Strain-Counterstrain is a manual therapy intervention involving p

Strain-Counterstrain is a manual therapy intervention involving passive positioning of the body or limbs. It has been proposed as a treatment for musculoskeletal pain and dysfunction (Jones et al 1995). When used to treat acute low back pain, this intervention can be considered as a form of spinal manipulative therapy because the pelvis, sacrum,

and lower limbs are used to position the lumbar and selleck kinase inhibitor sacral regions passively in degrees of flexion, extension, lateral flexion, and rotation. The rationale for Strain-Counterstrain treatment is unclear. A proprioceptive model (Korr, 1975), which has not been experimentally tested, provides the hypothetical basis for the Strain-Counterstrain assessment and treatment using digitally tender points (Jones et al 1995, Kusunose, 1993). To our knowledge, there is no experimental evidence to support the use of Strain-Counterstrain for the treatment of acute low back pain, although reductions in pain and disability following Strain-Counterstrain treatment for low back pain have been

reported in case studies (Lewis and Flynn, 2001). This randomised trial was intended to investigate the effect of Strain-Counterstrain treatment for acute low back pain in a clinical setting. The research questions for this study were: 1. Is a combination of Selleckchem Nutlin-3a Strain-Counterstrain and exercise more

effective than exercise alone in reducing levels of pain, disability, and dysfunction in participants with acute low back pain after 2 weeks? A single-centre, randomised controlled trial was Thalidomide conducted at the physiotherapy outpatient department of a rural public hospital in Australia. Participants were referred by public and private medical practitioners for treatment of acute low back pain or were recruited through posted notices and advertisement in local papers. Randomisation was achieved by having the participant select one of 100 sealed opaque envelopes, each containing a group allocation, which had been prepared and shuffled by an independent investigator. The experimental group received a combination of Strain- Counterstrain and exercise, while the control group received only the exercises. The interventions were provided at four visits occurring over two weeks. Measurements were recorded at baseline, at 2 weeks (immediately after the intervention), at 6 weeks, and at 28 weeks. The 28- week follow-up was expected to capture the majority of participants who would develop persistent low back pain or recurrence of low back pain within 12 months (Philips and Grant, 1991, Von Korff and Saunders, 1996).

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