United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care

UK BEAM Trial Team, Anthony Burton

Research output: Contribution to journalArticle

Abstract

Objective To estimate the effect of adding exercise classes, spinal manipulation delivered in NHS or private premises, or manipulation followed by exercise to “best care” in general practice for patients consulting with back pain.

Design Pragmatic randomised trial with factorial design.

Setting 181 general practices in Medical Research Council General Practice Research Framework; 63 community settings around 14 centres across the United Kingdom.

Participants 1334 patients consulting their general practices about low back pain.

Main outcome measures Scores on the Roland Morris disability questionnaire at three and 12 months, adjusted for centre and baseline scores.

Results All groups improved over time. Exercise improved mean disability questionnaire scores at three months by 1.4 (95% confidence interval 0.6 to 2.1) more than “best care.” For manipulation the additional improvement was 1.6 (0.8 to 2.3) at three months and 1.0 (0.2 to 1.8) at 12 months. For manipulation followed by exercise the additional improvement was 1.9 (1.2 to 2.6) at three months and 1.3 (0.5 to 2.1) at 12 months. No significant differences in outcome occurred between manipulation in NHS premises and in private premises. No serious adverse events occurred.

Conclusions Relative to “best care” in general practice, manipulation followed by exercise achieved a moderate benefit at three months and a small benefit at 12 months; spinal manipulation achieved a small to moderate benefit at three months and a small benefit at 12 months; and exercise achieved a small benefit at three months but not 12 months.
LanguageEnglish
Pages1377-1381
Number of pages5
JournalThe BMJ
Volume329
Early online date19 Nov 2004
DOIs
Publication statusPublished - 9 Dec 2004

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Back Pain
Primary Health Care
General Practice
Exercise
Spinal Manipulation
Pragmatic Clinical Trials
Low Back Pain
United Kingdom
Biomedical Research
Outcome Assessment (Health Care)
Confidence Intervals
Research

Cite this

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title = "United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care",
abstract = "Objective To estimate the effect of adding exercise classes, spinal manipulation delivered in NHS or private premises, or manipulation followed by exercise to “best care” in general practice for patients consulting with back pain.Design Pragmatic randomised trial with factorial design.Setting 181 general practices in Medical Research Council General Practice Research Framework; 63 community settings around 14 centres across the United Kingdom.Participants 1334 patients consulting their general practices about low back pain.Main outcome measures Scores on the Roland Morris disability questionnaire at three and 12 months, adjusted for centre and baseline scores.Results All groups improved over time. Exercise improved mean disability questionnaire scores at three months by 1.4 (95{\%} confidence interval 0.6 to 2.1) more than “best care.” For manipulation the additional improvement was 1.6 (0.8 to 2.3) at three months and 1.0 (0.2 to 1.8) at 12 months. For manipulation followed by exercise the additional improvement was 1.9 (1.2 to 2.6) at three months and 1.3 (0.5 to 2.1) at 12 months. No significant differences in outcome occurred between manipulation in NHS premises and in private premises. No serious adverse events occurred.Conclusions Relative to “best care” in general practice, manipulation followed by exercise achieved a moderate benefit at three months and a small benefit at 12 months; spinal manipulation achieved a small to moderate benefit at three months and a small benefit at 12 months; and exercise achieved a small benefit at three months but not 12 months.",
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United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial : effectiveness of physical treatments for back pain in primary care. / UK BEAM Trial Team, ; Burton, Anthony.

In: The BMJ, Vol. 329, 09.12.2004, p. 1377-1381.

Research output: Contribution to journalArticle

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