Document Detail

Psychological response in spinal manipulation (PRISM): a systematic review of psychological outcomes in randomised controlled trials.
MedLine Citation:
PMID:  18054729     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The most important risk factors for back and neck pain are psychosocial. Nevertheless, systematic reviews of spinal manipulation have concentrated on pain and spine related disability, and ignored psychological outcomes. OBJECTIVE: To assess whether spinal manipulation was effective in improving psychological outcome. DESIGN: Systematic review of randomised controlled trials (RCTs). METHODS: RCTs were identified by searching Medline, CINAHL, Embase, CENTRAL, AMED, PsycINFO until November 2005. Trials reporting psychological outcomes including the mental health components of generic outcomes were extracted, and combined where appropriate in meta-analyses. RESULTS: One hundred and twenty nine RCTs of spinal manipulation were identified; 12 had adequately reported psychological outcomes. Six trials with a verbal intervention comparator were combined in a meta-analysis, and found a mean benefit from spinal manipulation equivalent to 0.34 of the population standard deviation (S.D.) [95% confidence interval (CI) 0.23-0.45] at 1-5 months; 0.27 of the S.D. [95% CI 0.14-0.40] at 6-12 months. Eight trials with a physical treatment comparator were combined in a meta-analysis and found a mean benefit of 0.13 of the S.D. [95% CI 0.01-0.24] in favour of manipulation at 1-5 months; 0.11 of the S.D. [95% CI -0.02 to 0.25] at 6-12 months. CONCLUSIONS: There was some evidence that spinal manipulation improved psychological outcomes compared with verbal interventions.
Nefyn H Williams; Maggie Hendry; Ruth Lewis; Ian Russell; Alex Westmoreland; Clare Wilkinson
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2007-03-08
Journal Detail:
Title:  Complementary therapies in medicine     Volume:  15     ISSN:  0965-2299     ISO Abbreviation:  Complement Ther Med     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-03-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9308777     Medline TA:  Complement Ther Med     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  271-83     Citation Subset:  IM    
Department of General Practice, Cardiff University, Centre for Health Services Research/North Wales Clinical School, Gwenfro Building, Wrecsam Technology Park, Wrecsam LL13 7YP, United Kingdom.
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MeSH Terms
Anxiety / etiology,  therapy
Confidence Intervals
Depression / etiology,  therapy
Evidence-Based Medicine / statistics & numerical data*
Low Back Pain / complications,  psychology*,  therapy*
Manipulation, Spinal / psychology,  statistics & numerical data*
Odds Ratio
Randomized Controlled Trials as Topic
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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