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Journal Cover   Journal of Manipulative and Physiological Therapeutics
  [SJR: 0.841]   [H-I: 49]   [4 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0161-4754
   Published by Elsevier Homepage  [2800 journals]
  • Editorial Board
    • Abstract: Publication date: July–August 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 6




      PubDate: 2015-08-29T07:59:20Z
       
  • Table of Contents
    • Abstract: Publication date: July–August 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 6




      PubDate: 2015-08-29T07:59:20Z
       
  • Information for Readers
    • Abstract: Publication date: July–August 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 6




      PubDate: 2015-08-29T07:59:20Z
       
  • The Effectiveness of Passive Physical Modalities for the Management of
           Soft Tissue Injuries and Neuropathies of the Wrist and Hand: A Systematic
           Review by the Ontario Protocol for Traffic Injury Management (OPTIMa)
           Collaboration
    • Abstract: Publication date: Available online 21 August 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Kevin D’Angelo, Deborah Sutton, Pierre Côté, Sarah Dion, Jessica J. Wong, Hainan Yu, Kristi Randhawa, Danielle Southerst, Sharanya Varatharajan, Jocelyn Cox (Dresser), Courtney Brown, Roger Menta, Margareta Nordin, Heather M. Shearer, Arthur Ameis, Maja Stupar, Linda J. Carroll, Anne Taylor-Vaisey
      Objective The purpose of this systematic review was to determine the effectiveness of passive physical modalities compared to other interventions, placebo/sham interventions, or no intervention in improving self-rated recovery, functional recovery, clinical outcomes and/or administrative outcomes (eg, time of disability benefits) in adults and/or children with soft tissue injuries and neuropathies of the wrist and hand. Methods We systematically searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials, accessed through Ovid Technologies, Inc, and CINAHL Plus with Full Text, accessed through EBSCO host, from 1990 to 2015. Our search strategies combined controlled vocabulary relevant to each database (eg, MeSH for MEDLINE) and text words relevant to our research question and the inclusion criteria. Randomized controlled trials, cohort studies, and case-control studies were eligible. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best evidence synthesis principles. Results We screened 6618 articles and critically appraised 11 studies. Of those, 7 had low risk of bias: 5 addressed carpal tunnel syndrome (CTS) and 2 addressed de Quervain disease. We found evidence that various types of night splints lead to similar outcomes for the management of CTS. The evidence suggests that a night wrist splint is less effective than surgery in the short term but not in the long term. Furthermore, a night wrist splint and needle electroacupuncture lead to similar outcomes immediately postintervention. Finally, low-level laser therapy and placebo low-level laser therapy lead to similar outcomes. The evidence suggests that kinesio tape or a thumb spica cast offers short-term benefit for the management of de Quervain disease. Our search did not identify any low risk of bias studies examining the effectiveness of passive physical modalities for the management of other soft tissue injuries or neuropathies of the wrist and hand. Conclusions Different night orthoses provided similar outcomes for CTS. Night orthoses offer similar outcomes to electroacupuncture but are less effective than surgery in the short term. This review suggests that kinesio tape or a thumb spica cast may offer short-term benefit for the management of de Quervain disease.


      PubDate: 2015-08-25T07:39:24Z
       
  • First-Contact Care With a Medical vs Chiropractic Provider After
           Consultation With a Swiss Telemedicine Provider: Comparison of Outcomes,
           Patient Satisfaction, and Health Care Costs in Spinal, Hip, and Shoulder
           Pain Patients
    • Abstract: Publication date: Available online 16 August 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Taco A.W. Houweling, Andrea V. Braga, Thomas Hausheer, Marco Vogelsang, Cynthia Peterson, B. Kim Humphreys
      Objective The purpose of this study was to identify differences in outcomes, patient satisfaction, and related health care costs in spinal, hip, and shoulder pain patients who initiated care with medical doctors (MDs) vs those who initiated care with doctors of chiropractic (DCs) in Switzerland. Methods A retrospective double cohort design was used. A self-administered questionnaire was completed by first-contact care spinal, hip, and shoulder pain patients who, 4 months previously, contacted a Swiss telemedicine provider regarding advice about their complaint. Related health care costs were determined in a subsample of patients by reviewing the claims database of a Swiss insurance provider. Results The study sample included 403 patients who had seen MDs and 316 patients who had seen DCs as initial health care providers for their complaint. Differences in patient sociodemographic characteristics were found in terms of age, pain location, and mode of onset. Patients initially consulting MDs had significantly less reduction in their numerical pain rating score (difference of 0.32) and were significantly less likely to be satisfied with the care received (odds ratio = 1.79) and the outcome of care (odds ratio = 1.52). No significant differences were found for Patient's Global Impression of Change ratings. Mean costs per patient over 4 months were significantly lower in patients initially consulting DCs (difference of CHF 368; US $368). Conclusion Spinal, hip, and shoulder pain patients had clinically similar pain relief, greater satisfaction levels, and lower overall cost if they initiated care with DCs, when compared with those who initiated care with MDs.


      PubDate: 2015-08-17T07:07:28Z
       
  • Changes in Shoulder Pain and Disability After Thrust Manipulation in
           Subjects Presenting With Second and Third Rib Syndrome
    • Abstract: Publication date: Available online 5 August 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): James Dunning, Firas Mourad, Giuseppe Giovannico, Filippo Maselli, Thomas Perreault, César Fernández-de-las-Peñas
      Objective The purpose of this preliminary study was to investigate changes in shoulder pain, disability, and perceived level of recovery after 2 sessions of upper thoracic and upper rib high-velocity low-amplitude (HVLA) thrust manipulation in patients with shoulder pain secondary to second and third rib syndrome. Methods This exploratory study evaluated 10 consecutive individuals with shoulder pain, with or without brachial pain, and a negative Neer impingement test, who completed the Shoulder Pain and Disability Index (SPADI), the numeric pain rating scale (NPRS), and the global rating of change. Patients received 2 sessions of HVLA thrust manipulation targeting the upper thoracic spine bilaterally and the second and third ribs on the symptomatic side. Outcome measures were completed after the first treatment session, at 48 hours, 1 month, and 3 months. Results Patients showed a significant decrease in SPADI (F = 59.997; P = .001) and significant decrease in resting shoulder NPRS (F = 63.439; P = .001). For both NPRS and SPADI, there were significant differences between the pretreatment scores and each of the postintervention scores through 3-month follow-up (P < .05). Large within-group effect sizes (Cohen's d ≥ 0.8) were found between preintervention data and all postintervention assessments in both outcomes. Mean global rating of change scores (+6.8 at 3 months) indicated “a very great deal better” outcome at long-term follow-up. Conclusion This group of patients with shoulder pain secondary to second and third rib syndrome who received upper thoracic and upper rib HVLA thrust manipulations showed significant reductions in pain and disability and improvement in perceived level of recovery.


      PubDate: 2015-08-07T21:25:41Z
       
  • Evaluation of Isokinetic Trunk Muscle Strength in Adolescents With Normal
           and Abnormal Postures
    • Abstract: Publication date: Available online 5 August 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Katarzyna Barczyk-Pawelec, Jerzy Rafał Piechura, Wioletta Dziubek, Krystyna Rożek
      Objective The aim of this study was to assess existing differences in the isokinetic trunk muscle strength in males and females aged between 10 and 11 years depending on body posture. Methods The study included 145 children (67 males and 78 females) divided into 2 age groups: 10-year-old males ( x ¯ = 9.98 ± 2.34 years) and females ( x ¯ = 9.85 ± 2.94 years) and 11-year-old males ( x ¯ = 11.14 ± 2.22 years) and females ( x ¯ = 11.15 ± 2.32 years). Posture in the sagittal plane was assessed by photogrammetry using the moiré projection technique. Based on a classification system, the participants were divided into subgroups of males and females with normal and abnormal postures. Trunk muscle strength was measured using isokinetic dynamometry. Results A high prevalence of abnormal posture in children aged between 10 and 11 years was observed, primarily represented by an excessive curvature of the spine in the sagittal plane. The males and females with poor posture recorded lower values in isokinetic trunk muscle strength. Conclusion The results of the study point to the need for the application of suitable physiotherapy treatment (corrective measures/exercises) to treat musculoskeletal disorders to compensate for the loss of trunk flexor muscle strength in children with improper posture.


