Evidence map›Paper›PMID 30354023›Full record

Trial reportArthritis care & research2019

Short- or Long-Term Treatment of Spinal Disability in Older Adults With Manipulation and Exercise.

Michele Maiers, Jan Hartvigsen, Roni Evans, Kristine Westrom, Qi Wang, Craig Schulz, Brent Leininger, Gert Bronfort

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Arthritis care & research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 5 pooled it
1.5field-weighted citation impact, top 18% 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

11 citing papers in PubMed, 5 syntheses or guidelines pooled it, 19 citations in OpenAlex.

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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

8 authors at 3 institutions in 2 countries.

Michele MaiersNorthwestern Health Sciences University, Bloomington, Minnesota.
Jan HartvigsenUniversity of Southern Denmark and Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark.
Roni EvansUniversity of Minnesota, Minneapolis.
Kristine WestromNorthwestern Health Sciences University, Bloomington, Minnesota.
Qi WangUniversity of Minnesota, Minneapolis.
Craig SchulzUniversity of Minnesota, Minneapolis.
Brent LeiningerUniversity of Minnesota, Minneapolis.
Gert BronfortUniversity of Minnesota, Minneapolis.
University of Minnesota System · USNorthwestern Health Sciences University · USUniversity of Southern Denmark · DK

Funding

University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UL1TR002494 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R, WEISDORF, DANIEL J · 2018 to 2022
$34.9M
Cost effectiveness of manipulation for spine pain using individual patient dataK01AT008965 · NCCIH · UNIVERSITY OF MINNESOTA · PI LEININGER, BRENT · 2016 to 2020
$559k
Phase I Study of Noni in Cancer PatientsR21AT000896 · NCCIH · UNIVERSITY OF HAWAII AT MANOA · PI ISSELL, BRIAN F · 2001 to 2002
$341k
HRSA HHS R18HP15127NCATS NIH HHS UL1 TR002494NCCIH NIH HHS K01 AT008965NCCIH NIH HHS R21 AT000896
6 · The paper itself

Abstract

objectiveBack and neck pain are associated with disability and loss of independence in older adults. Whether long-term management using commonly recommended treatments is superior to shorter-term treatment is unknown. This randomized clinical trial compared short-term treatment (12 weeks) versus long-term management (36 weeks) of back- and neck-related disability in older adults using spinal manipulative therapy (SMT) combined with supervised rehabilitative exercises (SRE).

methodsEligible participants were ages ≥65 years with back and neck disability for ≥12 weeks. Coprimary outcomes were changes in Oswestry Disability Index (ODI) and Neck Disability Index (NDI) scores after 36 weeks. An intent-to-treat approach used linear mixed-model analysis to detect between-group differences. Secondary analyses included other self-reported outcomes, adverse events, and objective functional measures.

resultsA total of 182 participants were randomized. The short-term and long-term groups demonstrated significant improvements in back disability (ODI score -3.9 [95% confidence interval (95% CI) -5.8, -2.0] versus ODI score -6.3 [95% CI -8.2, -4.4]) and neck disability (NDI score -7.3 [95% CI -9.1, -5.5] versus NDI score -9.0 [95% CI -10.8, -7.2]) after 36 weeks, with no difference between groups (back ODI score 2.4 [95% CI -0.3, 5.1]; neck NDI score 1.7 [95% CI 0.8, 4.2]). The long-term management group experienced greater improvement in neck pain at week 36, in self-efficacy at weeks 36 and 52, and in functional ability, and balance.

conclusionFor older adults with chronic back and neck disability, extending management with SMT and SRE from 12 to 36 weeks did not result in any additional important reduction in disability.

Indexed as

Time FactorsAgedAged, 80 and overBack PainChronic PainDisability EvaluationExercise TherapyFemaleGeriatric AssessmentHumansMaleManipulation, SpinalNeck PainPhysical Functional PerformanceSelf EfficacyTreatment Outcome

Identifiers

PMID30354023
PMCPMC6800817
OpenAlexW2898221043

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.