John Ward Ken Tyer Amir Pourmoghaddam


Objective: The purpose of this study was to assess the immediate impact of lumbar spine manipulation on pain, functional reach, static balance, and walking gait kinematics of individuals with acute low back pain (LBP).

Methods: 68 participants (age= 49.0 + 16.2 years, height= 1.65 + 0.10 m, body mass= 78.3 + 20.4 kg: mean + SD) with LBP engaged in a baseline numeric rating scale (NRS) pain score assessment, functional reach test (FRT), static one-legged balance test of both lower limbs, and 1.5 mph walking gait evaluation utilizing VICON motion capture technology. They were randomly and equally assigned to 1 of 2 interventions: 1) bilateral lumbar spine manipulation at L-3 with the intent of impacting most of the lumbar spine (Manip group) or 2) no manipulation (No-Manip group). A post-intervention assessment was conducted on each participant.

Results: There was a significant main effect for NRS pain score for participants in the Manip group, F(1, 66) = 27.71, p < 0.001, r = 0.54 (large effect size), decrease of 1.4 points. There was a significant main effect for step length for participants in the Manip group, F(1, 66) = 4.69, p = 0.037, r= 0.26 (small to medium effect size), increase of 13.5 mm. No other significant study variables were noted.

Conclusions: Following a single spinal manipulation for acute LBP, participants’ pain decreased and they experienced an improvement in step length. Functional reach, single-leg balance, hip functional range of motion (ROM), knee functional ROM, ankle functional ROM, stride length, and percent stance time were unaffected.