ECU convention 2018 congress proceedings
Bibliographic record
Abstract
Study ObjectivesBack and neck pain are persistent and associated with disability and loss of independence in older adults.Spinal manipulative therapy (SMT) and supervised rehabilitative exercise (SRE) are both recommended treatments for spine pain in adults, often in combination with one another.It is unknown whether long-term management with these therapies is superior to shorter-term treatment.This study compares the effectiveness of short-term treatment (12 weeks) versus long-term management (36 weeks) of back and neck related disability in older adults using SMT combined with SRE. Methods and MaterialThis randomized clinical trial was approved by an Institutional Review Board and conducted at a private healthcare university.Participants were 65 years of age and older, community dwelling, and selfreported both back and neck disability >12 weeks in duration.Individuals were randomly assigned to receive either 12 or 36 weeks of SMT + SRE.Co-primary outcomes were changes in Oswestry and Neck Disability Index after 36 weeks.Secondary outcomes included self-reported pain, improvement, medication use, self-efficacy, and quality of life at weeks 4, 12, 24, 36, 52 and 78.Change in objective functional measures from baseline were measured post-intervention.Linear mixed models were used to compare between group differences in an intention to treat analysis Results 182 individuals participated (91 to each group).Both the short-term and long-term groups demonstrated significant improvements in back (-3.9, 95% confidence interval (CI) -5.8 to -2.0 versus -6.3, 95% CI -8.2 to -4.4) and neck disability (-7.3, 95% CI -9.1 to -5.5 versus -9.0, 95% CI = -10.8 to -7.2) after 36 weeks, with no difference between groups (back 2.4, 95% CI -0.3 to 5.1; neck 1.7, 95% CI -0.8 to 4.2).The long-term management group experienced greater improvement in neck pain at week 36, self-efficacy at week 36 and 52, functional ability and balance.On average, the short-term group attended 10 SMT and 4 SRE sessions; the long-term group attended 19 SMT and 9 SRE sessions.Conclusion For older adults with chronic back and neck disability, extending management with SMT + SRE from 12 to 36 weeks did not result in any additional important reduction in disability.Statistically significant differences in favor of long-term management were found for improvement in neck pain and self-efficacy, as well as functional measures of balance and physical performance.These findings may be important for healthy ageing and spine care in the elderly, and warrant further investigation.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.006 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.502 | 0.321 |
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; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
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".