A randomized trial of combined manipulation, stabilizing exercises, and physician consultation compared to physician consultation alone for XXXX .

@entity1 @entity1643 @entity308 @entity158 @entity717
STUDY DESIGN: A prospective randomized controlled trial. OBJECTIVES: To examine the effectiveness of combined manipulative treatment, stabilizing exercises, and physician consultation compared with physician consultation alone for @entity1643 . SUMMARY OF BACKGROUND DATA: Strong evidence exists that manual therapy provides more effective short-term @entity158 relief than does placebo treatment in the management of @entity1643 . The evidence for long-term effect is lacking. METHODS: Two hundred four @entity1643 @entity1 , whose @entity717 index was at least 16%, were randomly assigned to either a manipulative-treatment group or a consultation group. All were clinically examined, informed about their back @entity158 , provided with an educational booklet, and were given specific instructions based on the clinical evaluation. The treatment included four sessions of manipulation and stabilizing exercises aiming to correct the lumbopelvic rhythm. Questionnaires inquired about @entity158 intensity, self-rated disability, @entity308 , health-related quality of life, health care costs, and production costs. RESULTS: At the baseline, the groups were comparable, except for the percentage of employees (P = 0.01). At the 5- and 12-month follow-ups, the manipulative-treatment group showed more significant reductions in @entity158 intensity (P < 0.001) and in self-rated disability (P = 0.002) than the consultation group. However, we detected no significant difference between the groups in health-related quality of life or in costs. CONCLUSIONS: The manipulative treatment with stabilizing exercises was more effective in reducing @entity158 intensity and disability than the physician consultation alone. The present study showed that short, specific treatment programs with proper @entity1 information may alter the course of @entity1643 .
