Abstract
Background:
Spinal conditions are prevalent causes of pain and disability world
wide. Gaining insight into the comparative effectiveness of manual
therapy interventions with alternative treatments can enlighten patients
and healthcare professionals regarding the most suitable methods for
effectively managing these conditions.
Purpose:
The purpose of this umbrella review was to summarize, synthesize,
and integrate the evidence evaluating the effectiveness of manual
therapy intervention(s) with other interventions for the treatment of
different spinal conditions.
Methods:
This is an umbrella review of systematic reviews. We have searched
seven databases (CINAHL, Cochrane, EMBASE, Epistemonikos, Medline
(PubMed), SCOPUS, and Web of Science) and obtained systematic re
views that compare spinal manual therapy alone (mobilization,
manipulation, and manual traction) with control, no treatment, or sham
treatment. A pair of reviewers assessed the quality of the systematic
reviews using A Measurement Tool to Assess Systematic Reviews
(AMSTAR 2) tool. We extracted data related to study characteristics and
the effectiveness of spinal manual therapy, categorizing by treatment
technique, outcome measures, and condition. The corrected covered
area (CCA) index had been calculated to identify duplicating random
ized controlled trials.
Results:
A total of 3,918 citations were identified. We screened in 2,146 cita
tions after removing duplication. 179 articles were reviewed in full text
screening phase. In total, 21 systematic reviews met our eligibility criteria.
The quality of the included systematic reviews was rated mainly as criti
cally low (n = 14) or low (n = 6), while only one study was of high quality.
Although manipulation may provide short-term relief for acute and
chronic low back pain, its impact on functional improvement is uncertain.
Similarly, the short-term effects of manipulation on pain levels in acute and
chronic neck pain remain uncertain. Limited evidence exists comparing
mobilization alone to other interventions, and the effects of manipulation
and mobilization on pain and function are inconsistent. The CCA index was
3.97%, indicating a low overlapping of the included reviews.
Conclusion:
Due to the low-quality nature of the systematic reviews and meta-
analyses included in this study, the findings should be interpreted
with caution. No definitive recommendation can be made for the
effectiveness of spinal manual therapy. Higher-quality systematic re
views and randomized controlled trials are needed to further support the
use of spinal manual therapy in spinal pain conditions.
Implications:
These findings emphasize the need for caution in interpreting the effectiveness of spinal manual therapy due to the low-quality evidence
available. As such, healthcare professionals should approach the use of
manual therapy in managing spinal pain with careful consideration and
individualized decision-making. The future implementation of higher-
quality systematic reviews and randomized controlled trials is crucial
to providing more robust evidence to support or refute the use of spinal
manual therapy for spinal pain conditions.
Spinal conditions are prevalent causes of pain and disability world
wide. Gaining insight into the comparative effectiveness of manual
therapy interventions with alternative treatments can enlighten patients
and healthcare professionals regarding the most suitable methods for
effectively managing these conditions.
Purpose:
The purpose of this umbrella review was to summarize, synthesize,
and integrate the evidence evaluating the effectiveness of manual
therapy intervention(s) with other interventions for the treatment of
different spinal conditions.
Methods:
This is an umbrella review of systematic reviews. We have searched
seven databases (CINAHL, Cochrane, EMBASE, Epistemonikos, Medline
(PubMed), SCOPUS, and Web of Science) and obtained systematic re
views that compare spinal manual therapy alone (mobilization,
manipulation, and manual traction) with control, no treatment, or sham
treatment. A pair of reviewers assessed the quality of the systematic
reviews using A Measurement Tool to Assess Systematic Reviews
(AMSTAR 2) tool. We extracted data related to study characteristics and
the effectiveness of spinal manual therapy, categorizing by treatment
technique, outcome measures, and condition. The corrected covered
area (CCA) index had been calculated to identify duplicating random
ized controlled trials.
Results:
A total of 3,918 citations were identified. We screened in 2,146 cita
tions after removing duplication. 179 articles were reviewed in full text
screening phase. In total, 21 systematic reviews met our eligibility criteria.
The quality of the included systematic reviews was rated mainly as criti
cally low (n = 14) or low (n = 6), while only one study was of high quality.
Although manipulation may provide short-term relief for acute and
chronic low back pain, its impact on functional improvement is uncertain.
Similarly, the short-term effects of manipulation on pain levels in acute and
chronic neck pain remain uncertain. Limited evidence exists comparing
mobilization alone to other interventions, and the effects of manipulation
and mobilization on pain and function are inconsistent. The CCA index was
3.97%, indicating a low overlapping of the included reviews.
Conclusion:
Due to the low-quality nature of the systematic reviews and meta-
analyses included in this study, the findings should be interpreted
with caution. No definitive recommendation can be made for the
effectiveness of spinal manual therapy. Higher-quality systematic re
views and randomized controlled trials are needed to further support the
use of spinal manual therapy in spinal pain conditions.
Implications:
These findings emphasize the need for caution in interpreting the effectiveness of spinal manual therapy due to the low-quality evidence
available. As such, healthcare professionals should approach the use of
manual therapy in managing spinal pain with careful consideration and
individualized decision-making. The future implementation of higher-
quality systematic reviews and randomized controlled trials is crucial
to providing more robust evidence to support or refute the use of spinal
manual therapy for spinal pain conditions.
| Original language | English |
|---|---|
| Title of host publication | Conference abstracts from IFOMPT 24, the 12th world conference of musculoskeletal and manual physical therapy. Celebrating 50 years. Basel, Switzerland 4th–6th July |
| Pages | 28-29 |
| Volume | 72 |
| DOIs | |
| Publication status | Published - Aug 2024 |
Publication series
| Name | Musculoskeletal Science and Practice |
|---|---|
| Publisher | Elsevier Ltd |
| ISSN (Print) | 2468-8630 |