Immediate effects from manual therapy: much ado about nothing?
PainSci summary of Cook 2011?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★☆?4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
This short but technical article makes a simple, important point: we’ve seen a lot of less-than-awesome research showing that essentially any treatment can probably provide statistically significant immediate benefits (because pain is readily modulated by novel sensory input), but “the limited effect size for many … raises concerns about their clinical significance” and “may not provide substantial value during long-term, progressive, clinical decision making.”
What we need to further flesh out is which set of interventions that lead to immediate effects that are designed to define a clinical outcome, actually lead to long-term clinical benefits. What we don’t need is a litany of further studies that assume clinical importance because immediate effects occurred directly after the administration of a manual therapy intervention; we've got that covered.
related content
- “Closing the window of opportunity …,” Adam Meakins, Thesports.physio.
These two articles on PainScience.com cite Cook 2011 as a source:
- Frozen Shoulder Guide — An extremely detailed & readable guide to one of the strangest of all common musculoskeletal problems, for both patients and pros
- “Windows of Opportunity” in Rehab — The importance of WOO in recovery from injury and chronic pain (using frozen shoulder as an major example)
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.