      PubDate: 2015-08-07T21:25:41Z
       
  • Inertial Sensors as Real-Time Feedback Improve Learning Posterior-Anterior
           Thoracic Manipulation: A Randomized Controlled Trial
    • Abstract: Publication date: Available online 26 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Antonio I. Cuesta-Vargas, Manuel González-Sánchez, Yves Lenfant
      Objective The purpose of this study was to analyze the effect of real-time feedback on the learning process for posterior-anterior thoracic manipulation (PATM) comparing 2 undergraduate physiotherapy student groups. Methods The study design was a randomized controlled trial in an educational setting. Sixty-one undergraduate physiotherapy students were divided randomly into 2 groups, G1 (n = 31; group without feedback in real time) and G2 (n = 30; group with real-time feedback) participated in this randomized controlled trial. Two groups of physiotherapy students learned PATM, one using a traditional method and the other using real-time feedback (inertial sensor). Measures were obtained preintervention and postintervention. Intragroup preintervention and postintervention and intergroup postintervention scores were calculated. An analysis of the measures' stability was developed through an interclass correlation index. Time, displacement and velocity, and improvement (only between groups) to reach maximum peak and to reach minimum peak from maximum peak, total manipulation time, and stability of all outcome measures were the outcome measures. Results Statistically significant differences were found in all variables analyzed (intragroup and intergroup) in favor of G2. The values of interclass correlation ranged from 0.627 to 0.706 (G1) and between 0.881 and 0.997 (G2). Conclusions This study found that the learning process for PATM is facilitated when the student receives real-time feedback.


      PubDate: 2015-07-26T21:46:38Z
       
  • Head-Trunk Kinematics During High-Velocity–Low-Amplitude
           Manipulation of the Cervical Spine in Asymptomatic Subjects: Helical Axis
           Computation and Anatomic Motion Modeling
    • Abstract: Publication date: Available online 26 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Pierre-Michel Dugailly, Stéphane Sobczak, Bernard Van Geyt, Bruno Bonnechère, Laura Maroye, Fedor Moiseev, Marcel Rooze, Patrick Salvia, Véronique Feipel
      Objective This study aimed to analyze the in vivo 3-dimensional kinematics of the head during cervical manipulation including helical axis (HA) computation and anatomic motion representation. Methods Twelve asymptomatic volunteers were included in this study. An osteopathic practitioner performed 1 to 3 manipulations (high-velocity and low-amplitude [HVLA] multiple component technique) of the cervical spine (between C2 and C5) with the patient in the sitting position. During manipulation, head motion was collected using an optoelectronic system and expressed relative to the thorax. Motion data were processed to analyze primary and coupled motions and HA parameters. Anatomic motion representation including HA was obtained. Results During manipulation, average maximal range of motion was 39° (SD, 6°), 21° (SD, 7°), and 8° (SD, 5°) for lateral bending (LB), axial rotation (AR), and flexion extension, respectively. For the impulse period, magnitude averaged of 8° (SD, 2°), 5° (SD, 2°), and 3° (SD, 2°), for LB, AR, and flexion extension, respectively. Mean impulse velocity was 139°/s (SD, 39°/s). Concerning AR/LB ratios, an average of 0.6 (SD, 0.3) was observed for global motion, premanipulation positioning, and impulse. Mean HA was mostly located ipsilateral to the impulse side and displayed an oblique orientation. Conclusion This study demonstrated limited range of AR during cervical spine manipulation and provided new perspectives for the development of visualization tools, which might be helpful for practitioners and for the analysis of cervical manipulation using HA computation and anatomic representation of motion.


      PubDate: 2015-07-26T21:46:38Z
       
  • Short-Term Effects of Mulligan Mobilization With Movement on Pain,
           Disability, and Kinematic Spinal Movements in Patients With Nonspecific
           Low Back Pain: A Randomized Placebo-Controlled Trial
    • Abstract: Publication date: Available online 26 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Benjamin Hidalgo, Laurent Pitance, Toby Hall, Christine Detrembleur, Henri Nielens
      Objective The purpose of this clinical study was to compare the immediate- and short-term effects of lumbar Mulligan sustained natural apophyseal glides (SNAGs) on patients with nonspecific low back pain with respect to 2 new kinematic algorithms (KA) for range of motion and speed as well as pain, functional disability, and kinesiophobia. Methods This was a 2-armed randomized placebo-controlled trial. Subjects, blinded to allocation, were randomized to either a real-SNAG group (n = 16) or a sham-SNAG group (n = 16). All patients were treated during a single session of real/sham SNAG (3 × 6 repetitions) to the lumbar spine from a sitting position in a flexion direction. Two new KA from a validated kinematic spine model were used and recorded with an optoelectronic device. Pain at rest and during flexion as well as functional disability and kinesiophobia was recorded by self-reported measures. These outcomes were blindly evaluated before, after treatment, and at 2-week follow-up in both groups. Results Of 6 variables, 4 demonstrated significant improvement with moderate-to-large effect sizes (ES) in favor of the real-SNAG group: KA-R (P = .014, between-groups ES Cliff δ = −.52), pain at rest and during flexion (visual analog scale, P < .001; ES = −.73/−.75), and functional-disability (Oswestry Disability Index, P = .003 and ES = −.61). Kinesiophobia was not considered to be significant (Tampa scale, P = .03) but presented moderate ES = −.46. Kinematic algorithms for speed was not significantly different between groups (P = .118) with a small ES = −.33. All 6 outcome measures were significantly different (P ≤ .008) during within-group analysis (before and after treatment) only in the real-SNAG group. No serious or moderate adverse events were reported. Conclusion This study showed evidence that lumbar spine SNAGs had a short-term favorable effect on KA-R, pain, and function in patients with nonspecific low back pain.


      PubDate: 2015-07-26T21:46:38Z
       
  • The Effect of Pillow Height on Muscle Activity of the Neck and Mid-Upper
           Back and Patient Perception of Comfort
    • Abstract: Publication date: Available online 21 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Isabel C.N. Sacco, Ivye L.R. Pereira, Roberto C. Dinato, Vivian C. Silva, Beatriz Friso, Samires F. Viterbo
      Objective The purpose of this study was to evaluate the comfort and the electromyographic (EMG) activity of the neck and mid-upper back of asymptomatic adults using foam pillows of 3 different heights. Methods Twenty-one asymptomatic adults used foam pillows of 3 different heights (1: 5 cm, 2: 10 cm, and 3: 14 cm). Comfort was assessed using a 100-mm visual analog scale. Electromyographic activity was assessed in the lateral position. We calculated the root mean square (RMS) in 500-millisecond windows of bilateral EMG activity of the sternocleidomastoid and upper and middle trapezius, normalized by maximal isometric contraction of each individual. The RMS of the EMG signals was compared among pillow heights using repeated-measures analysis of variance (P < .05). Results The middle trapezius muscle of the down-side showed the highest RMS in height 1 when compared with heights 2 (P = .0163) and 3 (P = .0313), with no statistical significance between pillow heights 2 and 3 for this muscle. There were no statistical differences between pillows 2 and 3 in any muscle activity. Height 2 was considered the most comfortable (P < .001) compared with heights 1 and 3, and height 1 the least comfortable (P < .001) compared with the other heights. Conclusion For the participants in this study, there was an association among pillow height, myoelectric activity, and comfort.


      PubDate: 2015-07-22T21:33:40Z
       
  • Test-Retest Reliability of Trunk Motor Variability Measured By Large-Array
           Surface Electromyography
    • Abstract: Publication date: Available online 21 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jacques Abboud, François Nougarou, Michel Loranger, Martin Descarreaux
      Objective The objective of this study was to evaluate the test-retest reliability of the trunk muscle activity distribution in asymptomatic participants during muscle fatigue using large-array surface electromyography (EMG). Methods Trunk muscle activity distribution was evaluated twice, with 3 to 4 days between them, in 27 asymptomatic volunteers using large-array surface EMG. Motor variability, assessed with 2 different variables (the centroid coordinates of the root mean square map and the dispersion variable), was evaluated during a low back muscle fatigue task. Test-retest reliability of muscle activity distribution was obtained using Pearson correlation coefficients. Results A shift in the distribution of EMG amplitude toward the lateral-caudal region of the lumbar erector spinae induced by muscle fatigue was observed. Moderate to very strong correlations were found between both sessions in the last 3 phases of the fatigue task for both motor variability variables, whereas weak to moderate correlations were found in the first phases of the fatigue task only for the dispersion variable. Conclusion These findings show that, in asymptomatic participants, patterns of EMG activity are less reliable in initial stages of muscle fatigue, whereas later stages are characterized by highly reliable patterns of EMG activity.


