Changes in outcome attributable to manipulation followed by exercise.
Values are mean (SE) scores unless stated otherwise
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At three months
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At 12 months
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Outcome measure (description)
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Best care (max n=256/338: 76%)
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Best care plus manipulation plus exercise (max n=258/333: 77%)
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Net benefit from manipulation plus exercise (95% CI)
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Best care (max n=248/338: 73%)
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Best care plus manipulation plus exercise (max n=257/333: 77%)
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Net benefit from manipulation plus exercise (95% CI)
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Roland disability questionnaire (0-24, 0=best)
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6.71 (0.28) (n=256)
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4.84 (0.28) (n=258)
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1.87*** (1.15 to 2.60)
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6.02 (0.30) (n=248)
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4.72 (0.29) (n=257)
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1.30** (0.54 to 2.07)
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Modified Von Korff scale:
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Disability (0-100, 0=best)
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34.56 (1.50) (n=239)
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29.05 (1.49) (n=246)
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5.51** (1.75 to 9.28)
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34.80 (1.60) (n=235)
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28.09 (1.59) (n=246)
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6.71** (2.62 to 10.80)
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Pain (0-100, 0=best)
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48.96 (1.60) (n=239)
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40.76 (1.59) (n=246)
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8.21*** (4.20 to 12.21)
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46.39 (1.66) (n=235)
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39.68 (1.65) (n=245)
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6.71** (2.47 to 10.95)
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Back beliefs questionnaire (9-45, 45=best)
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27.97 (0.42) (n=239)
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31.25 (0.42) (n=245)
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3.28*** (2.23 to 4.33)
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27.61 (0.44) (n=233)
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30.56 (0.43) (n=244)
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2.96*** (1.84 to 4.07)
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Fear avoidance beliefs questionnaire—physical scale (0-24, 0=best)
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13.08 (0.40) (n=236)
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10.68 (0.39) (n=245)
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2.40*** (1.41 to 3.39)
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12.81 (0.45) (n=208)
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11.58 (0.48) (n=204)
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1.24* (0.07 to 2.41)
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SF-36 (mean=50, SD=10, 100=best):
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Physical component score
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43.91 (0.48) (n=227)
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46.46 (0.48) (n=231)
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2.55*** (1.34 to 3.75)
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42.58 (0.62) (n=221)
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45.11 (0.64) (n=221)
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2.53** (0.96 to 4.09)
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Mental component score
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46.59 (0.58) (n=227)
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48.89 (0.59) (n=231)
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2.30** (0.82 to 3.78)
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46.71 (0.73) (n=221)
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48.01 (0.75) (n=221)
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1.30 (–0.55 to 3.14)
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* Significant at 5% level; **significant at 1% level; ***significant at 0.1% level.
Estimated by analysis of covariance adjusting for centre and baseline score. Because correlation coefficients within clusters (centres, exercise classes, manipulators, and practices) are small, this analysis generates estimates very similar to the corresponding, but more complex, multilevel model.