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One Spinal Manipulation Session Does Not Affect Static, Quasi-Static and Dynamic Balance or Pressure Pain Threshold in Individuals With Chronic Low Back Pain: A Randomized Clinical Controlled Trial

Musculoskeletal Care. 2026 Mar;24(1):e70202. doi: 10.1002/msc.70202.

ABSTRACT

BACKGROUND: Chronic low back pain is a highly prevalent and disabling condition that impairs physical function and has a broad social impact. This study aimed to assess the effects of manipulative techniques on static, quasi-static, and dynamic balance in individuals with chronic low back pain, and to compare these outcomes between an experimental group and a placebo group. The study is justified by the high prevalence of low back pain, the economic burden associated with treatment and work absence, and the need to clarify the effectiveness of therapeutic approaches.

METHODS: A randomized, controlled, longitudinal, pre/post-intervention clinical trial was conducted with 30 participants (18-59 years), of both sexes, all experiencing chronic low back pain. Individuals with other musculoskeletal, neurological, cognitive, cardiorespiratory, or balance-affecting conditions were excluded. Participants were randomly allocated to an experimental group, which received global spinal manipulation in the thoracolumbar and lumbopelvic regions, or a placebo group. Assessments included the modified Sensory Organization Test (SOT), the Star Excursion Balance Test (SEBT), and pain pressure threshold algometry, applied before and after the intervention.

RESULTS: Results indicated that a single session of spinal manipulation did not produce significant changes in static, quasi-static, or dynamic balance variables. Additionally, comparisons between pre- and post-intervention (immediate, 24 h, and 1 week follow-up) revealed no statistically significant differences were found.

CONCLUSION: These findings suggest that a single session of spinal manipulation may not be sufficient to induce measurable changes in balance parameters in this population.

PMID:41807085 | DOI:10.1002/msc.70202

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