Evidence map›Paper›PMID 30042627›Full record

ArticleThe Journal of manual & manipulative therapy2018

The impact of pragmatic vs. prescriptive study designs on the outcomes of low back and neck pain when using mobilization or manipulation techniques: a systematic review and meta-analysis.

Daniel Roenz, Jake Broccolo, Steven Brust, Jordan Billings, Alexander Perrott, Jeremy Hagadorn, Chad Cook, Joshua Cleland

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of manual & manipulative therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 24% 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

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.

  1. Manual physical therapy for neck disorders: an umbrella review.The Journal of manual & manipulative therapy · 2025
    Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Article
  8. A Clinically-Reasoned Approach to Manual Therapy in Sports Physical Therapy.International journal of sports physical therapy · 2023
    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

8 authors at 2 institutions in 1 country.

Daniel RoenzPhysical Therapy Department, Franklin Pierce University, Rindge, NH, USA.
Jake BroccoloPhysical Therapy Department, Franklin Pierce University, Rindge, NH, USA.
Steven BrustPhysical Therapy Department, Franklin Pierce University, Rindge, NH, USA.
Jordan BillingsPhysical Therapy Department, Franklin Pierce University, Rindge, NH, USA.
Alexander PerrottPhysical Therapy Department, Franklin Pierce University, Rindge, NH, USA.
Jeremy HagadornPhysical Therapy Department, Franklin Pierce University, Rindge, NH, USA.
Chad CookPhysical Therapy Department, Duke University, Durham, NC, USA.
Joshua ClelandPhysical Therapy Department, Franklin Pierce University, Rindge, NH, USA.
Franklin Pierce University · USDuke University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe purpose of this systematic review and meta-analysis was to examine the impact of pragmatic versus prescriptive study designs on the outcomes of low back and neck pain when using mobilization or manipulation techniques.

methodsThis study design was a systematic review and meta-analysis, which was performed according to the PRISMA guidelines. A search of MEDLINE and CINAHL complete databases was performed. Article titles and abstracts were reviewed to identify studies comparing mobilization and manipulation in low back or neck pain that met eligibility criteria. Validity of studies was examined using the Cochrane Risk of Bias tool. Data analysis was performed using RevMan 5.3. Forest plots were constructed after data were analyzed to determine effect sizes.

resultsThirteen studies with a total of 1313 participants were included in the systematic review, and 12 studies with 977 participants in the meta-analysis. For most time-points prescriptive studies found manipulation to be superior to mobilization for both pain and disability. At no time-point did pragmatic designs find a difference between mobilization and manipulation for either pain or disability. DISCUSSION: When a pragmatic design was used, representing actual clinical practice, patients improved with both techniques with no difference between mobilization and manipulation. When clinicians were prescribed techniques, not representing true clinical practice, manipulation showed better outcomes than mobilization for pain and disability. LEVEL OF EVIDENCE: 1a.

Indexed as

disabilityManipulationmanual therapymobilizationpainpragmaticprescriptivespine

Identifiers

PMID30042627
PMCPMC6055961
OpenAlexW2769186487

What OpenQuestion holds

Textmetadata
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.