A classification and treatment protocol for low back disorders: Part 1 - specific manual therapy

Background: It has been widely recommended that clinical trials involving people with low back disorders should identify subgroups and provide specific treatment in order to increase the likelihood of clinically meaningful effects being demonstrated. The Maitland approach to providing manual therapy is an appropriate and widely used clinical method in providing specific treatment. However, few clinical trials have described a detailed clinical protocol that allows replication in clinical and research practice. Objectives: This paper presents a detailed classification and treatment protocol for people with clinical features indicating a likely positive response to specific manual therapy. Conclusion: The presented protocol will be used in the Specific Treatment for Problems of the Spine trials comparing specific physiotherapy to evidence-based advice.