Thrust and nonthrust manipulation for older adults with low back pain: an evaluation of pain and disability

J Manipulative Physiol Ther. 2013 Jun;36(5):284-91. doi: 10.1016/j.jmpt.2013.05.007. Epub 2013 Jun 12.


Objective: The purpose of the study was to compare the effects of thrust manipulation (TM) and non-TM (NTM) on a sample of older subjects with low back pain.

Methods: This is a secondary data analysis of a randomized control trial. Forty-nine subjects aged 55 to 88 years participated in the trial, who received either a TM or NTM on at least 2 occasions during the course of care, and were extracted from the larger data set. The treatment program included a standardized home exercise program for the first 2 sessions, which could be modified by the therapist after those 2 sessions. Numeric pain rating scale and Oswestry Disability Index (ODI) were the outcomes for this study.

Results: Multivariate analysis revealed no significant between-group differences for treatment group (P=.99) without group×time interaction (P=.90). Significant within-group changes were observed for both groups for ODI and numeric pain rating scale (P<.001); the average self-report of recovery was 78.0% (SD, 19.8%). Age stratification of the older subset revealed between-group differences in ODI change scores for the oldest subjects (>70 years) compared with 60 to 69 years (P=.02).

Conclusions: This study showed that outcomes for both TM and NTM improved in older adults with low back pain.

Keywords: Aged; Low Back Pain; Musculoskeletal Manipulations.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Disability Evaluation*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Low Back Pain / therapy*
  • Lumbar Vertebrae*
  • Male
  • Manipulation, Spinal / methods*
  • Middle Aged
  • Pain Measurement
  • Range of Motion, Articular / physiology
  • Treatment Outcome