Elsevier

Manual Therapy

Volume 8, Issue 1, February 2003, Pages 46-51
Manual Therapy

Professional Issue
Spinal manipulation for low-back pain: a treatment package agreed by the UK chiropractic, osteopathy and physiotherapy professional associations,☆☆,,★★,☆☆☆

https://doi.org/10.1054/math.2002.0472Get rights and content

Abstract

Trials of manipulative treatment have been compromised by, amongst other things, different definitions of the therapeutic procedures involved. This paper describes a spinal manipulation package agreed by the UK professional bodies that represent chiropractors, osteopaths and physiotherapists. It was devised for use in the UK Back pain Exercise And Manipulation (UK BEAM) trial—a national study of physical treatments in primary care funded by the Medical Research Council and the National Health Service Research and Development Programme. Although systematic reviews have reported some beneficial effects of spinal manipulation for low-back pain, due to the limited methodological quality of primary studies and difficulties in defining manipulation, important questions have remained unanswered. The UK BEAM trial was designed to answer some of those questions. Early in the design of the trial, it was acknowledged that the spinal manipulation treatment regimes provided by practitioners from the three professions shared more similarities than differences. Because the trial design specifically precluded comparison of the effect between the professions, it was necessary to devise a homogenous package representative of, and acceptable to, all three. The resulting package is ‘pragmatic’, in that it represents what happens to most people undergoing manipulation, and ‘explanatory’ in that it excludes discipline-specific variations and other ancillary treatments.

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    Emma Harvey, BSc, PhD, Research Fellow and UK BEAM Trial Manager, Department of Health Sciences, Alcuin College, University of York, York, UK

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    A Kim Burton, PhD, DO, Research Director and UK BEAM National Clinical Coordinator, Spinal Research Unit, University of Huddersfield, Queensgate, Huddersfield, UK.

    Jennifer Klaber Moffett, MSc, PhD, MCSP, Deputy Director and UK BEAM National Clinical Coordinator, Institute of Rehabilitation, University of Hull, Hull, UK.

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    Alan Breen, DC PhD, Research Director and UK BEAM Trial Working Group, Institute for Musculoskeletal Research and Clinical Implementation, Anglo-European College of Chiropractic, Bournemouth, Dorset, UK.

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    The UK BEAM trial team, Medical Research Council (MRC) General Practice Research Framework (GPRF) at the MRC Clinical Trials Unit, Stephenson House, London, UK

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    Correspondence to: EH, Baines Wing, School of Health Care Studies, University of Leeds, Leeds LS2 9JT, UK. E-mail: [email protected]

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