When to Manipulate and When not to Manipulate! That is the Question!

This was a randomized, controlled trial with the purpose of validating a manipulation clinical prediction rule. In other words predicting which patients with LBP will most likely from a manipulative technique and which ones will least likely benefit.

131 patients with low back pain were randomly assigned to receive manipulation plus exercise or exercise alone by a physical therapist for 4 weeks.

Patients were examined according to the clinical prediction rule criteria (symptom duration, symptom location, fear-avoidance beliefs, lumbar mobility, and hip rotation range of motion).

The top 5 clinical prediction rules were…


  • Duration of current episode of LBP less than 16 days
  • No symptoms below the knees
  • A score of < 19 on fear-avoidance belief questionnaire
  • At least one hypomobile segment of the lumbar spine on physical examination
  • Adequate motion (>35º) in at least one hip
    Posted on: November 23, 2005

Categories: Lumbar Spine

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