Abstract
Objective
To investigate the effects of an osteopathic manipulative treatment (OMT), which includes
a diaphragm intervention compared to the same OMT with a sham diaphragm intervention
in chronic nonspecific low back pain (NS-CLBP).
Design
Parallel group randomized controlled trial.
Setting
Private and institutional health centers.
Participants
Participants (N=66) (18-60y) with a diagnosis of NS-CLBP lasting at least 3 months.
Interventions
Participants were randomized to receive either an OMT protocol including specific
diaphragm techniques (n=33) or the same OMT protocol with a sham diaphragm intervention
(n=33), conducted in 5 sessions provided during 4 weeks.
Main Outcome Measures
The primary outcomes were pain (evaluated with the Short-Form McGill Pain Questionnaire
[SF-MPQ] and the visual analog scale [VAS]) and disability (assessed with the Roland–Morris
Questionnaire [RMQ] and the Oswestry Disability Index [ODI]). Secondary outcomes were
fear-avoidance beliefs, level of anxiety and depression, and pain catastrophization.
All outcome measures were evaluated at baseline, at week 4, and at week 12.
Results
A statistically significant reduction was observed in the experimental group compared
to the sham group in all variables assessed at week 4 and at week 12 (SF-MPQ [mean
difference −6.2; 95% confidence interval, −8.6 to −3.8]; VAS [mean difference −2.7;
95% confidence interval, −3.6 to −1.8]; RMQ [mean difference −3.8; 95% confidence
interval, −5.4 to −2.2]; ODI [mean difference −10.6; 95% confidence interval, −14.9
to 6.3]). Moreover, improvements in pain and disability were clinically relevant.
Conclusions
An OMT protocol that includes diaphragm techniques produces significant and clinically
relevant improvements in pain and disability in patients with NS-CLBP compared to
the same OMT protocol using sham diaphragm techniques.
Keywords
List of abbreviations:
FABQ (Fear-Avoidance Beliefs Questionnaire), HADS (Hospital Anxiety and Depression Scale), LBP (low back pain), MCID (minimal clinically important difference), NS-CLBP (chronic nonspecific low back pain), ODI (Oswestry Disability Index), OMT (osteopathic manipulative treatment), PCS (Pain Catastrophizing Scale), RMQ (Roland–Morris Questionnaire), SF-MPQ (Short-Form McGill Pain Questionnaire), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 19, 2018
Footnotes
Supported by CEU Cardenal Herrera University (grant no. INDI 16/35) and the Instituto de Salud Carlos III, Spain (grant no. PI12/02710).
Clinical Trial Registration No.: NCT02343185.
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
