The Audible Pop from high velocity thrust manipulation and outcome in individuals with low back pain

(Flynn, Childs, & Fritz, 2006)

Aim: To assess whether audible pop during manips are related to/affects outcome.

Methods: 70 participants primary complaint of LBP. 13 physios 5 sessions 4 weeks. Outcome measures: NPRS, Oswestry and Lx F° with inclinometer at baseline, 1 week and 4 weeks. In the two first sessions they received HVLA-manips. Manips to the symptomatic side, if no pop/cavitation heard, 4 attempts max: two on each side. + ROM exercises. 3-4 x10 rep/daily on the days they did not attend physio. Pain during PA + Stiffness subjective “scale”.

Results: 84 % of the patients had a pop, 16 % had no pop. No sign diff in ODDS ratio between poppers and no-poppers in pain, disability and lumbar ROM at any of the times points (baseline, 1 week, 4 weeks).

Limitations: More than one manip if no pop thus difference in treatment dose / Only one type of manipulation tested. / Other interventions may influence results (Cofounding factors)

In Practice: Perceived audible pop may not relate to improved outcomes from HVT manip for P with non-radicular LBP at immediate or long-term follow-up.

Flynn, T. W., Childs, J. D., & Fritz, J. M. (2006). The audible pop from high-velocity thrust manipulation and outcome in individuals with low back pain. In Journal of Manipulative and Physiological Therapeutics (Vol. 29, pp. 40–45).

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