Evidence map›Paper›PMID 29596158›Full record

Trial reportPain2018

Spinal manipulation and exercise for low back pain in adolescents: a randomized trial.

Roni Evans, Mitchell Haas, Craig Schulz, Brent Leininger, Linda Hanson, Gert Bronfort

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

Trial report in Pain, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 5 pooled it
2.4field-weighted citation impact, top 12% of its field
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

24 citing papers in PubMed, 5 syntheses or guidelines pooled it, 69 citations in OpenAlex.

  1. Pooled it
  2. Guideline
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  5. Manual therapy for the pediatric population: a systematic review.BMC complementary and alternative medicine · 2019
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  10. The Science of Tai Chi andJournal of integrative and complementary medicine · 2025
    Review
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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

6 authors at 2 institutions in 1 country.

Roni EvansIntegrative Health & Wellbeing Research Program, Earl E. Bakken Center for Spirituality and Healing, University of Minnesota, Minneapolis, MN, USA.
Mitchell Haas
Craig Schulz
Brent Leininger
Linda Hanson
Gert Bronfort
University of Minnesota · USBakken Museum · US

Funding

Cost effectiveness of manipulation for spine pain using individual patient dataK01AT008965 · NCCIH · UNIVERSITY OF MINNESOTA · PI LEININGER, BRENT · 2016 to 2020
$559k
Cost effectiveness of spinal manipulative therapy for seniors with neck painF32AT007507 · NCCIH · UNIVERSITY OF MINNESOTA · PI LEININGER, BRENT · 2012 to 2014
$214k
NCCIH NIH HHS F32 AT007507NCCIH NIH HHS K01 AT008965
6 · The paper itself

Abstract

Low back pain (LBP) is common in adolescence, but there is a paucity of high-quality research to inform care. We conducted a multicenter randomized trial comparing 12 weeks of spinal manipulative therapy (SMT) combined with exercise therapy (ET) to ET alone. Participants were 185 adolescents aged 12 to 18 years with chronic LBP. The primary outcome was LBP severity at 12, 26, and 52 weeks. Secondary outcomes included disability, quality of life, medication use, patient- and caregiver-rated improvement, and satisfaction. Outcomes were analyzed using longitudinal linear mixed effect models. An omnibus test assessing differences in individual outcomes over the entire year controlled for multiplicity. Of the 185 enrolled patients, 179 (97%) provided data at 12 weeks and 174 (94%) at 26 and 52 weeks. Adding SMT to ET resulted in a larger reduction in LBP severity over the course of 1 year (P = 0.007). The group difference in LBP severity (0-10 scale) was small at the end of treatment (mean difference = 0.5; P = 0.08) but was larger at weeks 26 (mean difference = 1.1; P = 0.001) and 52 (mean difference = 0.8; P = 0.009). At 26 weeks, SMT with ET performed better than ET alone for disability (P = 0.04) and improvement (P = 0.02). The SMT with ET group reported significantly greater satisfaction with care at all time points (P ≤ 0.02). There were no serious treatment-related adverse events. For adolescents with chronic LBP, spinal manipulation combined with exercise was more effective than exercise alone over a 1-year period, with the largest differences occurring at 6 months. These findings warrant replication and evaluation of cost effectiveness.

Indexed as

Exercise TherapyManipulation, SpinalPatient SatisfactionAdolescentChildCombined Modality TherapyDisability EvaluationFemaleHumansLow Back PainMaleTreatment Outcome

Identifiers

PMID29596158
PMCPMC6205160
OpenAlexW2794576301

What OpenQuestion holds

Textmetadata
LicenceTDM
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.