreed to participate. Agreement as to the proportion of patients who receive instantaneous relief was minimal (range 10–80%). A total of 62 items were ranked over the 3 rounds, with 18 of these retained following the third round. The highest rated of the 18 was ‘A history including a good response to previous spinal manipulation’.
Discussion/conclusion
Five categories; patient factors, practitioner factors, signs and symptoms of NSLBP presentation, an instrument of measurement (FABQ), and the presence of cavitation following SMT best describe the overall characteristics of the factors. The 18 factors identified in this study can potentially be used to create an instrument of measurement for further study to predict those patients with NSLBP who will receive instantaneous relief post-SMT.
Details
- Title
- Predictors of instantaneous relief from spinal manipulation for non-specific low back pain: A Delphi study
- Authors/Creators
- S. Innes (Author/Creator) - Murdoch UniversityA. Beynon (Author/Creator) - Murdoch UniversityC. Hodgetts (Author/Creator) - Murdoch UniversityR. Manassah (Author/Creator) - Murdoch UniversityD. Lim (Author/Creator) - Murdoch UniversityB.F. Walker (Author/Creator) - Murdoch University
- Publication Details
- Chiropractic & Manual Therapies, Vol.28, Article number: 39
- Publisher
- BioMed Central
- Identifiers
- 991005541079707891
- Copyright
- © 2020 The Authors
- Murdoch Affiliation
- School of Allied Health
- Language
- English
- Resource Type
- Journal article
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- Citation topics
- 1 Clinical & Life Sciences
- 1.129 Back pain
- 1.129.98 Low Back Pain
- Web Of Science research areas
- Rehabilitation
- ESI research areas
- Clinical Medicine