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. 2012 Feb;20(1):5-15.
doi: 10.1179/2042618611Y.0000000016.

A randomized, controlled trial of osteopathic manipulative treatment for acute low back pain in active duty military personnel

des Anges Cruser  1 , Douglas Maurer, Kendi Hensel, Sarah K Brown, Kathryn White, Scott T Stoll
Affiliations

A randomized, controlled trial of osteopathic manipulative treatment for acute low back pain in active duty military personnel

des Anges Cruser et al. J Man Manip Ther. 2012 Feb.

Abstract

Objective: Acute low back pain (ALBP) may limit mobility and impose functional limitations in active duty military personnel. Although some manual therapies have been reported effective for ALBP in military personnel, there have been no published randomized controlled trials (RCTs) of osteopathic manipulative treatment (OMT) in the military. Furthermore, current military ALBP guidelines do not specifically include OMT.

Methods: This RCT examined the efficacy of OMT in relieving ALBP and improving functioning in military personnel at Fort Lewis, Washington. Sixty-three male and female soldiers ages 18 to 35 were randomly assigned to a group receiving OMT plus usual care or a group receiving usual care only (UCO).

Results: The primary outcome measures were pain on the quadruple visual analog scale, and functioning on the Roland Morris Disability Questionnaire. Outcomes were measured immediately preceding each of four treatment sessions and at four weeks post-trial. Intention to treat analysis found significantly greater post-trial improvement in 'Pain Now' for OMT compared to UCO (P = 0·026). Furthermore, the OMT group reported less 'Pain Now' and 'Pain Typical' at all visits (P = 0·025 and P = 0·020 respectively). Osteopathic manipulative treatment subjects also tended to achieve a clinically meaningful improvement from baseline on 'Pain at Best' sooner than the UCO subjects. With similar baseline expectations, OMT subjects reported significantly greater satisfaction with treatment and overall self-reported improvement (P<0·01).

Conclusion: This study supports the effectiveness of OMT in reducing ALBP pain in active duty military personnel.

Keywords: Low back pain; Manipulation; Manual medicine.

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Figures

Figure 1
Figure 1
Participant flow.
Figure 2
Figure 2
Osteopathic manipulative treatment protocol.
Figure 3
Figure 3
Mean Pain Now, Typical, Best and Worst, and RMDQ by group and visit. OMT = osteopathic manipulative treatment; UCO = usual care only. (A) Effect of time (P<0·001) and treatment group (P = 0·025) were significant, but interaction (P = 0·175) was not. (B) Effect of time (P<0·001) and treatment group (P = 0·020) were significant, but interaction (P = 0·473) was not. (C) Effect of time (P<0·001) was significant; however, group effect (P = 0·065) was not. (D) Effect of time (P<0·001) was significant. Group (P = 0·198) and the time x group interaction (P = 0·080) were not significant. (E) Effect of time (P<0·001) was significant; however, the interaction (P = 0·691) and treatment group (P = 0·197) were not.
Figure 4
Figure 4
Time to clinical improvement in Pain Best for OMT and UCO groups.
See this image and copyright information in PMC

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