Are within and/or between session improvements in pain and function prognostic of medium and long-term improvements in musculoskeletal problems? A systematic review

Review written by Dr Sandy Hilton info

Key Points

  1. Sub-grouping is a popular tool to try to identify responders to a particular treatment intervention.
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BACKGROUND & OBJECTIVE

The aim of treatment is to make a significant positive change towards resolving the problem that motivated a person to seek treatment in the first place. Determining if a treatment meets that challenge is the underpinning reason for research into specific treatment techniques. In clinical practice and the marketing of that practice, claims are made about the ability to eliminate symptoms in one treatment, and to build on that progress with each successive treatment. Indeed, this within and between-session progress forms the reasoning for many advanced level and certification courses around the world despite weak to no evidence of specific effect.

The authors of this paper investigated the question - Is responding well within or between treatments predictive of a good long-term outcome?

The aim of treatment is to make a significant positive change towards resolving the problem the patient came in for.
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The ability to make a prognosis of long-term improvement based on within and between-session changes is not supported by the research.

METHODS

This review had a wide-ranging inclusion criterion of all musculoskeletal studies that reported within or between-session changes. The study had to be properly registered and follow standard screening criteria.

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