Manual therapy · 2014
Thoracic spinal manipulation for musculoskeletal shoulder pain: Can an instructional set change patient expectation and outcome?
Сравнительное исследованиеСтатьяРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Riley Sean P, Bialosky Joel, Cote Mark P, Swanson Brian T, Tafuto Vincent, Sizer Phillip S, Brismée Jean-Michel
Аннотация
STUDY DESIGN: Planned secondary analysis of a randomized clinical trial.
OBJECTIVES: To examine: 1) patients' baseline expectations for treatment outcome of thoracic high velocity low amplitude thrust manipulations (HVLATM) to the thoracic spine for shoulder pain; 2) if the message conveyed by the clinician changed the patients' expectation; 3) any differences in outcome based on expectation independent of messaging.; and 4) any differences in outcome for those patients whose expectations significantly changed as a result of the messaging.
BACKGROUND: Thoracic HVLATM may be an effective intervention for patients suffering from musculoskeletal shoulder pain. The role of expectation in the treatment effectiveness of this intervention has not been established.
METHODS: Subjects' expectations regarding the effectiveness of HVLATM on shoulder pain were recorded at baseline. This was reassessed immediately following the provision of positive or neutral instructional set. The subjects then received a thoracic or scapular HVLATM. The Shoulder Pain and Disability Index (SPADI) and the numeric pain rating scale (NPRS) were used as outcomes measures.
RESULTS: There was a 10 subject change (23%) in positive expectation that was statistically significant (p = 0.019) following a positive message. There was no statistically significant difference in pain and function when these subjects were compared to all other subjects.
CONCLUSION: Although patients' expectations of positive outcome significantly changed when providing a positive instructional set, these changes did not translate into clinically significant short term changes in shoulder pain and function.
LEVEL OF EVIDENCE: 1b.
OBJECTIVES: To examine: 1) patients' baseline expectations for treatment outcome of thoracic high velocity low amplitude thrust manipulations (HVLATM) to the thoracic spine for shoulder pain; 2) if the message conveyed by the clinician changed the patients' expectation; 3) any differences in outcome based on expectation independent of messaging.; and 4) any differences in outcome for those patients whose expectations significantly changed as a result of the messaging.
BACKGROUND: Thoracic HVLATM may be an effective intervention for patients suffering from musculoskeletal shoulder pain. The role of expectation in the treatment effectiveness of this intervention has not been established.
METHODS: Subjects' expectations regarding the effectiveness of HVLATM on shoulder pain were recorded at baseline. This was reassessed immediately following the provision of positive or neutral instructional set. The subjects then received a thoracic or scapular HVLATM. The Shoulder Pain and Disability Index (SPADI) and the numeric pain rating scale (NPRS) were used as outcomes measures.
RESULTS: There was a 10 subject change (23%) in positive expectation that was statistically significant (p = 0.019) following a positive message. There was no statistically significant difference in pain and function when these subjects were compared to all other subjects.
CONCLUSION: Although patients' expectations of positive outcome significantly changed when providing a positive instructional set, these changes did not translate into clinically significant short term changes in shoulder pain and function.
LEVEL OF EVIDENCE: 1b.