Evidence map›Paper›PMID 27317505›Full record

Trial reportManual therapy2016

Efficacy of classification-specific treatment and adherence on outcomes in people with chronic low back pain. A one-year follow-up, prospective, randomized, controlled clinical trial.

Linda R Van Dillen, Barbara J Norton, Shirley A Sahrmann, Bradley A Evanoff, Marcie Harris-Hayes, Gregory W Holtzman, Jeanne Earley, Irene Chou, Michael J Strube

Abstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Manual therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Exercise therapy for chronic low back pain.The Cochrane database of systematic reviews · 2021
    Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017
    Trial
  8. Review
  9. Exercise Prescription for Patients With Persistent Low Back Pain Who Present With Impaired Lateral Abdominal Muscle Activation: A Delphi Survey.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2025
    Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021.The Journal of orthopaedic and sports physical therapy · 2021
    Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Linda R Van DillenProgram in Physical Therapy, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Boulevard, St. Louis, MO, 63108, USA; Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 S. Euclid Ave, St. Louis, MO, 63110, USA. Electronic address: vandillenl@wusm.wustl.edu.
Barbara J NortonProgram in Physical Therapy, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Boulevard, St. Louis, MO, 63108, USA; Department of Neurology, Washington University School of Medicine, Campus Box 8111, 660 S. Euclid Ave, St. Louis, MO, 63110, USA.
Shirley A SahrmannProgram in Physical Therapy, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Boulevard, St. Louis, MO, 63108, USA; Department of Neurology, Washington University School of Medicine, Campus Box 8111, 660 S. Euclid Ave, St. Louis, MO, 63110, USA; Department of Cell Biology and Physiology, Washington University School of Medicine, Campus Box 8228, 660 S. Euclid Ave, St. Louis, MO, 63110, USA.
Bradley A EvanoffDepartment of Medicine, Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S Euclid Ave, St. Louis, MO, 63110, USA.
Marcie Harris-HayesProgram in Physical Therapy, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Boulevard, St. Louis, MO, 63108, USA; Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 S. Euclid Ave, St. Louis, MO, 63110, USA.
Gregory W HoltzmanProgram in Physical Therapy, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Boulevard, St. Louis, MO, 63108, USA; Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 S. Euclid Ave, St. Louis, MO, 63110, USA.
Jeanne EarleyPhysical Therapy Department, The Rehabilitation Institute of Saint Louis, 4455 Duncan Avenue, St. Louis, MO, 63110, USA.
Irene ChouPhysical Therapy Department, The Rehabilitation Institute of Saint Louis, 4455 Duncan Avenue, St. Louis, MO, 63110, USA.
Michael J StrubeProgram in Physical Therapy, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Boulevard, St. Louis, MO, 63108, USA; Department of Psychology, Washington University, Campus Box 1125, One Brookings Drive, St. Louis, MO, 63130, USA.

Funding

MULTICENTER CAREER DEVELOPMENT PROGRAM FOR PHYSICAL AND OCCUPATIONAL THERAPYK12HD055931 · NICHD · WASHINGTON UNIVERSITY · PI HAYES, MARCIE HARRIS · 2007 to 2021
$12.7M
Spinal Control during Functional Activities to Improve Low Back Pain OutcomesR01HD047709 · NICHD · WASHINGTON UNIVERSITY · PI VANDILLEN, LINDA R · 2006 to 2017
$3.7M
NICHD NIH HHS K12 HD055931NICHD NIH HHS R01 HD047709
6 · The paper itself

Abstract

backgroundIt is unknown if low back pain (LBP) outcomes are enhanced by classification-specific treatment based on the Movement System Impairment classification system. The moderating effect of adherence to treatment also is unknown.

objectivesCompare the efficacy of a classification-specific treatment (CS) and a non classification-specific (NCs) treatment and examine the moderating effect of adherence on outcomes.

design2 center, 2 parallel group, prospective, randomized, clinical trial.

methodParticipants with chronic LBP were classified and randomized. Self-report data was obtained at baseline, post-treatment, and 6 and 12 months post-treatment. The primary outcome was the modified Oswestry Disability Index (mODI; 0-100%). Treatment effect modifiers were exercise adherence and performance training adherence. An intention to treat approach and hierarchical linear modeling were used.

results47 people received CS treatment, 54 people received NCs treatment. Treatment groups did not differ in mODI scores (p > 0.05). For both groups, scores improved with treatment (p < 0.05), plateaued at 6 months (p > 0.05), and minimally regressed at 12 months (p < 0.05). Performance training adherence had a unique, independent effect on mODI scores above and beyond the effect of exercise adherence (p < 0.05). There were no treatment group effects on the relationship between mODI scores and the two types of adherence (p < 0.05).

conclusionsThere were no differences in function between the two treatment groups (CS and NCs). In both treatment groups, people with chronic LBP displayed clinically important long-term improvements in function. When both forms of adherence were considered, the improvements were uniquely related to adherence to performance training.

Indexed as

Exercise TherapyAdolescentAdultFemaleFollow-Up StudiesHumansLow Back PainMaleMiddle AgedPatient ComplianceProspective StudiesSelf ReportTreatment OutcomeUnited StatesYoung AdultAdherenceClassificationLow back pain

Identifiers

PMID27317505
PMCPMC4921225

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.