Benefits and Harms of Spinal Manipulative Therapy for Treating Recent and Persistent Nonspecific Neck Pain: A Systematic Review With Meta-analysis

Waste not, want not: call to action for spinal manipulative therapy researchers

BACKGROUND

Research waste is defined as research outcomes with no or minimal societal benefits. It is a widespread problem in the healthcare field. Four primary sources of research waste have been defined: (1) irrelevant or low priority research questions, (2) poor design or methodology, (3) lack of publication, and (4) biased or inadequate reporting. This commentary, which was developed by a multidisciplinary group of researchers with spinal manipulative therapy (SMT) research expertise, discusses waste in SMT research and provides suggestions to improve future research.

MAIN TEXT

This commentary examines common sources of waste in SMT research, focusing on design and methodological issues, by drawing on prior research and examples from clinical and mechanistic SMT studies. Clinical research is dominated by small studies and studies with a high risk of bias. This problem is compounded by systematic reviews that pool heterogenous data from varying populations, settings, and application of SMT. Research focusing on the mechanisms of SMT often fails to address the clinical relevance of mechanisms, relies on very short follow-up periods, and has inadequate control for contextual factors.

CONCLUSIONS

This call to action is directed to researchers in the field of SMT. It is critical that the SMT research community act to improve the way research is designed, conducted, and disseminated. We present specific key action points and resources, which should enhance the quality and usefulness of future SMT research.

Specific and shared mechanisms associated with treatment for chronic neck pain: study protocol for the SS-MECH trial

BACKGROUND

Treatment mechanisms involve the steps or processes through which an intervention unfolds and produces change in an outcome variable. Treatment mechanisms can be specific to the intervention provided (i.e. pain modulation) or shared with other treatments (i.e. reduced fear of movement). Whether specific and shared treatment mechanisms are different across interventions and whether they lead to the outcomes seen in trials is largely unknown. The management of individuals with chronic neck pain routinely include manual therapy (MT) and resistance exercise (RE), as both approaches are included in clinical practice guidelines and both yield similar outcomes.

OBJECTIVES

Our study plans to answer two research questions: 1) what are the specific mechanisms associated with MT versus interventions (and are these different), and 2) what are the shared mechanisms associated with these interventions, and do specific or shared mechanisms mediate clinical outcomes?

METHODS

This study will involve a 2-group parallel (1:1) single-blinded randomized trial to compare the specific and potential shared treatment mechanisms between these two approaches. We will enroll individuals with a history of chronic neck pain and evaluate whether specific or shared mechanisms mediate clinical outcomes.

RESULTS

We hypothesize that MT and RE approaches will both exhibit different specific treatment mechanisms, and that both approaches will exhibit shared treatment mechanisms, which will notably influence outcomes at both discharge and 6-months.

CONCLUSIONS

This study is important because it will help identify what specific or shared treatment mechanisms are associated with different interventions and, how different treatment mechanisms influence clinical outcomes.

Relationship between Athletes' Big Five Model of Personality and Athletic Performance: Meta-Analysis

Academic interest in athletic performance is ongoing. To examine the correlation between athletic performance and athletes' personality types, data extraction in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was completed in October 2021, and a meta-analysis was performed using 180 data from 18 selected papers using the "meta" package version 4.8-4 of R Studio 3.3.3. As a result, these selected studies proved to have reliable quality in proceeding with this study via quality assessment. The overall effect of personality on athletic performance (AP) was ESr = 0.124, p < 0.01. Furthermore, only conscientiousness (ESr = 0.178, p < 0.001) and extroversion (ESr = 0.145, p < 0.01), among the five personality types, showed statistically significant results, and these two personality types had a positive correlation with performance. In the publication bias test, this study found that (a) agreeableness had a publication bias; but, with an additional test using trim-and-fill, (b) the effect was not significant enough to be considered. In addition, the analysis of the moderating effects was conducted in four aspects, and all moderating effect analyses showed statistically significant differences between the groups, demonstrating the heterogeneity of this study. Therefore, this study found a significant relationship between personality and athletic performance and showed the importance of conscientiousness and extroversion.