Advice as Good as Manual Therapy?
This post is a follow-on to one of Larry's previous posts titled:
Advice could be as good as physical treatment for back pain
Larry linked to a press release referring to a LBP trial published by Hay and colleagues in the June 11 issue of The Lancet. The groups were essentially manual therapy versus information and advice, with no differences at 3 or 12 months. A copy of the trial is attached. Although the trial was well done from an internal validity perspective, Paul Shekelle and Tony Delitto point out several limitations of this study in their commentary published in the same issue (also attached). The limitations are primarily related to the study's incoproration of a one size fits all approach, which has been repeatedly shown to be ineffective. I would encourage you to read their commentary on the paper, as it well defines the issues and why the results of this trial should not be at all surprising.
John
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