      PubDate: 2015-07-22T21:33:40Z
       
  • Consistency and Malleability of Manipulation Performance in Experienced
           Clinicians: A Pre-Post Experimental Design
    • Abstract: Publication date: Available online 18 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): John J. Triano, Dominic Giuliano, Ismat Kanga, David Starmer, Jennifer Brazeau, C. Elaine Screaton, Curtis Semple
      Objective The purpose of this study was to sample the stability of spinal manipulation performance in peak impulse force development over time and the ability of clinicians to adapt to arbitrary target levels with short-duration training. Methods A pre-post experimental design was used. Human analog mannequins provided standardized simulation for performance measures. A convenience sample was recruited consisting of 41 local doctors of chiropractic with 5 years of active clinical practice experience. Thoracic impulse force was measured among clinicians at baseline, after 4 months at pretraining, and again posttraining. Intraclass correlation coefficient values and within-subject variability defined consistency. Malleability was measured by reduction of error (paired t tests) in achieving arbitrary targeted levels of force development normalized to the individual's typical performance. Results No difference was observed in subgroup vs baseline group characteristics. Good consistency was observed in force-time profiles (0.55 ≤ intraclass correlation coefficient ≤ 0.75) for force parameters over the 4-month interval. With short intervals of focused training, error rates in force delivery were reduced by 23% to 45%, depending on target. Within-subject variability was 1/3 to 1/2 that of between-subject variability. Load increases were directly related to rate of loading. Conclusion The findings of this study show that recalibration of spinal manipulation performance of experienced clinicians toward arbitrary target values in the thoracic spine is feasible. This study found that experienced clinicians are internally consistent in performance of procedures under standardized conditions and that focused training may help clinicians learn to modulate procedure characteristics.


      PubDate: 2015-07-18T21:33:29Z
       
  • Quantitative Ultrasound Measurements of Bone Quality in Female Adolescents
           with Idiopathic Scoliosis Compared To Normal Controls
    • Abstract: Publication date: Available online 18 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Qing Du, Xuan Zhou, Jian A. Li, Xiao H. He, Ju P. Liang, Li Zhao, Xiao Y. Yang, Nan Chen, Shu X. Zhang, Pei J. Chen
      Objective The aims of this study were to compare the speed-of-sound (SOS) between adolescent idiopathic scoliosis (AIS) patients and controls using quantitative ultrasound examination and to further analyze the relationship between the SOS and curve type, curve magnitude, maturation status and Risser's sign in AIS patients compared to controls. Methods Seventy-eight female AIS patients and 58 healthy female controls 10 to 16 years of age were recruited to participate. Quantitative ultrasound measurements were performed at the non-dominant distal end of the radius. The standard method for estimating the SOS and z-score was used. Comparisons were made between the SOS values and z-score in AIS patients and age-matched Asian adolescents. Results The SOS values of the patients were significantly lower than the controls (P < .01). The percentage of cases with low bone quality was 25% in the entire AIS sample. The prevalence of low bone quality in AIS patients was 20.5%. However, there were no correlations between the SOS and types of scoliosis (P > .05). The SOS values among different severity groups were significant, particularly between the 10° to 19° and 20° to 39° groups as well as between 10° to 19° and ≥40° groups. However, there was no significant correlation between the SOS and Cobb angles. Significant correlations were also found between the pre- and post-menarchy status in patients. There was a significant difference in the SOS values for different Rissers’ signs (P < .05). Conclusions Compared to nonscoliotic controls, subjects with AIS had a generally lower SOS, indicating lower bone quality. The age, Risser’s sign, or maturation status, may have an effect on the bone quality; however, the curve type and magnitude do not affect the bone quality. The results of this study indicate that slower bone maturation may affect the bone quality in adolescents with AIS.


      PubDate: 2015-07-18T21:33:29Z
       
  • Editorial Board
    • Abstract: Publication date: June 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 5




      PubDate: 2015-07-18T21:33:29Z
       
  • Table of Contents
    • Abstract: Publication date: June 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 5




      PubDate: 2015-07-18T21:33:29Z
       
  • Information for Readers
    • Abstract: Publication date: June 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 5




      PubDate: 2015-07-18T21:33:29Z
       
  • Ultrasound Assessment of Abdominal Muscle Thickness in Postpartum vs
           Nulliparous Women
    • Abstract: Publication date: June 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 5
      Author(s): Carol Ann Weis, John J. Triano, Jon Barrett, Michelle D. Campbell, Martine Croy, Jessica Roeder
      Objective The purpose of this study was to determine the effect size in measurable change of abdominal musculature morphology using ultrasonography in postpartum women within 1 month of a healthy, vaginal delivery. Methods One hundred fifty-six participants were recruited for this study. B-mode ultrasound imaging was used to measure abdominal muscle thickness on 80 nulliparous women and 76 mothers who had delivered within the past 4 weeks. Measures were taken for the upper and lower rectus abdominus, external and internal obliques, and transversus abdominus at rest. Results Statistically significant differences were found in the thickness of the rectus abdominus muscle at both sites; upper (P < .0001) and lower (P < .0001) as well as the internal oblique (P < .0001). All 3 muscles were thinner in postpartum participants (8.29 ± 1.83 mm, 8.89 ± 2.29 mm, and 7.06 ± 1.82 mm, respectively) within the first month of delivery than in controls (10.82 ± 1.93 mm, 11.13 ± 2.38 mm, and 8.36 ± 1.87 mm, respectively). Large effect sizes were found for the influence of pregnancy on the rectus muscle segments (1.35 for the upper rectus abdominus and 1.00 for the lower rectus abdominus) and a medium effect size for the internal oblique (0.71). No significant differences were observed in the remaining 2 muscles. Conclusion This study showed that there are differences in morphology of the abdominal muscles in pregnant women vs nonpregnant controls. The large effect sizes reported may provide the basis for future studies examining relationships between morphology, functional change, and back pain during pregnancy.


      PubDate: 2015-07-18T21:33:29Z
       
  • Grading Osteoarthritic Changes of the Zygapophyseal Joints from
           Radiographs: A Reliability Study
    • Abstract: Publication date: Available online 26 June 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Joshua W. Little , Thomas J. Grieve , Gregory D. Cramer , Jeffrey A. Rich , Evelyn E. Laptook , Joseph P.D. Stiefel , Kathleen Linaker
      Objective This study tested the reliability of a 5-point ordinal scale used to grade the severity of degenerative changes of zygapophyseal (Z) joints on standard radiographs. Methods Modifications were made to a Kellgren grading system to improve agreement for grading the severity of osteoarthritic changes in lumbar Z joints. These included adding 1 grade of no degeneration, multiple radiographic views, and structured examiner training. Thirty packets of radiographic files were obtained, which included representation of all 5 grades including no degeneration (0) and Kellgren's 4-point (1-4) joint degeneration classification criteria. Radiographs were digitized to create a radiographic atlas that was given to examiners for individual study and blinded evaluation sessions. Intrarater and interrater agreement was determined by weighted κ (κ w) from the examination of 79 Z joints (25 packets). Results Using the modified scale and after training, examiners demonstrated a moderate-to-substantial level of interrater agreement (κ w = 0.57, 0.60, and 0.68). Intrarater agreement was moderate (κ w = 0.42 and 0.54). Conclusions The modified Kellgren 5-point grading system provides acceptable intrarater and interrater reliability when examiners are adequately trained. This grading system may be a useful method for future investigations assessing radiographic osteoarthritis of the Z joints.


      PubDate: 2015-07-02T09:10:12Z
       
  • The Effectiveness of Exercise for the Management of Musculoskeletal
           Disorders and Injuries of the Elbow, Forearm, Wrist, and Hand: A
           Systematic Review by the Ontario Protocol for Traffic Injury Management
           (OPTIMa) Collaboration
    • Abstract: Publication date: Available online 27 June 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Roger Menta , Kristi Randhawa , Pierre Côté , Jessica J. Wong , Hainan Yu , Deborah Sutton , Sharanya Varatharajan , Danielle Southerst , Kevin D'Angelo , Jocelyn Cox , Courtney Brown , Sarah Dion , Silvano Mior , Maja Stupar , Heather M. Shearer , Gail M. Lindsay , Craig Jacobs , Anne Taylor-Vaisey
      Objective The purpose of this systematic review was to evaluate the effectiveness of exercise compared to other interventions, placebo/sham intervention, or no intervention in improving self-rated recovery, functional recovery, clinical, and/or administrative outcomes in individuals with musculoskeletal disorders and injuries of the elbow, forearm, wrist, and hand. Methods We searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Paired reviewers independently screened studies for relevance and assessed the risk of bias using the Scottish Intercollegiate Guidelines Network criteria. We synthesized the evidence using the best evidence synthesis methodology. Results We identified 5 studies with a low risk of bias. Our review suggests that, for patients with persistent lateral epicondylitis, (1) adding concentric or eccentric strengthening exercises to home stretching exercises provides no additional benefits; (2) a home program of either eccentric or concentric strengthening exercises leads to similar outcomes; (3) home wrist extensor strengthening exercises lead to greater short-term improvements in pain reduction compared to “wait and see”; and (4) clinic-based, supervised exercise may be more beneficial than home exercises with minimal improvements in pain and function. For hand pain of variable duration, supervised progressive strength training added to advice to continue normal physical activity provides no additional benefits. Conclusion The relative effectiveness of stretching vs strengthening for the wrist extensors remains unknown for the management of persistent lateral epicondylitis. The current evidence shows that the addition of supervised progressive strength training does not provide further benefits over advice to continue normal physical activity for hand pain of variable duration.


