systematic review of clinical trials of cervical manipulation control group procedures and pain outcomes系统综述的临床试验对照组颈操纵程序和痛苦的结果.pdf

Vernon et al. Chiropractic Manual Therapies 2011, 19:3 /content/19/1/3 CHIROPRACTIC MANUAL THERAPIES REVIEW Open Access Systematic review of clinical trials of cervical manipulation: control group procedures and pain outcomes * Howard Vernon , Aaron Puhl, Christine Reinhart Abstract Objective: To characterize the types of control procedures used in controlled clinical trials of cervical spine manipulation and to evaluate the outcomes obtained by subjects in control groups so as to improve the quality of future clinical trials Methods: A search of relevant clinical trials was performed in PubMed 1966-May 2010 with the following key words: “Chiropractic[Mesh] OR “Manipulation, Spinal[Mesh]) AND “Clinical Trial “[Publication Type]. Reference lists from these trials were searched for any additional trials. The reference lists of two prior studies, one review and one original study were also searched. Accepted reports were then rated for quality by 2 reviewers using the PEDro scale. Studies achieving a score of 50% were included for data extraction and analysis. Intra-group change scores on pain outcomes were obtained. For determining clinically important outcomes, a threshold of 20% improvement was used where continuous data were available; otherwise, an effect size of 0.30 was employed Results: The PubMed search yielded 753 citations of which 13 were selected. Eight (8) other studies were identified by reviewing two systematic reviews and through reference searches. All studies scored 50% on the PEDro scale. There were 9 multi-session studies and 12 single-session studies. The most commonly used control procedure was “manual contact/no thrust”. Four (4) studies used a placebo-control (patient blinded). For two of thes