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United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial : effectiveness of physical treatments for back pain in primary care

Team, UK Beam Trial, Russell, I., Underwood, M., Brealey, S., Burton, K., Coulton, S., Farrin, A., Garratt, A., Harvey, E., Letley, L., Manca, A., Martin, J., Klaber Moffett, J., Morton, V., Torgerson, D., Vickers, M., Whyte, K. and Williams, M. (2004) United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial : effectiveness of physical treatments for back pain in primary care. BMJ. pp. 1377-1384. ISSN 0959-8138

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Abstract

Objective: To estimate the effect of adding exercise classes, spinal manipulation delivered in NHS or private premises, or manipulation followed by exercise to "best care" in general practice for patients consulting with back pain. Design: Pragmatic randomised trial with factorial design. Setting: 181 general practices in Medical Research Council General Practice Research Framework; 63 community settings around 14 centres across the United Kingdom. Participants: 1334 patients consulting their general practices about low back pain. Main outcome measures: Scores on the Roland Morris disability questionnaire at three and 12 months, adjusted for centre and baseline scores. Results: All groups improved over time. Exercise improved mean disability questionnaire scores at three months by 1.4 (95% confidence interval 0.6 to 2.1) more than "best care." For manipulation the additional improvement was 1.6 (0.8 to 2.3) at three months and 1.0 (0.2 to 1.8) at 12 months. For manipulation followed by exercise the additional improvement was 1.9 (1.2 to 2.6) at three months and 1.3 (0.5 to 2.1) at 12 months. No significant differences in outcome occurred between manipulation in NHS premises and in private premises. No serious adverse events occurred. Conclusions: Relative to "best care" in general practice, manipulation followed by exercise achieved a moderate benefit at three months and a small benefit at 12 months; spinal manipulation achieved a small to moderate benefit at three months and a small benefit at 12 months; and exercise achieved a small benefit at three months but not 12 months.

Item Type: Article
Copyright, Publisher and Additional Information: Full author and affiliation details at http://www.bmj.com/cgi/content/full/bmj.38282.669225.AE/DC1
Institution: The University of York
Academic Units: The University of York > Health Sciences (York)
The University of York > Centre for Health Economics (York)
Depositing User: York RAE Import
Date Deposited: 17 Aug 2009 15:53
Last Modified: 16 Oct 2014 22:13
Published Version: http://dx.doi.org/10.1136/bmj.38282.669225.AE
Status: Published
Refereed: Yes
Related URLs:
URI: http://eprints.whiterose.ac.uk/id/eprint/5743

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