Comparative effectiveness of manual therapy and band exercises combined with high-intensity walking for pain, posture, and cardiorespiratory health in older adults: a randomised clinical trial
Bibliographic record
Abstract
Background Musculoskeletal pain and cardiovascular and pulmonary disorders affect the growing population of older adults. Manual therapy has proven to be effective, however, research using elastic bands is still scarce. The aim of this manuscript is to compare the effects of elastic band program training versus a manual therapy protocol, both combined with high-intensity walking, on age-related health parameters, such as pain, posture, and cardiorespiratory variables. Methods A multicentre randomised clinical trial was conducted on community dwelling older adults with non-specific musculoskeletal pain. Participants were divided into two groups: (1) Manual therapy and high-intensity walking group (MTWG), who received self-assisted manual therapy followed by supervised high-intensity walking and (2) Elastic band and high-intensity walking group (EBWG) who performed resistance exercises with elastic bands and high-intensity walking. Musculoskeletal pressure pain threshold in trapezius muscles, back pain intensity, postural pattern (change in thorax position and chest wall expansion) and cardiorespiratory variables (heart rate and oxygen saturation, SpO 2 ) were measured before the intervention (T0), after the 4-week programme (T1) and after the 4-week follow-up (T2). Results A total of 102 older adults (49 in the MTWG and 53 in EBWG) completed the study and were analysed. Five RM-MANCOVA models were specified. The EBWG showed significantly higher PPT scores than the MTWG across all data points ( p < 0.01); a between-within-subjects effect was found for VAS scores ( p < 0.05) (Model A). Statistically significant within-subject differences were found for the left acromion-to-bed distance scores ( p < 0.05) but not for the right-side scores (Model B). Similarly, significant between-subject differences for the upper chest wall were found ( p < 0.05), but not for the lower chest wall. However, univariate tests revealed significant within-subject for both the upper and lower chest wall scores. Finally, no significant differences were found in pulmonary function scores (Model D), heart rate (HR) or oxygen saturation scores (Model E). Conclusion Both protocols reduce pain. Manual therapy helps with non-specific back pain and improves acromion-to-table posture, while elastic band treatment enhances trapezius pressure threshold and upper thoracic expansion. Neither improved lower thoracic mobility or respiratory variables.
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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 | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".