{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:09:45Z","timestamp":1793308185232,"version":"4.5.0"},"reference-count":21,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Sport Exerc Med"],"accepted":{"date-parts":[[2019,8,9]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Spinal manipulation is commonly used to treat back pain. The application of spinal manipulation has traditionally involved an element of targeting the technique to a level of the spine where the proposed movement dysfunction is sited. We evaluated the effects of a targeted manipulative thrust versus a thrust applied generally to the lumbar region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A randomised controlled clinical trial in patients with low back pain following CONSORT (Consolidated Standards of Reporting Trials) guidelines. Sixty subjects were randomly allocated to two groups: one group received a targeted manipulative thrust (n=29) and the other a general manipulation thrust (GT) (n=31) to the lumbar spine. Thrust was either localised to a clinician-defined symptomatic spinal level or an equal force was applied through the whole lumbosacral region. We measured pressure-pain thresholds (PPTs) using algometry and muscle activity (magnitude of stretch reflex) via surface electromyography. Numerical ratings of pain and Oswestry Disability Index scores were collected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Repeated measures of analysis of covariance revealed no between-group differences in self-reported pain or PPT for any of the muscles studied.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>A GT procedure\u2014applied without any specific targeting\u2014was as effective in reducing participants\u2019 pain scores as targeted approaches.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"ISRCTN11994230\">ISRCTN11994230<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsem-2019-000514","type":"journal-article","created":{"date-parts":[[2019,10,5]],"date-time":"2019-10-05T15:05:11Z","timestamp":1570287911000},"page":"e000514","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Comparing targeted thrust manipulation with general thrust manipulation in patients with low back pain. A general approach is as effective as a specific one. A randomised controlled trial"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9453-5326","authenticated-orcid":false,"given":"Christopher J","family":"McCarthy","sequence":"first","affiliation":[{"name":"School of Physiotherapy, Manchester Metropolitan University, Manchester, UK"},{"name":"Manchester Metropolitan University, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Potter","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, School of Medicine, The University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie A","family":"Oldham","sequence":"additional","affiliation":[{"name":"Health Innovation, Manchester Oxford Road Corridor, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,5]]},"reference":[{"key":"2025083112230280000_5.1.e000514.1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34347"},{"key":"2025083112230280000_5.1.e000514.2","doi-asserted-by":"crossref","DOI":"10.5812\/asjsm.6(2)2015.24718","article-title":"Low back pain in athletes","volume":"6","author":"Mortazavi","year":"2015","journal-title":"Asian J Sports Med"},{"key":"2025083112230280000_5.1.e000514.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-010-1502-y"},{"key":"2025083112230280000_5.1.e000514.4","unstructured":"McCarthy C , Bialosky J , Rivett D . Spinal manipulation. Grieve's modern musculoskeletal physiotherapy. 4th edn. 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Part II. neurophysiological response","volume":"26","author":"Colloca","year":"2003","journal-title":"J Manipulative Physiol Ther"},{"key":"2025083112230280000_5.1.e000514.10","doi-asserted-by":"publisher","DOI":"10.1016\/S1529-9430(02)00587-9"},{"key":"2025083112230280000_5.1.e000514.11","unstructured":"Evans S , Day S , Royston P . Minin: allocation by minimisation in clinical trials, 2006. Available: www.sghms.ac.uk\/depts\/phs\/guide\/randser.htm [Accessed 20 Apr 2005]."},{"key":"2025083112230280000_5.1.e000514.12","unstructured":"Freriks B , Merletti R , Hermens HJ , et al . European recommendations for surface electromyography: Seniam8, 2001."},{"key":"2025083112230280000_5.1.e000514.13","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198303000-00004"},{"key":"2025083112230280000_5.1.e000514.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2006.01.005"},{"key":"2025083112230280000_5.1.e000514.15","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(83)90088-X"},{"key":"2025083112230280000_5.1.e000514.16","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/27.1.63"},{"key":"2025083112230280000_5.1.e000514.17","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ijosm.2006.11.002","article-title":"Algometer reliability in measuring pain pressure threshold over normal spinal muscles to allow quantification of anti-nociceptive treatment effects","volume":"9","author":"Potter","year":"2006","journal-title":"International Journal of Osteopathic Medicine"},{"key":"2025083112230280000_5.1.e000514.18","unstructured":"Kumar S , Mital A . Electromyography in Ergonomics. 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