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Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial

Current evidence on the effectiveness and safety of Chuna manipulative therapy (CMT) for managing non-acute lower back pain (LBP) is insufficient. We investigated the comparative effectiveness and safety of CMT, a Korean style of manipulation, plus usual care (UC) compared to UC alone for non-acute...

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Autores principales: Park, Sun-Young, Hwang, Eui-Hyoung, Cho, Jae-Heung, Kim, Koh-Woon, Ha, In-Hyuk, Kim, Me-riong, Nam, Kibong, Lee, Min ho, Lee, Jun-Hwan, Kim, Namkwen, Shin, Byung-Cheul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019562/
https://www.ncbi.nlm.nih.gov/pubmed/31948083
http://dx.doi.org/10.3390/jcm9010144
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author Park, Sun-Young
Hwang, Eui-Hyoung
Cho, Jae-Heung
Kim, Koh-Woon
Ha, In-Hyuk
Kim, Me-riong
Nam, Kibong
Lee, Min ho
Lee, Jun-Hwan
Kim, Namkwen
Shin, Byung-Cheul
author_facet Park, Sun-Young
Hwang, Eui-Hyoung
Cho, Jae-Heung
Kim, Koh-Woon
Ha, In-Hyuk
Kim, Me-riong
Nam, Kibong
Lee, Min ho
Lee, Jun-Hwan
Kim, Namkwen
Shin, Byung-Cheul
author_sort Park, Sun-Young
collection PubMed
description Current evidence on the effectiveness and safety of Chuna manipulative therapy (CMT) for managing non-acute lower back pain (LBP) is insufficient. We investigated the comparative effectiveness and safety of CMT, a Korean style of manipulation, plus usual care (UC) compared to UC alone for non-acute LBP. We conducted a parallel, two-armed, multi-centered, assessor blinded, pragmatic, randomized controlled trial at four major Korean medical hospitals. Overall, 194 patients were randomly allocated to either CMT plus UC (n = 97) or UC alone (n = 97), for six weeks of treatment and six months follow-up. The primary outcome was measured using the numerical rating scale (NRS) of LBP intensity at 7 weeks. Secondary outcomes included NRS of leg pain, Oswestry Disability Index (ODI) for functional disability, patient global impression of change (PGIC) scale, and safety. A total of 194 patients were included in the intention-to-treat analysis, and 174 patients provided complete data for the primary outcome. At 7 weeks, clinically significant differences between groups were observed in the NRS of LBP (CMT + UC: −3.02 ± 1.72, UC: −1.36 ± 1.75, p < 0.001), ODI scores (CMT + UC: −5.65 ± 4.29, UC: −3.72 ± 4.63, p = 0.003), NRS of leg pain (CMT + UC: −2.00 ± 2.33, UC: −0.44 ± 1.86, p < 0.0001), and PGIC (CMT + UC: −0.28 ± 0.85, UC: 0.01 ± 0.66, p = 0.0119). Mild to moderate safety concerns were reported in 21 subjects. CMT plus UC showed higher effectiveness compared to UC alone in patients with non-acute LBP in reducing LBP and leg pain and in improving function with good safety results using a powered sample size and including mid-term follow-up.
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spelling pubmed-70195622020-03-09 Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial Park, Sun-Young Hwang, Eui-Hyoung Cho, Jae-Heung Kim, Koh-Woon Ha, In-Hyuk Kim, Me-riong Nam, Kibong Lee, Min ho Lee, Jun-Hwan Kim, Namkwen Shin, Byung-Cheul J Clin Med Article Current evidence on the effectiveness and safety of Chuna manipulative therapy (CMT) for managing non-acute lower back pain (LBP) is insufficient. We investigated the comparative effectiveness and safety of CMT, a Korean style of manipulation, plus usual care (UC) compared to UC alone for non-acute LBP. We conducted a parallel, two-armed, multi-centered, assessor blinded, pragmatic, randomized controlled trial at four major Korean medical hospitals. Overall, 194 patients were randomly allocated to either CMT plus UC (n = 97) or UC alone (n = 97), for six weeks of treatment and six months follow-up. The primary outcome was measured using the numerical rating scale (NRS) of LBP intensity at 7 weeks. Secondary outcomes included NRS of leg pain, Oswestry Disability Index (ODI) for functional disability, patient global impression of change (PGIC) scale, and safety. A total of 194 patients were included in the intention-to-treat analysis, and 174 patients provided complete data for the primary outcome. At 7 weeks, clinically significant differences between groups were observed in the NRS of LBP (CMT + UC: −3.02 ± 1.72, UC: −1.36 ± 1.75, p < 0.001), ODI scores (CMT + UC: −5.65 ± 4.29, UC: −3.72 ± 4.63, p = 0.003), NRS of leg pain (CMT + UC: −2.00 ± 2.33, UC: −0.44 ± 1.86, p < 0.0001), and PGIC (CMT + UC: −0.28 ± 0.85, UC: 0.01 ± 0.66, p = 0.0119). Mild to moderate safety concerns were reported in 21 subjects. CMT plus UC showed higher effectiveness compared to UC alone in patients with non-acute LBP in reducing LBP and leg pain and in improving function with good safety results using a powered sample size and including mid-term follow-up. MDPI 2020-01-05 /pmc/articles/PMC7019562/ /pubmed/31948083 http://dx.doi.org/10.3390/jcm9010144 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Park, Sun-Young
Hwang, Eui-Hyoung
Cho, Jae-Heung
Kim, Koh-Woon
Ha, In-Hyuk
Kim, Me-riong
Nam, Kibong
Lee, Min ho
Lee, Jun-Hwan
Kim, Namkwen
Shin, Byung-Cheul
Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial
title Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial
title_full Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial
title_fullStr Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial
title_full_unstemmed Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial
title_short Comparative Effectiveness of Chuna Manipulative Therapy for Non-Acute Lower Back Pain: A Multi-Center, Pragmatic, Randomized Controlled Trial
title_sort comparative effectiveness of chuna manipulative therapy for non-acute lower back pain: a multi-center, pragmatic, randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019562/
https://www.ncbi.nlm.nih.gov/pubmed/31948083
http://dx.doi.org/10.3390/jcm9010144
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