      PubDate: 2015-07-02T09:10:12Z
       
  • The Effectiveness of Noninvasive Interventions for Musculoskeletal
           Thoracic Spine and Chest Wall Pain: A Systematic Review by the Ontario
           Protocol for Traffic Injury Management (OPTIMa) Collaboration
    • Abstract: Publication date: Available online 30 June 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Danielle Southerst , Andrée-Anne Marchand , Pierre Côté , Heather M. Shearer , Jessica J. Wong , Sharanya Varatharajan , Kristi Randhawa , Deborah Sutton , Hainan Yu , Douglas P. Gross , Craig Jacobs , Rachel Goldgrub , Maja Stupar , Silvano Mior , Linda J. Carroll , Anne Taylor-Vaisey
      Objective The purpose of this study was to critically appraise and synthesize evidence on the effectiveness of noninvasive interventions, excluding pharmacological treatments, for musculoskeletal thoracic pain. Methods Randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effectiveness of noninvasive interventions were eligible. We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials accessed through Ovid Technologies, Inc, and CINAHL Plus with Full Text accessed through EBSCOhost from 1990 to 2015. Our search strategies combined controlled vocabulary relevant to each database (eg, MeSH for MEDLINE) and text words relevant to our research question and the inclusion criteria. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with a low risk of bias were synthesized following best evidence synthesis principles. Results We screened 6988 articles and critically appraised 2 studies. Both studies had a low risk of bias and were included in our synthesis. One RCT compared thoracic spinal manipulation, needle acupuncture, and placebo electrotherapy for recent thoracic spine pain. There were statistically significant but clinically nonimportant short-term reductions in pain favoring manipulation. There were no differences between acupuncture and placebo electrotherapy. Another RCT compared a multimodal program of care and a session of education for recent musculoskeletal chest wall pain. The multimodal care resulted in statistically significant but clinically nonimportant short-term reductions in pain over education. However, participants receiving multimodal care were more likely to report important improvements in chest pain. Conclusions Quality evidence on the management of musculoskeletal thoracic pain is sparse. The current evidence suggests that compared to placebo, spinal manipulation is associated with a small and clinically nonimportant reduction in pain intensity and that acupuncture leads to similar outcomes as placebo. Furthermore, a multimodal program of care (ie, manual therapy, soft tissue therapy, exercises, heat/ice, and advice) and a single education session lead to similar pain reduction for recent-onset musculoskeletal chest wall pain. However, patients who receive multimodal care are more likely to report pain improvements.


      PubDate: 2015-07-02T09:10:12Z
       
  • Correlation of Lumbar-Hip Kinematics Between Trunk Flexion and Other
           Functional Tasks
    • Abstract: Publication date: Available online 20 June 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Raee S. Alqhtani , Michael D. Jones , Peter S. Theobald , Jonathan M. Williams
      Objective The purpose of this study was to explore the relationship between the kinematic profiles of flexion of the upper lumbar and lower lumbar (LL) spine and hip and 3 sagittally dominant functional tasks (lifting, stand-to-sit, and sit-to-stand). Methods Fifty-three participants were recruited for this study. Four sensors were attached to the skin over the S1, L3, T12, and lateral thigh. Relative angles between adjacent sensors were used to quantify the motion for the hip, LL, and upper lumbar spine. Pearson correlation coefficients were used to explore the relationship between the movements and more functional tasks. One-way analysis of variance was used to determine the significance of differences between the variables. Results Flexion resulted in a greater or similar range of motion (ROM) to the other tasks investigated for both spinal regions but less ROM for the hip. Strong correlations for ROM are reported between forward flexion tasks and lifting for the LL spine (r = 0.83) and all regions during stand-to-sit and sit-to-stand (r = 0.70-0.73). No tasks were strongly correlated for velocity (r = 0.03-0.55). Conclusion Strong correlations were only evident for the LL spine ROM between lifting and flexion; all other tasks afforded moderate or weak correlations. This study suggests that sagittal tasks use different lumbar-hip kinematics and place different demands on the lumbar spine and hip.


      PubDate: 2015-07-02T09:10:12Z
       
  • Effect of Connective Tissue Manipulation on Symptoms and Quality of Life
           in Patients With Chronic Constipation: a Randomized Controlled Trial
    • Abstract: Publication date: Available online 20 June 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Ceren Gürsen , Mintaze Kerem Günel , Serap Kaya , Taylan Kav , Türkan Akbayrak
      Objective The purpose of this study was to examine the effects of connective tissue manipulation (CTM) on the severity of constipation and health-related quality of life in individuals diagnosed with chronic constipation. Methods Fifty patients with a diagnosis of chronic constipation according to Rome III criteria were recruited and randomized to an intervention (n = 25) or control group (n = 25). The intervention group received CTM in addition to the lifestyle advice, whereas the control group was given only lifestyle advice for constipation. All assessments were performed at baseline and at the end of 4 weeks. The primary outcome measure was the Constipation Severity Instrument. Secondary outcomes included Patient Assessment of Constipation Quality of Life Questionnaire, Bristol Stool Scale, and 7-day bowel diary. Differences between groups were analyzed with t tests, Mann-Whitney U test and χ 2 test. Results Compared with the control group, subjects in the intervention group reported significantly greater improvement in total and subscale scores of the Constipation Severity Instrument and Patient Assessment of Constipation Quality of Life Questionnaire (P < .05). Based on the results from bowel diaries, the improvements in the number of bowel movements, duration of defecation, stool consistency, and the feeling of incomplete evacuation in the intervention group were also significantly more than the control group (P < .05). Conclusion This study showed that CTM and lifestyle advice were superior to reducing symptoms of constipation and quality of life compared with lifestyle advice alone for patients with chronic constipation.


      PubDate: 2015-07-02T09:10:12Z
       
  • Efficacy of Hand Behind Back Mobilization With Movement for Acute Shoulder
           Pain and Movement Impairment: A Randomized Controlled Trial
    • Abstract: Publication date: Available online 20 June 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Kiran H. Satpute , Prashant Bhandari , Toby Hall
      Objective The aim of this study was to investigate the effects of hand-behind-back (HBB) Mulligan mobilization with movement (MWM) techniques on acute shoulder pain, impairment, and disability. Methods This double-blind, randomized, controlled trial recruited 44 patients with acute shoulder pain and movement impairment presenting to an Indian general hospital. Participants were allocated to receive either MWM and exercise/hot pack (n = 22) or exercise/hot pack alone (n = 22). The average duration of symptoms was 4.1and 4.7 weeks in the exercise and MWM groups, respectively. The primary outcome was HBB range of motion (ROM). Secondary variables were shoulder internal rotation ROM, pain intensity score, and shoulder disability identified by the shoulder pain and disability index. All variables were evaluated by a blinded assessor before and immediately after 9 treatment sessions over 3 weeks. Results Paired t tests revealed that both groups demonstrated statistically significant improvements (P < .001) with large effect sizes for all variables. However, for all variables, the MWM-with-exercise group showed significantly greater improvements (P < .05) than the exercise group. Hand-behind-back ROM showed a mean difference of 9.31° (95% confidence interval, 7.38-11.27), favoring greater improvement in the MWM-with-exercise group. Conclusions In this study, the outcomes of patients with acute shoulder pain and disability receiving shoulder HBB MWM with exercise improved greater than those receiving exercise/hot packs alone.


