CLINICAL FEATURES: A patient with sudden-onset back pain, who had 4 of 5 criteria for a clinical prediction rule said to identify responders to manipulation, was successfully treated using repeated flexion in lying exercises.
OUTCOMES: Pain numeric score and Roland-Morris Disability Questionnaire were used to measure changes in pain and function. Pain score changed from 9/10 to 0/10 and disability score from 19/24 to 0/24 after 1 week and at 1 and 6 months of follow-up.
CONCLUSION: We have presented a case study that was positive for 4 of 5 items of the clinical prediction rule for manipulation responders, but this patient was successfully treated with flexion exercises. The clinical prediction rule may not represent a discrete subgroup but may include patients who can be effectively managed in other ways.
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