Manipulasjon og rettleia trening for pasientar med langvarige korsryggsmerter

Background data: Spinal manipulation and supervised exercise therapy have shown effect on long-lasting low back pain, but few studies combine these interventions. Due too new science about central stimulated pain in long-lasting low back pain patients it is also in interesting to see if a cognitive behavioural therapy is effective. Object: Does spinal manipulation and supervised exercise in combination with cognitive behavioural therapy have an effect on long-lasting low back pain? Materials and method: In this study, single subject study design (SSED) was used, and two participants were included. The intervention was spinal manipulation followed by supervised exercise with cognitive behavioural strategy. Eight treatments were given over a period of four weeks. The outcome measurement was Numeric Pain Rating Scale (NPRS) for pain, Roland Morris Questionnaire (RMQ) and Back Performance Scale (BPS) for function, and COOP/WONCA for health related quality of life. The test was preformed at baseline, after the intervention period and at three months follow-up. Result: After treatment both patients had reduced pain and improvement in function, and the improvement was of clinical importance in NPRS and RMQ. Only the woman had a result that was clinical important in BPS. Small differences were found in COOP/WONCA for both patients, but the woman had the greatest change in quality of life. Conclusion: The study shows a trend that spinal manipulation and supervised exercise with cognitive behavioural strategy can have an effect on long-lasting low back pain. Randomised controlled trails (RCT) are necessary to confirm the positive trend of this treatment in the future