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Title: A double blinded, placebo controlled study to determine the influence of the clinical ritual in instrument assisted adjusting during the management of mechanical low back pain
Authors: Dugmore, Belinda Rose 
Issue Date: 2006
Health care practitioners have known for some time that patients benefit from
specific manual intervention effects, but also from the manner in which these are
presented. The latter at times having as much impact on patient health as the
former. Thus the purpose of this study was to determine the effect of the clinical
ritual during instrument assisted adjusting whilst managing mechanical lower back
pain. The study was a randomized prospective study comprising of sixty participants
aged 18-59. These individuals were randomly allocated into two groups of thirty and
then further stratified to control for gender. Both Groups were diagnosed according
to the Activator Methods Chiropractic Technique (AMCT), however the tension was
set at maximum for group A, whilst the device was set to the minimum tension for
group B.
Each patient received three treatments and one follow up visit over a two-week
period. Subjective data was collected at the first, third and follow up visit. Subjective
data was recorded using the Visual Analogue Scale, the Numerical Pain Rating
Scale, the Roland Morris Questionnaire and the Short-form McGill Pain
Outcomes were analysed through with the SPSS statistical package at a 95% level
of confidence. After analysis of the collected data it was found that there was no
statistical difference between the groups, but there was a non-specific trend
suggesting a better outcome in the full tension activator group (Group A).
Thus, the research indicated that patients perceptions, the patient-practitioner
relationship, and the assumption of an outcome of success as well as the power of
placebo or non-specific effects play a large role in the managing of lower back pain
in a chiropractic environment.
Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban Institute of Technology, Durban, South Africa, 2006.
Appears in Collections:Theses and dissertations (Health Sciences)

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