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Journal Cover Journal of Manipulative and Physiological Therapeutics
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   Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 0161-4754
     Published by Elsevier Homepage  [2563 journals]   [SJR: 0.965]   [H-I: 45]
  • Ultrasound Imaging of the Trapeziometacarpal Articular Cavity to
           Investigate the Presence of Intraarticular Gas Bubbles After Chiropractic
           Manipulation
    • Abstract: Publication date: Available online 10 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Allan R. Jones , Christopher J. Yelverton , Charmaine Bester
      Objective The purpose of this study was to investigate the presence of intraarticular gas bubbles in the trapeziometacarpal joint cavity after chiropractic manipulation with audible cavitation and to assess the state of the gas bubbles after a 20-minute refractory period. Methods This investigation included 18 asymptomatic male and female participants between the ages of 21 and 26 years. High-resolution (15 MHz) sonograms of the trapeziometacarpal articular cavity were obtained by an experienced musculoskeletal ultrasonographer at 3 intervals: premanipulation, within 30 seconds postmanipulation, and at 20 minutes postmanipulation. The sonograms were saved as digital copies for subsequent reports that were correlated with reports compiled during dynamic visualization of the articular cavity. Data were extracted from the reports for analysis. Results The premanipulative sonograms showed that 27.78% of joints contained minute gas bubbles, also known as microcavities, within the synovial fluid before the joint was manipulated. The remaining 72.22% of joints contained no intraarticular microcavities. All of the postmanipulative sonograms revealed numerous large conspicuous gas bubbles within the synovial fluid. The postrefractory sonograms showed that, in 66.66% of the synovial fluid, gas bubbles were still visible, whereas the remaining 33.34% had no presence of gas bubbles or microcavities, and the synovial fluid had returned to its premanipulative state. Conclusion The findings of this study suggest that synovial fluid may contain intraarticular microcavities even before a manipulation is performed. Numerous large intraarticular gas bubbles are formed during manipulation due to cavitation of the synovial fluid and were observed in the absence of an axial distractive load at the time of imaging. In most cases, these gas bubbles remained within the joint for longer than 20 minutes.


      PubDate: 2014-08-15T04:48:16Z
       
  • Report of the National Institutes of Health Task Force on Research
           Standards for Chronic Low Back Pain
    • Abstract: Publication date: Available online 12 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Richard A. Deyo , Samuel F. Dworkin , Dagmar Amtmann , Gunnar Andersson , David Borenstein , Eugene Carragee , John Carrino , Roger Chou , Karon Cook , Anthony DeLitto , Christine Goertz , Partap Khalsa , John Loeser , Sean Mackey , James Panagis , James Rainville , Tor Tosteson , Dennis Turk , Michael Von Korff , Debra K. Weiner
      Objectives Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed nonspecific and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. The purpose of this article is to disseminate the report of the National Institutes of Health (NIH) task force on research standards for cLBP. Methods The NIH Pain Consortium charged a research task force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel developed a 3-stage process, each with a 2-day meeting. Results The panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimal data set to describe research subjects (drawing heavily on the Patient Reported Outcomes Measurement Information System methodology); reporting “responder analyses” in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved these recommendations, which investigators should incorporate into NIH grant proposals. Conclusions The RTF believes that these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of cLBP. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes. We expect the RTF recommendations will become a dynamic document and undergo continual improvement.


      PubDate: 2014-08-15T04:48:16Z
       
  • Development of a Neck Pain Risk Score for Predicting Nonspecific Neck Pain
           With Disability in Office Workers: A 1-Year Prospective Cohort Study
    • Abstract: Publication date: Available online 12 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Arpalak Paksaichol , Prawit Janwantanakul , Chaipat Lawsirirat
      Objective The purpose of this study was to develop a neck pain risk score for office workers (NROW) to identify office workers at risk for developing nonspecific neck pain with disability. Methods A 1-year prospective cohort study of 559 healthy office workers was conducted. At baseline, risk factors were assessed using questionnaires and standardized physical examination. The incidence of neck pain was collected every month thereafter. Disability level was evaluated using the neck disability index. Logistic regression was used to select significant factors to build a risk score. The coefficients from the logistic regression model were transformed into the components of a risk score. Results Among 535 (96%) participants who were followed up for 1 year, 23% reported incident neck pain with disability (≥5). After adjusting for confounders, the onset of neck pain with disability was significantly associated with history of neck pain, chair adjustability, and perceived muscular tension. Thus, the NROW comprises 3 questions about history of neck pain, chair adjustability, and perceived muscular tension. The NROW had scores ranging from 0 to 4. A cut-off score of at least 2 had a sensitivity of 82% and specificity of 48%. The positive and negative predictive values were 29% and 91%, respectively. The area under the receiver operating characteristic curve was 0.75. Conclusion The risk score for nonspecific neck pain with disability in office workers was developed, and it contained 3 items with scores ranging from 0 to 4. This study shows that the score appears to have reasonable sensitivity, specificity, positive predictive value, and negative predictive values for the cut-off point of at least 2.


