Assessing the Pelvic Alignment

[neuromuscular]

CLINICAL PREDICTION RULE FOR MANIPULATION IN BACK PAIN

■ Duration of symptom < 16 Days
■ Fear-Avoidance Beliefs Questionnaire (FABQ) work subscale score < 19
■ At least one hip with > 35 degrees of internal rotation ROM
■ Hypomobility in the lumbar region
■ No Symptoms distal to the knee

The presence of more variables of five in the prediction rule increases the likelihood of success with manipulation.

Reference: Flynn, T., Fritz, J., Whitman, J., Wainner, R., Magel, J., Rendeiro, D., Butler, B., Garber, M., Allison, S. A Clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with spinal manipulation. Spine; 27 (24), 2835-2843.

Dear Sagarnaik;

The manipulative approach has been used for many years by several disciplines including - osteopathic, chiropractic besides physiotherapy- with disappointing success rates and lack of proof that the manipulation worked. As stated there are several trials of the standard approaches that are giving success rates in the 27.5% to 34% success rates. That is too low for my liking.


If there is not change as I have often seen when comparing therapy procedures at seminars, then it is questionable that the therapy worked.

Therefore, I would request that you take the pelvic angle readings before therapy and after therapy. If there is no difference in the pretherapy and postterapy readings then it is questionable that thetherapy had the desired effect.

Manipulative therapy can have the effect of turning off the nociceptors and mechanoreceptors. Therefore, allowing the body to recalibrate to an abnormal position as if it were the normal antomical neutral position. The patient has no or limited pain, but is not at the ideal antomical neutral position and will return for treatment with a reoccurring problem Proprioceptive sense has a powerful ability to compensate in the body for position as we are just starting to fully realize.

Try the test and compare your results.

Best regards,

Neuromuscular