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This study aimed to determine expectations of 3 treatments (HVLA, placebo light touch, …


Biology Articles » Health and Medicine » Medicine and Diagnosis » Patient expectations for placebo treatments commonly used in osteopathic manipulative treatment (OMT) clinical trials: a pilot study » Results

Results
- Patient expectations for placebo treatments commonly used in osteopathic manipulative treatment (OMT) clinical trials: a pilot study

Thirty of 40 eligible subjects participated for a 75% response rate. Demographic characteristics of the sample are presented in Table 2. Of the participants, 22 (73%) were female, 16 (53%) were Caucasian, and 11 (37%) had completed college. The mean age was 43 years (SD = 15, min = 20, max = 68). Ten (33.3%) subjects had previously experienced osteopathic manipulative treatment, 14 (46.7%) chiropractic treatment, 11 (36.7%) massage therapy, and 20 (66.7%) ultrasound. Mean responses for each question are presented in Table 3. The sphericity assumption for repeated measures ANOVA was met for all questions.

Statement 1: "I believe this treatment would allow me to get better quicker"

Repeated measures analyses of variance (ANOVA) revealed an overall statistically significant difference in responses between groups for Statement 1, (F(2,58) = 3.388, p = 0.041) (Table 4). Post hoc analysis identified significant differences in responses between HVLA and LT (p = 0.025) with a mean difference of -0.367 out of a maximum of 4. Participants responded more positively to the statement "I believe this treatment would allow me to get better quicker" for the HVLA treatment. There were no statistically significant differences between responses for HVLA and ULTRA (p = 0.136) or between ULTRA and LT (p = 0.231). The partial eta squared (η2p) = 0.105.

Cohen's d (d) = -0.29 for HVLA and ULTRA; -0.21 for ULTRA and LT; and -0.49 for HVLA and LT (Table 5). Each of these represents a medium effect size between responses for the treatment groups. The Cohen's d represents a borderline medium effect size for HVLA and ULTRA and for ULTRA and LT; however, the there is a borderline medium/large effect size for HVLA and LT.

Statement 2: "I believe this treatment would decrease my low back pain"

Repeated measures ANOVA revealed no statistically significant difference between responses to Statement 2, "I believe this treatment would decrease my low back pain", (F(2,58) = 2.257, p = 0.114) (Table 4). The partial eta squared (η2p) = 0.072.

Cohen's d (d) = -0.11 for HVLA and ULTRA; -0.31 for ULTRA and LT; and -0.38 for HVLA and LT (Table 5). A small effect is observed for HVLA and ULTRA. A medium effect is observed for both ULTRA and LT; and HVLA and LT, suggesting similar responses for each group.

Statement 3: "I believe this treatment would make me more able to do the things I want to do"

Statistically significant differences were found between responses for Statement 3, (F(2,58) = 3.485, p = 0.037) with repeated measures ANOVA (Table 4). Post hoc analysis demonstrated significant differences between HVLA and LT (p = 0.039) with a mean difference of -0.367 and between HVLA and ULTRA (p = 0.048) with a mean difference of -0.300. Participants responded more positively to the statement "I believe this treatment would make me more able to do the things I want to do" for HVLA than both the LT and ULTRA. There was not a statistically significant difference between ULTRA and LT (p = 0.601). The partial eta squared (η2p) = 0.107.

Cohen's d (d) = -0.41 for HVLA and ULTRA; -0.09 for ULTRA and LT; and -0.47 for HVLA and LT (Table 5). A very small effect is observed for ULTRA and LT, while a medium effect is observed for HVLA and ULTRA; and HVLA and LT. This suggests similar responses for HVLA and ULTRA and for HVLA and LT.

Statement 4: "This seems like a logical way to treat low back pain"

Repeated measures ANOVA revealed no statistically significant difference between responses to Statement 4, "This seems like a logical way to treat low back pain", (F(2,58) = 0.707, p = 0.497) (Table 4). The partial eta squared (η2p) = 0.024.

Cohen's d (d) = -0.21 for HVLA and ULTRA; 0 for ULTRA and LT; and -0.19 for HVLA and LT (Table 5). There is no effect observed for ULTRA and LT for this question and only a small effect for HVLA and LT. A marginally medium effect is observed for HVLA and ULTRA.

Manipulative treatment

A significant difference was observed between those having ever received manipulative treatment (osteopathic manipulative treatment or chiropractic treatment) and those not having ever received manipulative treatment when responding to Statement 1 for the ULTRA group (p = 0.03). Those who had never received manipulative treatment (mean = 1.83) responded more favourably than those who had received manipulative treatment (mean = 2.39).

No other differences were found between having ever received manipulative treatment and not having ever received manipulative treatment for any other question pertaining to either the ULTRA or LT treatments. However, the difference did approach significance for Statement 4 with the ULTRA treatment (p = 0.06), also with those who had never received manipulative treatment (mean = 1.83) responding more favourably than those who had received manipulative treatment (mean = 2.33).

A similar analysis of subjects who had never received ultrasound and subjects who had received ultrasound was conducted. No significant differences were observed between the groups for any of the 4 statements relating to HVLA or LT.



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