      PubDate: 2014-08-15T04:48:16Z
       
  • Quantification of the Lumbar Flexion-Relaxation Phenomenon: Comparing
           Outcomes of Lumbar Erector Spinae and Superficial Lumbar Multifidus in
           Standing Full Trunk Flexion and Slumped Sitting Postures
    • Abstract: Publication date: Available online 7 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Alison Schinkel-Ivy , Brian C. Nairn , Janessa D.M. Drake
      Objective The purpose of this study was to identify differences in flexion-relaxation outcomes in asymptomatic participants, with respect to both flexion-relaxation phenomenon (FRP) occurrence and spinal onset angles, as a function of posture and choice of muscle being examined. Methods This was a cross-sectional study in a laboratory setting. Thirty asymptomatic participants performed standing full trunk flexion and slumped sitting postures while activation levels of the lumbar erector spinae and superficial lumbar multifidus were monitored. Two thresholds were used to define whether FRP was present in each muscle and, if present, at what trunk flexion angle it occurred. These outcomes were compared descriptively between muscles and between postures. Results Most participants displayed FRP in both muscles during standing full flexion; occurrences were more variable in slumped sitting. On average, FRP during standing full flexion and slumped sitting occurred at approximately 80% and 52% of participants' maximum flexion value, respectively. Variability in the slumped sitting onset angles was greater than that in standing full flexion. Conclusion Outcomes for FRP during standing full flexion in asymptomatic participants appeared to be more robust and were not affected by the choice of either lumbar erector spinae or superficial lumbar multifidus. Conversely, during slumped sitting, FRP occurrence varied substantially depending on choice of muscle, although onset angles were relatively consistent between muscles. Although the choice of one muscle over the other may be warranted, it may be prudent to examine both muscles during FRP investigations in sitting postures, in order to fully characterize the behavior and activation patterns of the lumbar musculature.


      PubDate: 2014-08-10T04:10:35Z
       
  • Global Body Posture and Plantar Pressure Distribution in Individuals With
           and Without Temporomandibular Disorder: A Preliminary Study
    • Abstract: Publication date: Available online 6 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Juliana A. Souza , Fernanda Pasinato , Eliane C.R. Corrêa , Ana Maria T. da Silva
      Objective The aim of this study was to evaluate body posture and the distribution of plantar pressure at physiologic rest of the mandible and during maximal intercuspal positions in subjects with and without temporomandibular disorder (TMD). Methods Fifty-one subjects were assessed by the Diagnostic Criteria for Research on Temporomandibular Disorders and divided into a symptomatic group (21) and an asymptomatic group (30). Postural analysis for both groups was conducted using photogrammetry (SAPo version 0.68; University of São Paulo, São Paulo, Brazil). The distribution of plantar pressures was evaluated by means of baropodometry (Footwork software), at physiologic rest and maximal intercuspal positions. Results Of 18 angular measurements, 3 (17%) were statistically different between the groups in photogrammetric evaluation. The symptomatic group showed more pronounced cervical distance (P = .0002), valgus of the right calcaneus (P = .0122), and lower pelvic tilt (P = .0124). The baropodometry results showed the TMD subjects presented significantly higher rearfoot and lower forefoot distribution than those in the asymptomatic group. No differences were verified in maximal intercuspal position in the between-group analysis and between the 2 mandibular positions in the within-group analysis. Conclusions Subjects with and without TMD presented with global body posture misalignment. Postural changes were more pronounced in the subjects with TMD. In addition, symptomatic subjects presented with abnormal plantar pressure distribution, suggesting that TMD may have an influence on the postural system.


