Effectiveness of manual therapy for patients with low back pain from the perspective of physical and psychosocial factors.
Hotaka Nakagawa, Yu Okubo, Hiroshi Hattori and 4 others
PMID 39493684WHAT IT FOUND
All 18 patients who completed this manual therapy study improved in pain and disability scores over eight weeks.
However, without a control group, natural recovery or concurrent medication may explain these gains rather than the treatment itself.
Key findings
01Participants showed significant improvement across all measured outcomes, including pain, disability, and physical function, from baseline to the final assessment.
02The study had no control group, and patients could receive medication, so observed improvements cannot be definitively attributed to the manual therapy alone.
03Only 18 of 39 eligible participants completed the study, resulting in a 46% completion rate and a very small sample size.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had no control group, so improvements cannot be separated from natural recovery or regression to the mean. The sample size was very small (18 completers), and the High risk group contained only two participants, requiring them to be combined with the Medium risk group. The completion rate was low (46%), raising concerns about selection bias. Participants were not blinded to the treatment, and concurrent medication was permitted, which may have influenced outcomes. The study population had heterogeneous causes of low back pain, making it difficult to determine if the treatment works for specific subgroups.
Declared interests
The authors declared no conflicts of interest, and the research received no external funding.
The easy way to misread this
Do not conclude that this specific manual therapy caused the observed improvements. Because there was no control group and patients could take medication, the results may reflect natural recovery, placebo effects, or the impact of other treatments rather than the efficacy of the AKA-Hakata method.