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Patient Expectations Between OMT, Subtherapeutic Ultrasound and Light Touch Placebo Controls

Journal: The Journal of the American Osteopathic Association Date: 2006/08, 106(8):Pages: 487. doi: Subito , type of study: crossover study

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2006.106.8.471/html)

Keywords:

attitude [128]
crossover study [8]
high velocity low amplitude [43]
HVLA [40]
patients [90]

Abstract:

Purpose: The purpose of this study was to determine attitudes towards 3 treatments (HVLA, placebo light touch, placebo subtherapeutic ultrasound) commonly used in OMT clinical research trials. Methods: A randomized, cross-over design was utilized. Subjects were recruited from the Family Medicine Clinic, TCOM. Participants watched a video of 2 minute demonstrations of a High Velocity Low Amplitude (HVLA), placebo light touch (LT), and placebo subtherapeutic ultrasound (ULTRA) treatment for low back pain. Randomization of treatments controlled for order effect bias. Subjects indicated if they Strongly Agree, Agree, Disagree, or Strongly Disagree with 4 statements after each treatment: 1) I believe this treatment would allow me to get better quicker; 2) I believe this treatment would decrease my low back pain; 3) I believe this treatment would make me more able to do the things I want to do; 4) This seems like a logical way to treat low back pain. Repeated measures analysis of variance was performed, and a Partial Eta squared is presented for each question. Cohen's d was calculated for 2 groups at a time. The UNTHSC IRB approved this study. Results: Thirty of 40 eligible subjects participated. Twenty-two (73.3%) were female, 16 (53.3%) were Caucasian, and 11 (36.6%) had completed college. The mean age was 43 (SD=15.11). Repeated measures ANOVA revealed no significant differences for statements 2 and 4. For statements 1 (P=0.025) and 3 (P=0.039), post hoc analysis revealed a difference between HVLA and LT. Partial Eta squared was 0.105, 0.072, 0.107, and 0.024 for each statement, respectively. For statement 1, Cohen's d=–0.29 for HVLA and ULTRA, –0.49 for HVLA and LT, and –0.21 for ULTRA and LT. For statement 2, Cohen's d=–0.11 for HVLA and ULTRA, –0.38 for HVLA and LT, and –0.31 for ULTRA and LT. For statement 3, Cohen's d=–0.41 for HVLA and ULTRA, –0.47 for HVLA and LT, and –0.09 for ULTRA and LT. For statement 4, Cohen's d=–0.21 for HVLA and ULTRA, –0.19 for HVLA and LT, and 0 for ULTRA and LT. Conclusions: There is a difference in treatment expectation between HVLA and LT for statements 1 and 3. Participants responded more positively after viewing the HVLA treatment than LT treatment suggesting subtherapeutic ultrasound is the better placebo when examining treatment expectation.


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