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The findings of this study, which are comparable in magnitude to those found after a one-year follow-up, show that spinal manipulation in combination with low-tech rehabilitative exercise and MedX rehabilitative exercise is superior to spinal manipulation alone over a two-year period. These findings imply that patients with chronic neck discomfort may benefit from therapies that include carefully supervised rehabilitative exercise. Additional research is required to determine the cost-effectiveness of these treatments and how spinal manipulation stacks up against minimal or no intervention.
What is Abstract of two-year follow-up of a randomized clinical trial of spinal manipulation and two types of exercise for patients with chronic neck pain?
- Objectives: To compare the results of spinal manipulation alone, spinal manipulation combined with low-tech rehabilitative exercise, or spinal manipulation combined with MedX rehabilitative exercise over a two-year follow-up period.
- Background information in summary: Most randomized clinical trials of spinal manipulation and therapeutic exercise for patients with neck pain have only documented short-term results.
- Methods: One of the three therapies was administered to 199 patients with chronic neck pain for a total of 11 weeks. After five and eleven weeks of treatment, as well as three, six, twelve, and twenty-four months later, patient self-report questionnaires were collected to assess pain, disability, general health status, improvement, satisfaction, and usage of over-the-counter medications. Repeated measures analyses were used to examine the data while accounting for all time points.
- Results: Ninety-three percent (178) of the patients who were randomly assigned to receive the intervention phase completed it, and 76% (145) of them provided data throughout the study's two-year follow-up. With no group-time interaction, a difference in patient-rated pain was seen in favor of the two exercise groups [F(2141) = 3.2; P= 0.04]. The combination of spinal manipulation and low-tech rehabilitative exercise was shown to be superior than MedX rehabilitative exercise (P = 0.02) and spinal manipulation alone (P 0.001) in terms of patient satisfaction with care [F(2143) = 7.7; P= 0.001]. For neck disability, overall health status, improvement, and OTC drug use, no significant group differences were discovered, despite the fact that the two exercise groups showed a longer-term trend toward better health.
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