PTRCTThe South African journal of physiotherapy2020

Comparison between high-velocity low-amplitude manipulation and muscle energy technique on pain and trunk neuromuscular postural control in male workers with chronic low back pain: A randomised crossover trial.

Leandro A Sturion, Alexandre H Nowotny, Fabrice Barillec and 5 others

PMID 33241157

WHAT IT FOUND

HVLA thrust manipulation and muscle energy technique reduced pain in men with chronic low back pain.

Pain fell after the first session and again after 15 days. No clear change was seen in trunk muscle activation or standing balance.

Key findings

01Pain fell significantly after both techniques: 26% with HVLA and 39% with MET immediately after the first session, and 52% and 73% after 15 days.

02No significant differences were observed between groups or across measurement times for trunk muscle activation or centre of pressure balance variables during standing tasks with and without load.

03Disability, fear-avoidance beliefs, and lumbar flexion mobility did not change significantly, although some values improved.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Only 12 male workers aged 35 to 55 years were recruited, and the tables report groups of 10 participants, so the findings are narrow and the participant number is not fully clear. Follow-up was short, only up to 15 days after the first session, so long-term effects are unknown. The study included only men, so it does not show what would happen in women. Lumbar mobility was tested only in forward bending, and no high-tech kinematic system was used. One therapist delivered HVLA and another delivered MET, so therapist differences may have influenced the comparison.

Declared interests

No funding or conflict-of-interest declaration appears in the supplied text.

The easy way to misread this

Do not conclude that HVLA or MET corrects trunk neuromuscular control or postural instability. The study found pain reduction, but it did not find significant changes in trunk muscle activation or standing balance, and it included only 12 male workers.

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The study

Participants
12 male workers aged 35 to 55 years recruited; the tables report groups of 10 participants
Certainty of evidence
Moderate

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Cite

Leandro A Sturion, Alexandre H Nowotny, Fabrice Barillec, et al. Comparison between high-velocity low-amplitude manipulation and muscle energy technique on pain and trunk neuromuscular postural control in male workers with chronic low back pain: A randomised crossover trial. The South African journal of physiotherapy. 2020.

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