      PubDate: 2014-08-10T04:10:35Z
       
  • Activation of Rectus Capitis Posterior Major Muscles During Voluntary
           Retraction of the Head in Asymptomatic Subjects
    • Abstract: Publication date: Available online 6 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Richard C. Hallgren , Jacob J. Rowan , Peng Bai , Steven J. Pierce , Gail A. Shafer-Crane , Lawrence L. Prokop
      Objective The purpose of this study was to assess levels of electromyographic activity measured from rectus capitis posterior major (RCPM) muscles of asymptomatic subjects as their heads moved from a self-defined neutral position to a retracted position. Methods A 2 × 2 within-subjects factorial research design was used. Disposable, intramuscular electrodes were used to collect electromyographic data from asymptomatic subjects between the ages of 20 and 40 years old. Data analysis was performed using mixed effects β regression models. Results Activation of RCPM muscles was found to significantly increase (P < .0001) as the head moved from a self-defined neutral position to a retracted position. Rectus capitis posterior major muscle activation levels, measured as a function of head position, have not been previously reported. Conclusions The findings from this study showed that RCPM muscle activation significantly increases during voluntary retraction of the head.


      PubDate: 2014-08-10T04:10:35Z
       
  • The Clinical and Sonographic Effects of Kinesiotaping and Exercise in
           Comparison With Manual Therapy and Exercise for Patients With Subacromial
           Impingement Syndrome: A Preliminary Trial
    • Abstract: Publication date: Available online 6 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Derya Ozer Kaya , Gul Baltaci , Ugur Toprak , Ahmet Ozgur Atay
      Objective The purpose of this study was to compare the effects of manual therapy with exercise to kinesiotaping with exercise for patients with subacromial impingement syndrome. Methods Randomized clinical before and after trial was used. Fifty-four patients diagnosed as having subacromial impingement syndrome who were referred for outpatient treatment were included. Eligible patients (between 30 and 60 years old, with unilateral shoulder pain) were randomly allocated to 2 study groups: kinesiotaping with exercise (n = 28) or manual therapy with exercise (n = 26). In addition, patients were advised to use cold packs 5 times per day to control for pain. Visual analog scale for pain, Disability of Arm and Shoulder Questionnaire for function, and diagnostic ultrasound assessment for supraspinatus tendon thickness were used as main outcome measures. Assessments were applied at the baseline and after completing 6 weeks of related interventions. Results At the baseline, there was no difference between the 2 group characteristics (P > .05). There were significant differences in both groups before and after treatment in terms of pain decrease and improvement of Disability of Arm and Shoulder Questionnaire scores (P < .05). No difference was observed on ultrasound for tendon thickness after treatment in both groups (P > .05). The only difference between the groups was at night pain, resulting in favor of the kinesiotaping with exercise group (P < .05). Conclusion For the group of subjects studied, no differences were found between kinesiotaping with exercise and manual therapy with exercise. Both treatments may have similar results in reducing pain and disability in subacromial impingement in 6 weeks.


      PubDate: 2014-08-10T04:10:35Z
       
  • A Pilot Randomized Controlled Trial of Flexion-Distraction Dosage for
           Chiropractic Treatment of Lumbar Spinal Stenosis
    • Abstract: Publication date: Available online 6 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jerrilyn A. Cambron , Michael Schneider , Jennifer M. Dexheimer , Grant Iannelli , Mabel Chang , Lauren Terhorst , Gregory D. Cramer
      Objective The purpose of this pilot clinical trial was to assess the feasibility of recruiting older adults with lumbar spinal stenosis (LSS) into a clinical trial that used different dosages of flexion-distraction manipulation. Methods This randomized controlled trial used a 4-group design. Three groups consisted of chiropractic flexion-distraction manipulation applied at different dosages (8, 12, or 18 treatments). The fourth group was given 8 treatments of placebo care. Feasibility measures included recruitment goals, adherence to various treatment schedules, credibility of the placebo treatment, and rates of adverse events. The primary outcome measure was the Swiss Spinal Stenosis Questionnaire, a validated self-report of LSS symptom severity and physical function. Results The recruitment and adherence goals of the study were met with a total of 60 subjects randomized (n = 15 per group) and most subjects attending at least 75% of their scheduled visits. No adverse events were reported by any of the subjects in the trial. Our placebo treatment did not appear to be credible; most subjects correctly guessed that they were receiving a placebo treatment. Between-group effect size estimates were small, indicating larger samples are needed for future studies. Conclusion This pilot study showed that it is feasible to recruit patients with LSS and that most subjects will adhere to a 6-week treatment schedule. The information gained from this trial will be useful to inform the design of larger trials.


