Brunarski D J
J Manipulative Physiol Ther. 1984 Dec;7(4):243-9.
The literature has produced sufficient evidence to suggest that spinal manipulation may be more effective than standard medical care in the management of painful musculoskeletal conditions; most notably that of low back pain. However, much of the research has been severely criticized because of poor methodological design characteristics, the incorporation of systematic bias and the increased likelihood of making serious beta errors. This review identifies the essential components which distinguish 'good' clinical research and critically appraises the nearly four dozen clinical trials of spinal manipulation which have been published to date. It was observed that only the randomized control clinical trials demonstrated sufficient rigor to adequately control the data collection and analysis but agreement about the clinically relevant outcomes of manipulative therapy still have not been consistently demonstrated.
文献已提供了充分的证据表明，在治疗疼痛性肌肉骨骼疾病，尤其是下背痛方面，脊柱推拿可能比标准医疗护理更有效。然而，由于方法设计特征不佳、存在系统偏差以及出现严重Ⅱ类错误的可能性增加，许多研究受到了严厉批评。本综述确定了区分“良好”临床研究的基本要素，并对迄今为止已发表的近40项脊柱推拿临床试验进行了批判性评估。据观察，只有随机对照临床试验表现出足够的严谨性来充分控制数据收集和分析，但关于推拿治疗的临床相关结果仍未得到一致证明。
