{"doi":"10.1001/jamainternmed.2021.0005","title":"Effect of Osteopathic Manipulative Treatment vs Sham Treatment on Activity Limitations in Patients With Nonspecific Subacute and Chronic Low Back Pain","abstract":null,"journal":"JAMA Internal Medicine","year":2021,"id":671597,"datarank":1.5359650707470438,"base_score":4.394449154672439,"endowment":4.394449154672439,"self_citation_contribution":0.6591673732008659,"citation_network_contribution":0.8767976975461778,"self_endowment_contribution":0.6591673732008659,"citer_contribution":0.8767976975461778,"corpus_percentile":null,"corpus_rank":null,"citation_count":80,"citer_count":53,"citers_with_citation_signal":34,"citers_with_endowment":34,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":497,"name":"Isabelle Boutron","orcid":"0000-0002-5263-6241","position":1,"is_corresponding":false},{"id":1754582,"name":"Rafael Zegarra-Parodi","orcid":null,"position":2,"is_corresponding":false},{"id":1275868,"name":"Gabriel Baron","orcid":"0000-0003-4893-2926","position":3,"is_corresponding":false},{"id":1754583,"name":"Sophie Alami","orcid":null,"position":4,"is_corresponding":false},{"id":451654,"name":"Katherine Sanchez","orcid":"0000-0002-2249-3024","position":5,"is_corresponding":false},{"id":1754584,"name":"Camille Daste","orcid":null,"position":6,"is_corresponding":false},{"id":1754585,"name":"Margaux Boisson","orcid":null,"position":7,"is_corresponding":false},{"id":1020544,"name":"Laurent Fabre","orcid":null,"position":8,"is_corresponding":false},{"id":1754586,"name":"Peggy Krief","orcid":null,"position":9,"is_corresponding":false},{"id":1754587,"name":"Guillaume Krief","orcid":null,"position":10,"is_corresponding":false},{"id":1754588,"name":"Marie-Martine Lefèvre-Colau","orcid":null,"position":11,"is_corresponding":false},{"id":1102565,"name":"François Rannou","orcid":"0000-0001-8780-4797","position":12,"is_corresponding":false},{"id":1102563,"name":"Christelle Nguyen","orcid":"0000-0001-7141-3230","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Effect of Osteopathic Manipulative Treatment vs Sham Treatment on Activity Limitations in Patients With Nonspecific Subacute and Chronic Low Back Pain","abstract":"<h4>Importance</h4>Osteopathic manipulative treatment (OMT) is frequently offered to people with nonspecific low back pain (LBP) but never compared with sham OMT for reducing LBP-specific activity limitations.<h4>Objective</h4>To compare the efficacy of standard OMT vs sham OMT for reducing LBP-specific activity limitations at 3 months in persons with nonspecific subacute or chronic LBP.<h4>Design, setting, and participants</h4>This prospective, parallel-group, single-blind, single-center, sham-controlled randomized clinical trial recruited participants with nonspecific subacute or chronic LBP from a tertiary care center in France starting February 17, 2014, with follow-up completed on October 23, 2017. Participants were randomly allocated to interventions in a 1:1 ratio. Data were analyzed from March 22, 2018, to December 5, 2018.<h4>Interventions</h4>Six sessions (1 every 2 weeks) of standard OMT or sham OMT delivered by nonphysician, nonphysiotherapist osteopathic practitioners.<h4>Main outcomes and measures</h4>The primary end point was mean reduction in LBP-specific activity limitations at 3 months as measured by the self-administered Quebec Back Pain Disability Index (score range, 0-100). Secondary outcomes were mean reduction in LBP-specific activity limitations; mean changes in pain and health-related quality of life; number and duration of sick leaves, as well as number of LBP episodes at 12 months; and consumption of analgesics and nonsteroidal anti-inflammatory drugs at 3 and 12 months. Adverse events were self-reported at 3, 6, and 12 months.<h4>Results</h4>Overall, 200 participants were randomly allocated to standard OMT and 200 to sham OMT, with 197 analyzed in each group; the median (range) age at inclusion was 49.8 (40.7-55.8) years, 235 of 394 (59.6%) participants were women, and 359 of 393 (91.3%) were currently working. The mean (SD) duration of the current LBP episode was 7.5 (14.2) months. Overall, 164 (83.2%) patients in the standard OMT group and 159 (80.7%) patients in the sham OMT group had the primary outcome data available at 3 months. The mean (SD) Quebec Back Pain Disability Index scores for the standard OMT group were 31.5 (14.1) at baseline and 25.3 (15.3) at 3 months, and in the sham OMT group were 27.2 (14.8) at baseline and 26.1 (15.1) at 3 months. The mean reduction in LBP-specific activity limitations at 3 months was -4.7 (95% CI, -6.6 to -2.8) and -1.3 (95% CI, -3.3 to 0.6) for the standard OMT and sham OMT groups, respectively (mean difference, -3.4; 95% CI, -6.0 to -0.7; P = .01). At 12 months, the mean difference in mean reduction in LBP-specific activity limitations was -4.3 (95% CI, -7.6 to -1.0; P = .01), and at 3 and 12 months, the mean difference in mean reduction in pain was -1.0 (95% CI, -5.5 to 3.5; P = .66) and -2.0 (95% CI, -7.2 to 3.3; P = .47), respectively. There were no statistically significant differences in other secondary outcomes. Four and 8 serious adverse events were self-reported in the standard OMT and sham OMT groups, respectively, though none was considered related to OMT.<h4>Conclusions and relevance</h4>In this randomized clinical trial of patients with nonspecific subacute or chronic LBP, standard OMT had a small effect on LBP-specific activity limitations vs sham OMT. However, the clinical relevance of this effect is questionable.<h4>Trial registration</h4>ClinicalTrials.gov Identifier: NCT02034864.","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"33720272","pmcid":"PMC7961471","openalex_id":null,"authors":[],"funders":[],"total_grants":0,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"bronze","license":null,"oa_locations":[{"url":"https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/2777527/jamainternal_nguyen_2021_oi_210001_1641923438.06975.pdf","host_type":"publisher"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/7961471","host_type":"repository"}],"fields_of_study":[],"mesh_terms":["Humans","Low Back Pain","Placebos","Treatment Outcome","Manipulation, Osteopathic","Prospective Studies","Single-Blind Method","Adult","Middle Aged","Quebec","Female","Male","Chronic Pain"],"keywords":[],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"nct"},{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-16T03:29:13.338482Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}