Classification and Manipulation for Low Back Pain—Should They Be Linked?

Debators: Timothy W Flynn, PT, PhD, OCS, FAAOMPT, and Christopher Maher, PT, PhD; Moderator: Daniel L Riddle, PT, PhD, FAPTA

Files in this Data Supplement:

• Debate Podcast - "We have in physical therapy, and in particular manual physical therapy, a language problem."

  "We need a lot more evidence before we throw a lot of these techniques away."

  Christopher Maher, PT, PhD, and Timothy W Flynn, PT, PhD, OCS, FAAOMPT, have both published studies to assess the effectiveness of manipulation, but they used different strategies. Find out why they chose the strategies they chose, and hear them debate the differences in their results and the implications for practice. The debate centers on the following articles:

  Childs JD, Fritz JM, Flynn TW, et al. A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study. Ann Intern Med. 2004;141:920-928.

  Hancock MJ, Maher CG, Latimer J, et al. Assessment of diclofenac or spinal manipulative therapy, or both, in addition to recommended first-line treatment for acute low back pain: a randomised controlled trial. Lancet. 2007;370(9599):1638-1643.

  Evidence in Motion (EIM) blog alert: find out what your colleagues have to say about this debate.

  References

  In the debate, Flynn refers to the following:

  UK Beam Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. BMJ. 2004;329(7479):1377. Epub 2004 Nov 19.

  Running time: 21:13 (9.7 MB)