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Table 1 Summary of trials.

From: Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials

  Hoehler 1981 [42] Gibson 1985 [43] Cleary 1994 [47]
Years conducted 1973–1979 ... 1991–1992
Country United States United Kingdom United Kingdom
Setting University clinic Hospital outpatient clinic Ambulatory clinic
No. of subjects randomized 95 109 30*
Comparison OMT vs soft tissue massage and sham manipulation OMT vs short-wave diathermy
OMT vs detuned short-wave diathermy
OMT vs sham manipulation
Subject
characteristics
   Age, y    
Mean ± SD OMT, 30.1 ± 8.4
Controls, 32.1 ± 9.8
OMT, 34 ± 14
Short-wave diarthermy controls, 35 ± 16
Detuned short-wave diathermy controls, 40 ± 16
Overall age range, 50–60
   Sex    
% male OMT, 59
Controls, 59
OMT, 49
Detuned short-wave diathermy controls, 68
Short-wave diarthermy controls, 53
OMT, 0
Controls, 0
   Type of low back pain Referred patients with acute or chronic low back pain Referred patients with low back pain of greater than 2 months' and less than 12 months' duration Recruited subjects with chronic low back pain in conjunction with menopausal symptoms
OMT protocol
   Technique High-velocity, low-amplitude thrust only Variety of techniques Low-force techniques
   No. of treatments    
Mean ± SD OMT, 4.8 ± 2.7
Controls, 3.9 ± 2.5
4, per protocol 10, per protocol
Outcomes assessment Blinded Blinded Assessment independent of treatment, blinding not specified
No. of pain contrasts 3 6 (3 for each of the two OMT vs control treatment comparisons) 1
Type of pain outcome Dichotomous pain outcomes Dichotomous pain outcomes Dichotomous pain outcome
Timing of pain contrasts    
   Short-term First treatment and mean, 20–30 days following randomization 2 and 4 weeks ...
   Intermediate-term Mean, 41–51 days following randomization ... ...
   Long-term ... 12 weeks 15 weeks
  Andersson 1999 [44] Burton 2000 [45] Licciardone 2003 [46]
Years conducted 1992–1994 ... 2000–2001
Country United States United Kingdom United States
Setting Health maintenance organization Hospital orthopedic department University clinic
No. of subjects randomized 178 40 91
Comparison Usual care and OMT vs usual care only OMT vs chemonucleolysis Usual care and OMT vs usual care and sham manipulation
Usual care and OMT vs usual care only
Subject characteristics    
   Age, y    
Mean ± SD OMT, 28.5 ± 10.6
Controls, 37.0 ± 11.0
Overall, 41.9 ± 10.6 Usual care and OMT, 49 ± 12
Usual care and sham manipulation controls, 52 ± 12
Usual care only controls, 49 ± 12
   Sex    
% male OMT, 41
Controls, 44
Overall, 48 Usual care and OMT, 31
Usual care and sham manipulation controls, 43
Usual care only controls, 35
   Type of low back pain Patients with low back pain of 3 or more weeks' and less than 6 months' duration Recruited patients with low back pain and sciatica; mean duration, 30 and 32 weeks in OMT and chemonucleolysis groups, respectively Recruited subjects with low back pain of at least 3 months' duration
OMT protocol    
   Technique Variety of techniques, individualized to patient Variety of techniques, individualized to patient Variety of techniques, individualized to subject
   No. of treatments    
Mean ± SD 8, per protocol Mean for OMT, 11; range 6–18 7, per protocol
Outcomes assessment Blinded Blinded Blinded
No. of pain contrasts 1 3 6 (3 for each of the two OMT vs control treatment comparisons)
Type of pain outcome Pain scale Pain scales Pain scales
Timing of pain contrasts    
   Short-term ... 2 weeks 1 month
   Intermediate-term 12 weeks 6 weeks 3 months
   Long-term ... 12 months 6 months
  1. OMT denotes osteopathic manipulative treatment.
  2. *A total of 30 subjects with menopausal symptoms were randomized; however, only 12 subjects had low back pain.