      PubDate: 2015-07-02T09:10:12Z
       
  • Editorial Board
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4




      PubDate: 2015-07-02T09:10:12Z
       
  • Table of Contents
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4




      PubDate: 2015-07-02T09:10:12Z
       
  • Information for Readers
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4




      PubDate: 2015-07-02T09:10:12Z
       
  • Effects of Mobilization With Movement on Pain and Range of Motion in
           Patients With Unilateral Shoulder Impingement Syndrome: A Randomized
           Controlled Trial
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4
      Author(s): José A. Delgado-Gil , Eva Prado-Robles , Daiana P. Rodrigues-de-Souza , Joshua A. Cleland , César Fernández-de-las-Peñas , Francisco Alburquerque-Sendín
      Objective The purpose of this study was to compare the immediate effects of mobilization with movement (MWM) to a sham technique in patients with shoulder impingement syndrome. Methods A randomized controlled trial was performed. Forty-two patients (mean ± SD age, 55 ± 9 years; 81% female) satisfied eligibility criteria, agreed to participate, and were randomized into an MWM group (n = 21) or sham manual contact (n = 21). The primary outcome measures including pain intensity, pain during active range of motion, and maximal active range of motion were assessed by a clinician blinded to group allocation. Outcomes were captured at baseline and after 2 weeks of MWM treatment or sham intervention. The primary analysis was the group×time interaction. Results The 2×2 analysis of variance revealed a significant group×time interaction for pain intensity during shoulder flexion (F = 7.054; P = .011), pain-free shoulder flexion (F = 32.853; P < .001), maximum shoulder flexion (F = 18.791; P < .01), and shoulder external rotation (F = 7.950; P < .01) in favor of the MWM group. No other significant differences were found. Conclusions Patients with shoulder impingement syndrome who received 4 sessions of MWM exhibited significantly better outcomes for pain during shoulder flexion, pain-free range of shoulder flexion, maximal shoulder flexion, and maximal external rotation than those patients who were in the sham group.


      PubDate: 2015-07-02T09:10:12Z
       
  • Effect of Upper Thoracic Manipulation on Mouth Opening and
           Electromyographic Activity of Masticatory Muscles in Women With
           Temporomandibular Disorder: A Randomized Clinical Trial
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4
      Author(s): Amanda Carine Packer , Paulo Fernandes Pires , Almir Vieira Dibai-Filho , Delaine Rodrigues-Bigaton
      Objective The purpose of this study was to assess the effect of upper thoracic manipulation on vertical mouth opening (VMO) and electromyographic activity of the masticatory muscles in women with temporomandibular disorder (TMD). Methods A randomized, controlled, blinded study involving 32 women (mean age of 24.78 ± 5.41 years) diagnosed with TMD was performed. Subjects were randomly allocated to an experimental group (n = 16) or a sham manipulation (placebo) group (n = 16). A single session of manipulation was administered to the T1 vertebral area. Electromyography was used to determine activity of masticatory muscles with the mandible at rest and during isometric contraction. Vertical mouth opening was measured using a ruler. Measurements were made before manipulation, immediately after manipulation, and at the short-term follow-up (2 to 4 days after manipulation). Results No significant differences were found in any of the comparisons of mandibular VMO or electromyographic activity of the masticatory muscles at rest or during isometric contraction of mandibular elevator muscles (P > .05). Regarding isometric contraction of the mandibular depressors, an immediate increase in muscle activity was found in the suprahyoid (P = .014) and left masseter (P = .005) muscles. Conclusion In the present study, no significant differences were found regarding VMO between the experimental and placebo groups or among the different evaluations times in each group. Moreover, Cohen d test revealed no clinical effect of the technique. Therefore, based upon the findings of this study, manipulation administered to the T1 vertebral area appears to have no effect on VMO and electromyographic activity of the masticatory muscles in women with TMD.


      PubDate: 2015-07-02T09:10:12Z
       
  • Association Between Muscle Trigger Points, Ongoing Pain, Function, and
           
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4
      Author(s): Anabel Alburquerque-García , Daiana P. Rodrigues-de-Souza , César Fernández-de-las-Peñas , Francisco Alburquerque-Sendín
      Objective The objectives of this study were to investigate if referred pain elicited by active trigger points (TrPs) reproduced the symptoms in individuals with painful knee osteoarthritis (OA) and to determine the relationship between the presence of active TrPs, intensity of ongoing pain, function, quality of life, and sleep quality in individuals with painful knee OA. Methods Eighteen women with bilateral painful knee OA, aged 79 to 90years, and 18 matched controls participated. Muscle TrPs were bilaterally explored in several muscles of the lower extremity. Trigger points were considered active if the elicited referred pain reproduced knee symptoms, and TrPs were considered latent if the elicited pain did not reproduce symptoms. Pain was collected with a numerical pain rate scale (0-10), function was assessed with Western Ontario and McMaster Universities, quality of life was assessed with the Medical Outcomes Study Short Form 36 questionnaire, and sleep quality was determined with the Pittsburgh Sleep Quality Index. Results Women with knee OA exhibited a greater number of active TrPs (mean, 1 ± 1; P < .001) but similar number of latent TrPs (mean, 4 ± 2) than healthy women (mean, 4 ± 3; P = .613). A greater number of active TrPs were associated with higher intensity of ongoing pain (r = 0.605; P = .007). Higher intensity of ongoing knee pain was associated with lower physical function (P < .05). Conclusions The referred pain elicited by active TrPs in the lower extremity muscles contributed to pain symptoms in painful knee OA. A higher number of active TrPs was associated with higher intensity of ongoing knee pain.


      PubDate: 2015-07-02T09:10:12Z
       
  • Learning Spinal Manipulation: The Effect of Expertise on Transfer
           Capability
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4
      Author(s): Martin Descarreaux , Claude Dugas , Julien Treboz , Charlène Cheron , François Nougarou
      Objective Transfer capability represents the changes in performance in one task that result from practice or experience in other related tasks. Increased transfer capability has been associated with expertise in several motor tasks. The purpose of this study was to investigate if expertise in spinal manipulation therapy, assessed in groups of trainees and experienced chiropractors, is associated with increased transfer capabilities. Methods Forty-nine chiropractic students (fifth- and sixth-year students) and experienced chiropractors were asked to perform blocks of 10 thoracic spine manipulations in 3 different conditions: preferred position and table setting, increased table height, and unstable support surface. Spinal manipulations were performed on a computer-connected device developed to emulate a prone thoracic spine manipulation. Thrust duration, thrust force rate of force application, and preload force were obtained for each trial and compared across groups and conditions. Results Results indicated that both expertise and performance conditions modulated the biomechanical parameters of spinal manipulation. Decreased thrust duration and increased rate of force application were observed in experienced clinicians, whereas thrust force and thrust rate of force application were significantly decreased when task difficulty was increased. Increasing task difficulty also led to significant increases in performance variability. Conclusion Overall, this study suggests that when instructed to perform spinal manipulation in a challenging context, trainees and experts choose to modulate force to optimize thrust duration, a characteristic feature of high-velocity, low-amplitude spinal manipulation. Given its known association with motor proficiency, transfer capability assessments should be considered in spinal manipulative therapy training.


      PubDate: 2015-07-02T09:10:12Z
       
  • Reliability of an Accelerometer-Based System for Quantifying Multiregional
           Spinal Range of Motion
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4
      Author(s): Raee S. Alqhtani , Michael D. Jones , Peter S. Theobald , Jonathan M. Williams
      Objectives The purpose of this study was to investigate the reliability of a novel motion analysis device for measuring the regional breakdown of spinal motion and describing the relative motion of different segments of the thoracolumbar (TL) spine. Methods Two protocols were applied to 18 healthy participants. In protocol 1, 2 sensors were placed on the forehead and T1 to measure cervical range of motion (ROM). In protocol 2, 6 sensors were placed on the spinous processes of T1, T4, T8, T12, L3, and S1 to measure TL regional ROM. Intraclass correlation coefficients were used to evaluate the repeatability of movement, whereas SEM was used to define the extent of error. Ranges of motion were demonstrated in flexion extension, right-left lateral flexion, and right-left rotation of the head-cervical, upper thoracic, middle thoracic, lower thoracic, upper lumbar, and lower lumbar. Results The intraclass correlation coefficient values, for all regions, were found to be high, ranging from 0.88 to 0.99 for all movements, and regions of the spine and SEM values ranged from 0.4° to 5.2°. Multiregional spine ROM ranged from 3° in the upper thoracic and mid-thoracic during flexion and 80° at head cervical during right rotation. Conclusion The described methodology was reliable for assessing regional spinal ROM across multiple spinal regions while providing the relative motions of different segments of the TL spine.


