Lumbar spine manipulation, compared to combined lumbar spine and ankle manipulation for the treatment of chronic mechanical low back pain
Bibliographic record
Abstract
The low back and the lower limb are generally viewed as two isolated regions, however, there are many authors who believe that these two regions are functionally related. This is due to the two regions being connected to each other through the kinematic chain of the lower extremity. The lumbar spine is the link between the lower extremities and the trunk, and plays a significant role in the transfer of forces through the body via the kinematic chain. The physical link between the low back and the lower limb is supplied by the thoracolumbar fascia, which plays an important role in the transfer of forces between the spine, pelvis and legs. Although a relationship between the lower extremity and low back pain is often assumed, little research has been published to demonstrate the association. Most of the evidence so far has been anecdotal, without scientific research to support it. This study was designed to compare the relative effectiveness of lumbar spine manipulation, compared to combined lumbar spine and subtalar manipulation for the treatment of chronic mechanical low back pain, using subjective and objective measures, for the management of chronic mechanical low back pain. The study design was a quantitative clinical trial, using purposive sampling. It consisted of forty voluntary participants with chronic mechanical low back pain. There were two groups of twenty participants each, each of whom received six treatments within a three week period. Group A received manipulation of the lumbar spine only, whilst Group B received manipulation of both the lumbar spine and subtalar joint. The outcome measures included the response of the participants to the Numerical Pain Rating Scale-101 and the Quebec Low Back Pain and Disability Questionnaire. Objective data was obtained from three digital Algometer measures. Data was collected prior to the initial, third and sixth treatment. iv Statistically both groups showed improvements, subjectively and objectively, with regards to chronic mechanical low back pain. Inter-group testing for NRS over time showed no significant effect for both treatment groups. There was a significant treatment effect for Algometer Average TP1 while the treatment effect for Algometer Average TP2 was not significant. However, inter-group testing for the Quebec LBP over time showed no significant effect for both treatment groups. Inter-group analysis demonstrated no statistical significance between the two groups for subjective and objective measurements, thus suggesting that there is no additional benefit in treating the subtalar joint in the management of mechanical low back pain. Further studies will also benefit greatly from the use of larger sample sizes to improve statistical relevance of data.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".