Evidence map›Paper›PMID 42875790›Full record

Trial reportChiropractic & manual therapies2026

Immediate effects of spinal manipulation, exercise therapy, and open-label placebo on lifting performance and pain in individuals with chronic non-specific back pain: a motion laboratory-based crossover randomized controlled trial.

Fredrik Borg, Filip Gedin, Erika Franzén, Wilhelmus Johannes Andreas Grooten

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Chiropractic & manual therapies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06891625 (Acute Effects of Spinal Manipulative Therapy, Exercise Therapy and Open-label Placebo on Movement Performance in Individuals With Chronic Back Pain), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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.

NCT06891625 narecruitingnot on this map

Acute Effects of Spinal Manipulative Therapy, Exercise Therapy and Open-label Placebo on Movement Performance in Individuals With Chronic Back Pain

TypeinterventionalSponsorKarolinska InstitutetRan2025 to 2026Enrolled40ConditionsChronic Low-back Pain, Back DisorderArmsSMT, ET, OLP
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

4 authors.

Fredrik BorgDepartment of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, Stockholm, 141 83, Sweden. fredrik.borg@ki.se.ORCID http://orcid.org/0009-0001-9912-1165
Filip GedinDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID http://orcid.org/0000-0002-8408-5106
Erika FranzénDepartment of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, Stockholm, 141 83, Sweden.ORCID http://orcid.org/0000-0001-5520-544X
Wilhelmus Johannes Andreas GrootenDepartment of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, Stockholm, 141 83, Sweden.ORCID http://orcid.org/0000-0002-1697-9781

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic non-specific back pain (CBP) is a leading cause of disability worldwide and is commonly associated with limitations in movements such as lifting. Although spinal manipulation (SMT) and exercise therapy (ET) are recommended treatments for CBP, their effects on objectively measured movement performance remain insufficiently explored. Open-label placebo (OLP) has gained attention for engaging placebo-related mechanisms ethically. This study aimed to investigate the immediate effects of SMT, ET, and OLP on lifting performance and pain in individuals with CBP, and to evaluate the add-on effects of OLP.

methodsA motion laboratory-based crossover randomized controlled trial included 50 individuals with CBP. Participants were recruited between April and July 2025 and attended a single laboratory session between September and October 2025. Participants performed lifting tasks using light and heavy loads before and after SMT, ET, and OLP interventions in randomized order. Three-dimensional motion capture was used to assess temporal, spatial, and spatiotemporal aspects of lifting performance. Subjective outcomes included pain intensity, perceived effectiveness, willingness to undergo each treatment, and treatment preference. Data were analyzed using linear mixed-effects models and functional data analysis.

resultsOverall lifting performance changed to a small degree following the interventions. No significant between-group differences were observed at the primary endpoint. Significant within-group changes were observed following SMT, including altered intersegmental coordination during the light lift, characterized by a greater relative contribution of back movement early in the lifting phase, reduced thorax-pelvis tilt during the heavy lift, and reduced pain. OLP was associated with reduced thorax-pelvis tilt and increased hip and knee flexion during the light lift. Subjective evaluations did not consistently correspond to objective biomechanical changes.

conclusionSMT, ET, and OLP demonstrated limited immediate effects on overall lifting performance in individuals with CBP. However, some within-group changes in thorax-pelvis movement and intersegmental coordination suggest that certain aspects of movement quality may respond to short-term interventions even when conventional biomechanical outcomes remain largely unchanged. The findings suggest the value of integrating subjective and objective outcomes, while advanced biomechanical analyses may provide insight into subtle movement changes in CBP.

trial registrationThe trial is registered at ClinicalTrials.gov (ID NCT06891625).

Indexed as

Back PainChronic PainExercise TherapyLiftingManipulation, SpinalAdultCross-Over StudiesFemaleHumansMaleMiddle AgedBiomechanicsEveryday activitiesFunctional data analysisIntersegmental coordinationMotion captureMovement qualityPhysical functionPlacebo effectsSpinal manipulative therapy

Identifiers

PMID42875790
PMCPMC13670478

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Registered trials

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.