      PubDate: 2015-07-02T09:10:12Z
       
  • Reliability of 2 Protocols for Assessing Pressure Pain Threshold in
           Healthy Young Adults
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4
      Author(s): Leanne M. Bisset , Kerrie Evans , Neil Tuttle
      Objective The purposes of this study were to determine whether there were differences in mean values or reliability for 2 frequently used protocols for pressure pain threshold (PPT) and to calculate how large a difference in PPT is necessary to be 95% confident that a real change has occurred. Methods Thirteen participants (8 females) aged 22.3 (±2.3) years from a university community were included. Two testers evaluated participants using 2 protocols, in which PPT was measured 3 times at 8 different body locations. The “cluster protocol” consisted of 3 successive measurements at each location with a 30-second rest between each measurement. The “circuit protocol” consisted of 1 measurement taken at each anatomical location until “the circuit” was complete and then repeated a total of 3 times. Results A 2-way analysis of variance did not reveal significant differences between protocols at any body location (P = .46-.98). Intertester reliability was good to excellent for all locations (intraclass correlation coefficient, 0.84-0.96), and limits of agreement ranged from 108 to 223 kPa. Conclusions Either the cluster or circuit protocol can be used to measure PPT in clinical or research setting. A difference of 160 kPa is considered sufficient to indicate a real difference between repeated measures of PPT regardless of protocol used for testing.


      PubDate: 2015-07-02T09:10:12Z
       
  • A New Approach to the Measurement of Pelvic Asymmetry: Proposed Methods
           and Reliability
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4
      Author(s): Rafael Gnat , Maciej Biały
      Objective This is a methodological study presenting a novel method of pelvic asymmetry (PA) measurement for use in the research laboratory setting. The purpose of the study is (1) to establish intrarater and interrater reliability of the proposed measures of PA, (2) to verify the influence of repeated measurements on the reliability, and (3) to assess correlation between the proposed measures of PA. Methods Twelve healthy volunteers participated, and 2 teams of raters were involved. Registration of anatomic landmarks’ positions in the optical motion capture system was repeated 3 times. Two asymmetry indexes were calculated: for pelvic torsion and for lateral pelvic tilt. Interclass correlation coefficients (ICCs), standard errors of measurement, and smallest detectable differences were used to describe the intrarater and interrater reliability of the 2 indexes. Results After 2 repeated registrations of pelvic landmarks’ positions, the reliability of our asymmetry indexes was good and excellent. The ICCs for intrarater reliability ranged from 0.96 to 0.97; the ICCs for interrater reliability ranged 0.81 to 0.90. There was moderate, nonsignificant correlation between asymmetry indexes for pelvis torsion and for lateral pelvic tilt (r = 0.45, P = .14). Conclusion The 2 proposed asymmetry indexes showed good and excellent intrarater and interrater reliability after 2 repeated registrations of pelvic landmarks’ positions and thus may be useful in the research laboratory setting. However, these indexes are not strongly correlated, which suggests that the 2 types of PA may constitute different clinical entities.


      PubDate: 2015-07-02T09:10:12Z
       
  • Validation of Palpatory Methods for Evaluating Anatomical Bone Landmarks
           of the Cervical Spine: A Systematic Review
    • Abstract: Publication date: May 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 4
      Author(s): Luciana Cid Póvoa , Ana Paula Antunes Ferreira , Julio Guilherme Silva
      Objective The aim of this study was to systematically review the literature for validity of palpatory procedures for evaluating anatomical bone landmarks in the cervical spine. Methods A systematic search of electronic databases identified observational studies assessing validity and/or accuracy regarding evaluation of anatomical bone landmarks of cervical spine palpatory procedures. The databases used in the search included the US National Library of Medicine of the National Institutes of Health (MEDLINE/PubMed), the Regional Library of Medicine (Bireme), the Scientific Electronic Library Online (SciELO), the Physiotherapy Evidence Database (PEDro), the Latin American and Caribbean Health Sciences Literature database (LILACS), the Cochrane Library, and Coordination of Personnel Improvement of Higher Education (CAPES/Brazil). Data were extracted by a primary reviewer, and 2 independent reviewers used a critical appraisal tool to estimate the quality of the retrieved studies. The results were synthesized qualitatively within the Quality Assessment of Diagnostic Accuracy Studies criteria. After completing the synthesis and scoring, the reviewers applied classifications such as “low,” “fair,” and “good.” Results The initial search yielded 69860 articles. After selection criteria were applied, 5 studies satisfied the eligibility criteria. Three studies verified the validity of the manual palpatory procedure, and 2 studies correlated the findings of the palpatory procedures with other measured results. According to Quality Assessment of Diagnostic Accuracy Studies criteria, 3 studies presented good methodological quality, and 2 presented fair methodological quality. Studies demonstrated an accuracy range from 51% to 87.8%. Conclusion There are few studies that evaluate the validity of manual palpatory procedures for examining boney landmarks of the cervical spine. The 5 that were found showed fair to good methodological quality. However, we note that there may be poor external validity due to the sampling heterogeneity of these studies.


      PubDate: 2015-07-02T09:10:12Z
       
  • Chiropractors' Characteristics Associated With Physician Referrals:
           Results From a Survey of Canadian Doctors of Chiropractic
    • Abstract: Publication date: Available online 1 May 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Marc-André Blanchette , Michèle Rivard , Clermont E. Dionne , J. David Cassidy
      Objective The purpose of this study was to identify characteristics of Canadian doctors of chiropractic (DCs) associated with the number of patients referred by medical doctors (MDs). Methods Secondary data analyses were performed on the 2011 cross-sectional survey of the Canadian Chiropractic Resources Databank. The Canadian Chiropractic Resources Databank survey included 81 questions about the practice of DCs. Of the 6533 mailed questionnaires, 2529 (38.7%) were returned and 489 did not meet our inclusion criteria. Our analyzed sample included 2040 respondents. Bivariate analyses were conducted between predetermined potential predictors and the annual number of patients referred by MDs, and negative binomial multivariate regression was performed. Results On average, DCs reported receiving 15.6 (standard deviation, 31.3) patient referrals from MDs per year and nearly one-third did not receive any. The type of clinic (multidisciplinary with MD), the province of practice (Atlantic provinces), the number of treatments provided per week, the number of practicing hours, rehabilitation and sports injuries as the main sector of activity, prescription of exercises, use of heat packs and ultrasound, and the percentage of patients referred to other health care providers were associated with a higher number of MD referrals to DCs. The percentage of patients with somatovisceral conditions, using a particular chiropractic technique (hole in one and Thompson), taking his/her own radiographs, being the client of a chiropractic management service, and considering maintenance/wellness care as a main sector of activity were associated with fewer MD referrals. Conclusion Canadian DCs who interacted with other health care workers and who focus their practice on musculoskeletal conditions reported more referrals from MDs.


      PubDate: 2015-07-02T09:10:12Z
       
  • Editorial Board
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3




      PubDate: 2015-07-02T09:10:12Z
       
  • Table of Contents
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3




      PubDate: 2015-07-02T09:10:12Z
       
  • Information for Readers
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3




      PubDate: 2015-07-02T09:10:12Z
       
  • The Effect of Adding Forward Head Posture Corrective Exercises in the
           Management of Lumbosacral Radiculopathy: A Randomized Controlled Study
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3
      Author(s): Ibrahim M. Moustafa , Aliaa A. Diab
      Objective The purpose of this study was to determine the immediate and long-term effects of a multimodal program, with the addition of forward head posture correction, in patients with chronic discogenic lumbosacral radiculopathy. Methods This randomized clinical study included 154 adult patients (54 females) who experienced chronic discogenic lumbosacral radiculopathy and had forward head posture. One group received a functional restoration program, and the experimental group received forward head posture corrective exercises. Primary outcomes were the Oswestry Disability Index (ODI). Secondary outcomes included the anterior head translation, lumbar lordosis, thoracic kyphosis, trunk inclination, lateral deviation, trunk imbalance, surface rotation, pelvic inclination, leg and back pain scores, and H-reflex latency and amplitude. Patients were assessed at 3 intervals (pretreatment, 10-week posttreatment, and 2-year follow-up). Results A general linear model with repeated measures indicated a significant group × time effect in favor of the experimental group on the measures of ODI (F = 89.7; P < .0005), anterior head translation (F = 23.6; P < .0005), H-reflex amplitude (F = 151.4; P < .0005), H-reflex latency (F = 99.2; P < .0005), back pain (F = 140.8; P < .0005), and leg pain (F = 72; P < .0005). After 10 weeks, the results revealed an insignificant difference between the groups for ODI (P = .08), back pain (P = .29), leg pain (P = .019), H-reflex amplitude (P = .09), and H-reflex latency (P = .098). At the 2-year follow-up, there were significant differences between the groups for all variables adopted for this study (P < .05). Conclusions The addition of forward head posture correction to a functional restoration program seemed to positively affect disability, 3-dimensional spinal posture parameters, back and leg pain, and S1 nerve root function of patients with chronic discogenic lumbosacral radiculopathy.


