Spinal Manipulation and Clinician-Supported Self-Management for Preventing Chronic Low Back Pain Impact: The PACBACK Randomized Clinical Trial.

Este estudio ha sido identificado como potencialmente de alto impacto. La métrica de alto impacto de OE, basada en la inteligencia artificial, estima la influencia que puede tener un artículo integrando señales procedentes tanto de la revista en la que se publica como del contenido científico del propio artículo. Desarrollado mediante el procesamiento del lenguaje natural más avanzado, el modelo de Alto Impacto de OE predice con mayor precisión el futuro rendimiento de las citas de un estudio que el factor de impacto de la revista por sí solo. Esto permite reconocer antes las investigaciones clínicamente significativas y ayuda a los lectores a centrarse en los artículos con más probabilidades de configurar la práctica futura.

Resumen del estudio

1000 patients with acute or subacute low back pain (LBP) at moderate to high risk of developing chronic pain were randomized to receive clinician-supported self-management (SSM), spinal manipulation therapy (SMT), combined SSM and SMT, or guideline-based medical care (MC). The primary outcome of interest was LBP impact, measured using the National Institutes of Health (NIH) Task Force chronic LBP impact score, averaged over months 10 to 12. Secondary outcomes included chronic pain development, pain interference with daily activities, healthcare and medication use, work productivity, functional disability, patient satisfaction, and psychological outcomes. Outcomes were assessed up to 12 months. Overall, the results revealed that SSM, alone or combined with SMT, significantly reduced LBP impact compared with MC, although the differences were small. SMT alone did not significantly improve LBP impact, and adding SMT to SSM provided no additional benefit. These findings suggested that clinician-supported biopsychosocial self-management could help prevent chronic disabling LBP in patients at increased risk.