Naprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in Sweden

Abstract Background Musculoskeletal pain is among the most common reasons for seeking care, specialist competence for its treatment in primary care limited and waiting lists for orthopaedics often amongst the longest. Many referrals to orthopaedics do not concern disorders that benefit from surgery....

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Autores principales:	Stina Lilje, Andreas Eklund, Anders Wykman, Tobias Sundberg, Eva Skillgate
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Orthopaedic waiting lists Non-surgical musculoskeletal disorders Long-term follow-up Manual therapy Complementary medicine Integrative medicine Chiropractic RZ201-275 Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/ab46ec9284234899807e1f245af22d4b
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spelling	oai:doaj.org-article:ab46ec9284234899807e1f245af22d4b2021-11-08T11:16:56ZNaprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in Sweden10.1186/s12998-021-00400-62045-709Xhttps://doaj.org/article/ab46ec9284234899807e1f245af22d4b2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12998-021-00400-6https://doaj.org/toc/2045-709XAbstract Background Musculoskeletal pain is among the most common reasons for seeking care, specialist competence for its treatment in primary care limited and waiting lists for orthopaedics often amongst the longest. Many referrals to orthopaedics do not concern disorders that benefit from surgery. Manual therapy is effective, yet not integrated in national health care systems, and there is a lack of research on other than neck and low back pain, and a lack of long-term follow-ups. The present study evaluates the long-term effects of a manual therapy (naprapathy) for common orthopaedic disorders. Methods An 8-year follow-up (96 months) of a pragmatic randomized controlled trial of naprapathy (experimental group) versus standard orthopaedic care (control group) for non-surgical patients of working age with the most common musculoskeletal disorders on the waiting lists (n = 78). Bodily pain, physical function (SF36), Quality of life (QoL; SF6D), and data on health care utilization were collected. The treatments lasted from January 2007 to November 2007. Results N = 75 participants in the original study sample completed the 8-year follow-up. The differences in bodily pain (21.7 (95% CI: 9.1–34.3)), physical function (17.6 (6.7–28.4)), and QoLs (0.823 (95% CI: 0.785–0.862) compared with 0.713 (95% CI: 0.668–0.758)) were statistically significantly in favor of the experimental group (p-values < 0.01). After sensitivity analysis the experimental group had altogether 260 health care visits compared with 1161 in the control group. Conclusions Naprapathy is a continuously effective treatment. Together with earlier research our study suggests that specialized manual therapy should be considered when triaging patients with common non-surgical musculoskeletal disorders in national health care systems. Trial registration: Not applicable, as per information given by ClinicalTrials.gov.Stina LiljeAndreas EklundAnders WykmanTobias SundbergEva SkillgateBMCarticleOrthopaedic waiting listsNon-surgical musculoskeletal disordersLong-term follow-upManual therapyComplementary medicineIntegrative medicineChiropracticRZ201-275Diseases of the musculoskeletal systemRC925-935ENChiropractic & Manual Therapies, Vol 29, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopaedic waiting lists Non-surgical musculoskeletal disorders Long-term follow-up Manual therapy Complementary medicine Integrative medicine Chiropractic RZ201-275 Diseases of the musculoskeletal system RC925-935
spellingShingle	Orthopaedic waiting lists Non-surgical musculoskeletal disorders Long-term follow-up Manual therapy Complementary medicine Integrative medicine Chiropractic RZ201-275 Diseases of the musculoskeletal system RC925-935 Stina Lilje Andreas Eklund Anders Wykman Tobias Sundberg Eva Skillgate Naprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in Sweden
description	Abstract Background Musculoskeletal pain is among the most common reasons for seeking care, specialist competence for its treatment in primary care limited and waiting lists for orthopaedics often amongst the longest. Many referrals to orthopaedics do not concern disorders that benefit from surgery. Manual therapy is effective, yet not integrated in national health care systems, and there is a lack of research on other than neck and low back pain, and a lack of long-term follow-ups. The present study evaluates the long-term effects of a manual therapy (naprapathy) for common orthopaedic disorders. Methods An 8-year follow-up (96 months) of a pragmatic randomized controlled trial of naprapathy (experimental group) versus standard orthopaedic care (control group) for non-surgical patients of working age with the most common musculoskeletal disorders on the waiting lists (n = 78). Bodily pain, physical function (SF36), Quality of life (QoL; SF6D), and data on health care utilization were collected. The treatments lasted from January 2007 to November 2007. Results N = 75 participants in the original study sample completed the 8-year follow-up. The differences in bodily pain (21.7 (95% CI: 9.1–34.3)), physical function (17.6 (6.7–28.4)), and QoLs (0.823 (95% CI: 0.785–0.862) compared with 0.713 (95% CI: 0.668–0.758)) were statistically significantly in favor of the experimental group (p-values < 0.01). After sensitivity analysis the experimental group had altogether 260 health care visits compared with 1161 in the control group. Conclusions Naprapathy is a continuously effective treatment. Together with earlier research our study suggests that specialized manual therapy should be considered when triaging patients with common non-surgical musculoskeletal disorders in national health care systems. Trial registration: Not applicable, as per information given by ClinicalTrials.gov.
format	article
author	Stina Lilje Andreas Eklund Anders Wykman Tobias Sundberg Eva Skillgate
author_facet	Stina Lilje Andreas Eklund Anders Wykman Tobias Sundberg Eva Skillgate
author_sort	Stina Lilje
title	Naprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in Sweden
title_short	Naprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in Sweden
title_full	Naprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in Sweden
title_fullStr	Naprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in Sweden
title_full_unstemmed	Naprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in Sweden
title_sort	naprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in sweden
publisher	BMC
publishDate	2021
url	https://doaj.org/article/ab46ec9284234899807e1f245af22d4b
work_keys_str_mv	AT stinalilje naprapathyversusorthopaedicstandardcareforcommonmusculoskeletaldisordersan8yearfollowupofapragmaticrandomizedcontrolledtrialinsweden AT andreaseklund naprapathyversusorthopaedicstandardcareforcommonmusculoskeletaldisordersan8yearfollowupofapragmaticrandomizedcontrolledtrialinsweden AT anderswykman naprapathyversusorthopaedicstandardcareforcommonmusculoskeletaldisordersan8yearfollowupofapragmaticrandomizedcontrolledtrialinsweden AT tobiassundberg naprapathyversusorthopaedicstandardcareforcommonmusculoskeletaldisordersan8yearfollowupofapragmaticrandomizedcontrolledtrialinsweden AT evaskillgate naprapathyversusorthopaedicstandardcareforcommonmusculoskeletaldisordersan8yearfollowupofapragmaticrandomizedcontrolledtrialinsweden
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Naprapathy versus orthopaedic standard care for common musculoskeletal disorders: an 8-year follow-up of a pragmatic randomized controlled trial in Sweden

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