      PubDate: 2015-07-02T09:10:12Z
       
  • Inclusion of Trigger Point Dry Needling in a Multimodal Physical Therapy
           Program for Postoperative Shoulder Pain: A Randomized Clinical Trial
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3
      Author(s): José L. Arias-Buría , Raquel Valero-Alcaide , Joshua Aland Cleland , Jaime Salom-Moreno , Ricardo Ortega-Santiago , María A. Atín-Arratibel , César Fernández-de-las-Peñas
      Objective The purpose of this study was to evaluate the effects of including 1 session of trigger point dry needling (TrP-DN) into a multimodal physiotherapy treatment on pain and function in postoperative shoulder pain. Methods Twenty patients (5 male; 15 female; age, 58 ± 12 years) with postoperative shoulder pain after either open reduction and internal fixation with Proximal Humeral Internal Locking System plate plate or rotator cuff tear repair were randomly divided into 2 groups: physiotherapy group (n = 10) who received best evidence physical therapy interventions and a physical therapy plus TrP-DN group (n = 10) who received the same intervention plus a single session of TrP-DN targeted at active TrPs. The Constant-Murley score was used to determine pain, activities of daily living, range of motion, and strength, which was captured at baseline and 1 week after by an assessor blinded to group assignment. Results Analysis of variance showed that subjects receiving TrP-DN plus physical therapy exhibited greater improvement in the Constant-Murley total score (P < .001) and also activities of daily living (P < .001) and strength (P = .019) subscales than those receiving physical therapy alone. Between-group effect sizes were large in favor of the TrP-DN group (0.97 < SMD < 1.45). Both groups experienced similar improvements in pain (P < .001) and range of motion (P < .001). Conclusions Our results suggest that including a single session of TrP-DN in the first week of a multimodal physical therapy approach may assist with faster increases in function in individuals with postoperative shoulder pain.


      PubDate: 2015-07-02T09:10:12Z
       
  • Immediate Effects of Electrical Stimulation, Diathermy, and Physical
           Exercise on Lower Limb Arterial Blood Flow in Diabetic Women With
           Peripheral Arterial Disease: A Randomized Crossover Trial
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3
      Author(s): Elaine Caldeira de Oliveira Guirro , Rinaldo Roberto de Jesus Guirro , Almir Vieira Dibai-Filho , Siane Cristina Santarosa Pascote , Delaine Rodrigues-Bigaton
      Objective The purpose of this study was to assess the effects of high-voltage electrical stimulation (HVES), continuous short wave diathermy, and physical exercise on arterial blood flow in the lower limbs of diabetic women with peripheral arterial disease. Methods A crossover study was carried out involving 15 diabetic women (mean age of 77.87 ± 6.20 years) with a diagnosis of peripheral arterial disease. One session of each therapeutic resource was held, with a 7-day washout period between protocols. Blood flow velocity was evaluated before each session and 0, 20, 40 and 60 minutes after the administration of each protocol. Two-way repeated-measures analysis of variance with Bonferroni post hoc test was used for the intragroup and intergroup comparisons. Results In the intragroup analysis, a significant reduction (P < .05) was found in blood flow velocity in the femoral and popliteal arteries over time with HVES and physical exercise and in the posterior tibial artery with the physical exercise protocol. However, no significant differences were found in the intergroup analysis (P > .05). Conclusion Proximal blood circulation in the lower limb of diabetic women with peripheral arterial disease was increased by a single session of HVES and physical exercise, whereas distal circulation was only increased with physical exercise.


      PubDate: 2015-07-02T09:10:12Z
       
  • Effect of Abdominal Resistance Exercise on Abdominal Subcutaneous Fat of
           Obese Women: A Randomized Controlled Trial Using Ultrasound Imaging
           Assessments
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3
      Author(s): Ramin Kordi , Saeed Dehghani , Pardis Noormohammadpour , Mohsen Rostami , Mohammad Ali Mansournia
      Objectives The aim of this study was to compare the effect of diet and an abdominal resistance training program to diet alone on abdominal subcutaneous fat thickness and waist circumference of overweight and obese women. Methods This randomized clinical trial included 40 overweight and obese women randomly divided into 2 groups: diet only and diet combined with 12 weeks of abdominal resistance training. Waist and hip circumferences and abdominal skin folds of the subjects were measured at the beginning and 12 weeks after the interventions. In addition, abdominal subcutaneous fat thickness of the subjects was measured using ultrasonography. Percentage body fat and lean body mass of all the subjects were also measured using a bioelectric impedance device. Results After 12 weeks of intervention, the weight of participants in both groups decreased; but the difference between the 2 groups was not significant (P = .45). Similarly, other variables including abdominal subcutaneous fat, waist circumference, hip circumference, body mass index, body fat percentage, and skin fold thickness were reduced in both groups; but there were no significant differences between the groups. Conclusions This study found that abdominal resistance training besides diet did not reduce abdominal subcutaneous fat thickness compared to diet alone in overweight or obese women.


      PubDate: 2015-07-02T09:10:12Z
       
  • Differences in Cervical Multifidus Muscle Thickness During Isometric
           Contraction of Shoulder Muscles: A Comparison Between Patients With
           Chronic Neck Pain and Healthy Controls
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3
      Author(s): Leila Rahnama , Asghar Rezasoltani , Minoo Khalkhali Zavieh , Farhang NooriKochi , Alireza Akbarzadeh Baghban
      Objective The purposes of this study were to (1) measure the thickness of cervical multifidus muscle (CMM) in different maximal voluntary contraction percentages of isometric contraction of shoulder muscles, (2) evaluate the differences of the CMM thickness in different directions of the shoulder movement, and (3) compare the changes in the CMM thickness of participants with neck pain and also of healthy individuals. Methods Twenty healthy men (age, 27.45 ± 4.37 years; height, 177 ± 4.66 cm; weight, 72.85 ± 6.46 kg) and 20 men with chronic mechanical neck pain (age, 28.90 ± 5.53 years; height, 176 ± 5.98 cm; weight, 73.15 ± 7.82 kg) participated in the study. Both the right and left CMM thicknesses were measured using an ultrasound device while participants performed isometric contraction of shoulder muscles in 6 movement directions. Results In both groups, an increment of CMM thickness followed as the increase of isometric force (P < .01).The increase of muscle thickness of healthy participants was substantially more than the chronic mechanical neck pain participants (P = .03). Although no significant difference of CMM thickness was seen among the effects of the 6 force directions (P > .05), there was a significant difference of activity noted between the left and right sides (P = .047). Conclusion The results of the present study indicate that isometric contraction of shoulder muscles caused an increase in the CMM thickness regardless of force direction. This increase was seen in both groups of healthy participants and patients with neck pain. However, less thickness changes were observed in participants with neck pain, which may be interpreted as reduced CMM activity in such people.


      PubDate: 2015-07-02T09:10:12Z
       
  • Passive Range of Movement of the Shoulder: A Standardized Method for
           Measurement and Assessment of Intrarater Reliability
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3
      Author(s): Justin Dougherty , Sarah Walmsley , Peter G. Osmotherly
      Objective The purpose of this study was to determine the intrarater reliability and reproducibility of a standardized procedure for measuring passive shoulder movement in asymptomatic individuals. Methods A single assessor used a digital inclinometer and standardized protocol to measure the passive range of motion of 7 shoulder movements in 168 asymptomatic shoulders. Following a warm-up maneuver, 3 measurements were taken for each movement on 2 occasions. Both shoulders were measured using a standardized order of movement. Selection of measurement beginning with left or right shoulder was randomly determined. The entire process was repeated 7 days later to assess reproducibility. Intraclass correlation coefficients (ICCs) with 95% confidence intervals and standard errors of measurement (SEMs) were calculated to assess the intrarater reliability of the methods. Results The intrarater reliability of our methods was substantial for total shoulder flexion (ICC = 0.82, SEM = 12.3°), whereas all other movements demonstrated moderate reliability (ICC range = 0.64-0.75) except external rotation in neutral abduction, for which reliability was classed as slight (ICC = 0.28, SEM = 31°). Moderate reliability was evident for all movements on follow-up at 7 days (ICC range = 0.60-0.77). Conclusions These methods of measurement have moderate to substantial reliability for the majority of tested passive shoulder movements, with moderate reliability sustained after 1 week, in a large sample of asymptomatic individuals.