      PubDate: 2014-08-10T04:10:35Z
       
  • Short Term Effects of Classic Massage Compared to Connective Tissue
           Massage on Pressure Pain Threshold and Muscle Relaxation Response in Women
           With Chronic Neck Pain: A Preliminary Study
    • Abstract: Publication date: Available online 6 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Yesim Bakar , Meral Sertel , Asuman Öztürk , Eylem Tütün Yümin , Necati Tatarli , Handan Ankarali
      Objective The purpose of this study was to evaluate the short-term effects of classic massage (CM) and connective tissue massage (CTM) on pressure pain threshold and muscle relaxation response in women with chronic neck pain. Methods Participants included 45 female volunteers (ages between 25 and 45 years) presenting to the Köroglu State Hospital Neurosurgery Polyclinic who had experienced neck pain for 3 to 6 months. The volunteers were randomly assigned to 2 groups (CM or CTM to the thoracic spine and the neck). Each treatment was carried out for 1 session. Outcome measures were obtained before and after treatment, which included pressure pain threshold that was measured with an algometer and muscle relaxation response that was evaluated with electromyography biofeedback (EMG-BF). Results Pressure pain threshold of the sternocleidomastoid muscle was significantly different for the CM (P < .05) group. The EMG-BF values were significantly different for the CTM group (P < .05). Comparing the results of CM and CTM, EMG-BF averages favored the CTM group (P < .05). Conclusion For the group of women with chronic neck pain that were included in this study, 1 treatment of CTM demonstrated relaxation responses and 1 treatment of CM demonstrated pain reduction.


      PubDate: 2014-08-10T04:10:35Z
       
  • Effectiveness of Global Postural Reeducation Compared to Segmental
           Exercises on Function, Pain, and Quality of Life of Patients With Scapular
           Dyskinesis Associated With Neck Pain: A Preliminary Clinical Trial
    • Abstract: Publication date: Available online 2 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Cinthia Santos Miotto de Amorim , Mauro Emilio Conforto Gracitelli , Amélia Pasqual Marques , Vera Lúcia dos Santos Alves
      Objective The purpose of this study was to assess the effectiveness of global postural reeducation (GPR) relative to segmental exercises (SE) in the treatment of scapular dyskinesis (SD) associated with neck pain. Methods Participants with SD and neck pain (n = 30) aged 18 to 65 years were randomly assigned to one of two groups: GPR and SE (stretching exercises). The upper extremity was assessed using the Disabilities of the Arm, Shoulder, and Hand questionnaire; function of the neck was estimated using the Neck Disability Index; pain severity was measured using a visual analogical scale; and health-related quality of life was assessed using the Short Form–12. Assessments were conducted at baseline and after 10 weekly sessions (60 minutes each). The significance level adopted was α < .05. Results For pre-post treatment comparisons, GPR was significantly associated with improvements in function of neck and upper extremities, pain, and physical and mental domains of quality of life (P < .05). Segmental exercises improved function of upper extremities and of the neck and severity of pain (P < .05). When contrasting groups, GPR was significantly superior to SE in improving pain and physical domains of the quality of life. Conclusion This study showed that GPR and SE had similar effects on function of the neck and upper extremity in patients with SD associated with neck pain. When comparing groups, GPR was superior to SE in improving pain and quality of life.


