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2 types of physical therapy have similar positive effects on low back

Though many agree that therapy is needed, research is lacking

Low back pain (LBP) is one of the most common medical problems in modern society. When this pain lasts for more than three months, it's called chronic LBP. Some LBP causes like too much physical activity, weak abdominal muscles and bad posture may create instability in back joints that can make LBP worse. Manual therapy, a type of physical therapy that's performed by a physical therapist's hands, is believed to be beneficial in treating LBP patients; however, research is lacking on this topic. Based on this, a study was conducted that compared two types of manual therapy with each other and a basic exercise to determine which was most effective for LBP patients.

Small sample of patients randomly divided into three groups

Patients with chronic LBP for more than 12 weeks were recruited, and a total of 36 accepted and were then randomly divided into three groups: the manipulation, mobilization and control group. In manipulation, the physical therapist applied a force to certain joints in the lower back with the patients lying on their backs. Mobilization used a slower, more-controlled stretching of patients' backs while lying on their chests. All patients also performed a series of exercises, but the control group did not receive any manual therapy. Each intervention was conducted three times a week for six weeks, and all patients were assessed before and afterwards for functional abilities, range of motion (ROM) of their back, and overall mental state.

Manipulation and mobilization lead to similar improvements

Results showed that all groups improved in all measurements taken, but the manipulation and mobilization groups experienced more significant improvements than controls. These two manual therapy groups reported very similar results in both functional abilities and ROM, but the overall mental state was more improved in the manipulation group. These findings suggest that both manipulation and mobilization can lead to significant improvements in patients with chronic LBP. Though the manipulation group had a slight edge, both forms of manual therapy appear to be effective for treating this common condition. Physical therapists should therefore be encouraged to integrate this type of treatment into their strategies for these patients.

-As reported in the Novemeber '14 issue of journal of Physical Therapy Science

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