Naprapathic Manual Therapy or Conventional Orthopedic Care for Outpatients on Orthopedic Waiting Lists? A pragmatic randomized controlled trial.

Document type: Journal Articles
Article type: Original article
Peer reviewed: Yes
Full text:
Author(s): Stina Lilje, Håkan Friberg, Anders Wykman, Eva Skillgate
Title: Naprapathic Manual Therapy or Conventional Orthopedic Care for Outpatients on Orthopedic Waiting Lists? A pragmatic randomized controlled trial.
Translated title: Naprapatisk manuell terapi eller konventionellt ortopediskt omhändertagande för patienter i ortopedkö? En pragmatisk randomiserad kontrollerad studie.
Journal: Clinical Journal of Pain
Year: 2010
Volume: 26
Issue: 7
Pagination: 602-610
ISSN: 0749-8047
Publisher: Lippincott Williams & Wilkins
URI/DOI: 10.1097/AJP.0b013e3181d71ebd
Organization: Blekinge Institute of Technology
Department: School of Health Science (Sektionen för hälsa)
School of Health Science S-371 79 Karlskrona
+46 455 38 50 00
http://www.bth.se/hal/
Authors e-mail: titti.lilje@bth.se
Language: English
Abstract: Objectives: Traditionally, orthopedic outpatient waiting lists are long, and many referrals are for conditions that do not respond to interventions available at an orthopedic outpatient department. The overall objective of this trial was to investigate whether it is possible to reduce orthopedic waiting lists through integrative medicine. Specific aims were to compare the effects of naprapathic manual therapy to conventional orthopedic care for outpatients with nonurgent musculoskeletal disorders unlikely to benefit from
surgery regarding pain, physical function, and perceived recovery.
Methods: Seventy-eight patients referred to an orthopedic outpatient department in Sweden were included in this pragmatic randomized controlled trial. The 2 interventions compared were naprapathic manual therapy (index group) and conventional orthopedic care (control group). Pain, physical function, and perceived recovery were measured by questionnaires at baseline and after 12, 24, and 52 weeks. The number of patients being discharged from the waiting lists and the level of agreement concerning management decisions between the naprapath and the orthopedists were also estimated.
Results: After 52 weeks, statistically significant differences betweenthe groups were found regarding impairment in pain, increasedphysical function, and regarding perceived recovery, favoring theindex group. Sixty-two percent of the patients in the index group agreed to be discharged from the waiting list. The level of agreement concerning the management decisions was 80%.
Discussion: The trial suggests that naprapathic manual therapy may be an alternative to consider for orthopedic outpatients with disorders unlikely to benefit from surgery.
Subject: Medical Sciences
Public Health\General
Keywords: orthopedic outpatient waiting lists, musculoskeletal manipulations, referral and consultation, integrative medicine.
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