      PubDate: 2015-07-02T09:10:12Z
       
  • Comparison of Parameters Characterizing Lumbar Lordosis in Radiograph and
           Photogrammetric Examination of Adults
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3
      Author(s): Justyna Drzał-Grabiec , Aleksandra Truszczyńska , Adam Tarnowski , Maciej Płaszewski
      Objective The purpose of this study was to test validity of photogrammetry compared with radiography as a method of measuring the Cobb angle and the size of anterior-posterior spine curvatures in adults. Methods The study included 50 volunteers, 23 men and 27 women whose mean age was 52.6 years. The average weight of the subjects was 81.3 kg, average body height was 172.0 cm, and the average body mass index was 27.4. Based on radiologic examination, the length and depth of lumbar lordosis were determined and the size of the Cobb angle of lumbar scoliosis. After the radiologic examination, a photogrammetric test was performed for each subject with the projection moire phenomenon. Results The Pearson correlation found statistically significant associations concerning the length of lordosis (P < .001) and the Cobb angle (P < .001). Correlation of the depth of lordosis indicated a strong trend (P = .063). Conclusions This study found that the moire method of photogrammetric measurement produced similar findings to radiographic measurements in determining size of the Cobb angle and the length of lumbar lordosis.


      PubDate: 2015-07-02T09:10:12Z
       
  • Evaluation of Palpation, Pressure Algometry, and Electromyography for
           Monitoring Trigger Points in Young Participants
    • Abstract: Publication date: March–April 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 3
      Author(s): Marcin Wytrążek , Juliusz Huber , Joanna Lipiec , Aleksandra Kulczyk
      Objective The aims of this study were to assess trigger points (TrPs), their pain threshold, and the activity of motor units in the neck and shoulder girdle muscles of young volunteers and to assess palpation, algometry, and surface electromyography (EMG) for their detection. Methods Seventy participants aged from 19 to 26 years (20.6 ± 1.4 years [mean ± SD]) were examined to identify TrPs through palpation, an algometer test for pressure pain threshold (PPT), a test for the activity of muscle motor units at rest (rEMG) and at maximal contraction (mcEMG) with surface EMG recordings. Results Palpation studies revealed numerous symmetrical nonreferring latent TrPs (379/560 performed tests), referring latent TrPs (91/560), and few active TrPs (4/560). Algometry confirmed the lowest PPT in active TrPs and the highest PPT in participants with no TrPs (86/560). Pressure pain thresholds were lower in nonpregnant women than in men, especially in the trapezius and sternocleidomastoid muscles with nonreferring and referring latent TrPs. Trigger points evoked a moderate increase of rEMG amplitude but with no evident changes in mcEMG. Conclusions This study showed that the preliminary algometry and rEMG recordings monitored a decrease in PPT and an increase in muscle tension in all cases of TrPs in each of the 3 types detected in people younger than 30 years.


      PubDate: 2015-07-02T09:10:12Z
       
  • The Chiropractic Hospital-Based Interventions Research Outcomes Study:
           Consistency of Outcomes Between Doctors of Chiropractic Treating Patients
           With Acute Lower Back Pain
    • Abstract: Publication date: Available online 24 June 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jeffrey A. Quon , Paul B. Bishop , Brian Arthur
      Objective The aim of this study was to determine if effectiveness differs between community-based doctors of chiropractic administering standardized evidence-based care that includes high-velocity low-amplitude spinal manipulative therapy (SMT) for acute low back pain (LBP). Methods A secondary analysis of randomized controlled trial and observational pilot study data was performed with nonrandom allocation to 4 DCs. Patients included those with Quebec Task Force categories less than or equal to 2 and acute LBP of 2 to 4 weeks' duration. The intervention provided was clinical practice guidelines–based care including high-velocity low-amplitude SMT. Primary outcomes included changes from baseline in modified Roland Disability Questionnaire (RDQ) at 24 weeks. Comparisons of simple main effects at 24 weeks and of marginal main effects in repeated-measures analyses were performed. Results Between groups, adjusted point-specific differences in RDQ change were minimally clinically important but not statistically significant at 24 weeks (largest pairwise difference, −3.1; 95% confidence interval, −6.3 to 0.1; overall P = .10). However, in optimal analyses that considered the repeated nature of the measurements for each outcome, significant differences in marginal mean RDQ changes were found between groups (largest pairwise difference, −3.8; 95% confidence interval, −4.9 to 2.6; overall P = .03). Conclusions Overall, DCs differed modestly in their effectiveness in improving LBP-specific disability. The point estimates mirrored typically reported effect sizes from recent systematic reviews of SMT; however, confidence limits did not exclude clinically negligible effects.


      PubDate: 2015-06-27T02:56:52Z
       
  • Kinematic Comparison and Description of the 3-Dimensional Shoulder
           Kinematics of 2 Shoulder Rotation Tests
    • Abstract: Publication date: Available online 1 May 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Augusto Gil Pascoal , Nuno Morais
      Objectives The purpose of this study was to compare shoulder external rotation range of motion (ROM) during the hand-behind-neck (HBN) test and a standard shoulder external rotation test and to describe the 3-dimensional scapular motion during the HBN test. Methods An electromagnetic tracking device was used to assess the dominant shoulder of 14 healthy participants while performing active full ROM in a standard shoulder external rotation test in an elevated position (EREP) and in the HBN test. The humeral and scapular 3-dimensional positions at the end of EREP and HBN were compared using a paired-sample t test. A correlation analysis was performed between humeral and scapular angles to assess the contribution of scapular motion to the full shoulder ROM during the HBN test. Results No significant differences were found between the HBN test and the EREP at the end-range of the glenohumeral external rotation (HBN: 15.6° ± 6.3° vs EREP: 23.4° ± 4.7°; P = .08) and on scapular internal-external rotation (HBN test: 21.2° ± 6.3° vs EREP: 15.6° ± 1.8°; P = .23). Significant differences were found in scapular upward rotation (HBN: 21.2° ± 6.3° vs EREP: 15.6° ± 1.8°; P < .01) and scapular spinal tilt (HBN: −0.4° ± 2.3° vs EREP: 8.1° ± 2.1°; P < .01). There was a positive correlation between the humeral angles and scapular internal and posterior spinal tilt angles with the HBN test. Conclusions The results of the present study showed that, in young asymptomatic participants with no known shoulder pathology, the end-range of shoulder rotation was similar in the HBN test and in a standard shoulder rotation test. During the HBN test, the scapula assumed a more internal and anterior spinal tilted position at the end-range of active shoulder external rotation. These results suggest that the HBN test may be used to assess the end-range of glenohumeral external rotation.


      PubDate: 2015-05-05T09:18:57Z
       
  • Clinical Outcomes for Neurogenic Claudication Using a Multimodal Program
           for Lumbar Spinal Stenosis: A Retrospective Study
    • Abstract: Publication date: Available online 22 January 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Carlo Ammendolia , Ngai Chow
      Objective The purpose of this preliminary study was to assess the effectiveness of a 6-week, nonsurgical, multimodal program that addresses the multifaceted aspects of neurogenic claudication. Methods In this retrospective study, 2 researchers independently extracted data from the medical records from January 2010 to April 2013 of consecutive eligible patients who had completed the 6-week Boot Camp Program. The program consisted of manual therapy twice per week (eg, soft tissue and neural mobilization, chiropractic spinal manipulation, lumbar flexion-distraction, and muscle stretching), structured home-based exercises, and instruction of self-management strategies. A paired t test was used to compare differences in outcomes from baseline to 6-week follow-up. Outcomes included self-reported pain, disability, walking ability, and treatment satisfaction. Results A total of 49 patients were enrolled, with a mean age of 70 years. The mean difference in the Oswestry Disability Index was 15.2 (95% confidence interval [CI], 11.39-18.92), and that for the functional and symptoms scales of the Swiss Spinal Stenosis Questionnaire was 0.41 (95% CI, 0.26-0.56) and 0.74 (95% CI, 0.55-0.93), respectively. Numeric pain scores for both leg and back showed statistically significant improvements. Improvements in all outcomes were clinically important. Conclusions This study showed preliminary evidence for improved outcomes in patients with neurogenic claudication participating in a 6-week nonsurgical multimodal Boot Camp Program.


      PubDate: 2015-01-22T15:15:45Z
       
 
 
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