      PubDate: 2014-08-06T03:53:22Z
       
  • A Qualitative Exploration of Key Informant Perspectives Regarding the
           Nature and Impact of Contemporary Legislation on Professional Development:
           A Grounded Theory Study of Chiropractic in Denmark
    • Abstract: Publication date: Available online 2 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Corrie Myburgh
      Objective The purpose of this study was to construct a substantive framework of the manner in which the Danish government interacts with the Danish chiropractic profession and influences professional practice. Methods An exploratory, qualitative study was performed using a substantive grounded theory (GT) approach. Unstructured, face-to-face, individual interviews were conducted during the years 2012 and 2013 and thematically analyzed. Six people were interviewed for this study including a gatekeeper and witness to legislative history, a previous chiropractic political representative and witness to legislative history, a previous Department of Health negotiator and previous administrator of chiropractic affairs and witness to legislative history, a current administrator of chiropractic affairs, an active chiropractic political representative and witness to legislative history, and a chief negotiator for Danish Regional Health Care Services. Results Open and axial coding yielded 2 themes centering on licensing chiropractors in Denmark and the resultant developmental issues encountered. Through further selective coding, the GT core construct, “chiropractic practice in the Danish heath care system” emerged. The GT highlights the tension between the strategic political importance of legislation and the restrictive nature of the overly specific act currently regulating chiropractic practice. Moreover, the GT also revealed the perceived negative effect that the National Board of Health may exert on clinical practice due to its conservative interpretation of the act. Conclusions The Danish government is perceived to act as a countervailing power related to chiropractic practice. The derived substantive GT suggests that the Danish government's dualistic action relative to the Danish chiropractic community may inhibit the spontaneous evolution of contemporary Danish chiropractic practice. Although historically narrow legislation may limit chiropractic practice, conservative interpretations by the Danish National Board of Health may also play an important role.


      PubDate: 2014-08-06T03:53:22Z
       
  • The Chiropractic Scope of Practice in the United States: A Cross-Sectional
           Survey
    • Abstract: Publication date: Available online 8 July 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Mabel Chang
      Objective The purpose of this study was to assess the current status of chiropractic practice laws in the United States. This survey is an update and expansion of 3 original surveys conducted in 1987, 1992, and 1998. Methods A cross-sectional survey of licensure officials from the Federation of Chiropractic Licensing Boards e-mail list was conducted in 2011 requesting information about chiropractic practice laws and 97 diagnostic, evaluation, and management procedures. To evaluate content validity, the survey was distributed in draft form at the fall 2010 Federation of Chiropractic Licensing Boards regional meeting to regulatory board members and feedback was requested. Comments were reviewed and incorporated into the final survey. A duplicate question was imbedded in the survey to test reliability. Results Partial or complete responses were received from 96% (n = 51) of the jurisdictions in the United States. The states with the highest number of services that could be performed were Missouri (n = 92), New Mexico (n = 91), Kansas (n = 89), Utah (n = 89), Oklahoma (n = 88), Illinois (n = 87), and Alabama (n = 86). The states with the highest number of services that cannot be performed are New Hampshire (n = 49), Hawaii (n = 47), Michigan (n = 42), New Jersey (n = 39), Mississippi (n = 39), and Texas (n = 30). Conclusion The scope of chiropractic practice in the United States has a high degree of variability. Scope of practice is dynamic, and gray areas are subject to interpretation by ever-changing board members. Although statutes may not address specific procedures, upon challenge, there may be a possibility of sanctions depending on interpretation.


      PubDate: 2014-07-28T03:21:46Z
       
  • Evaluation of the Usefulness of 2 Prediction Models of Clinical Prediction
           Models in Physical Therapy: A Qualitative Process Evaluation
    • Abstract: Publication date: June 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5
      Author(s): Lieke van Oort , Arianne Verhagen , Bart Koes , Riekie de Vet , Han Anema , Martijn Heymans
      Objective The purposes of this study were to (1) evaluate the usefulness of 2 prediction models by assessing the actual use and advantages/disadvantages of application in daily clinical practice and (2) propose recommendations to enhance their implementation. Methods Physical therapists working in 283 practices in the area of Breda (the Netherlands) were invited to participate in this study. Two prediction models were presented: (1) to predict persistent shoulder pain and (2) to predict the preferable treatment in nonspecific neck pain. Participants were asked to apply both models in practice. After 2 months, their opinions about the usefulness of both models were gathered during a focus group meeting or by using an online questionnaire in order to identify the most important advantages/disadvantages of each prediction model. Results In total, 46 physical therapists (13.8%) of 39 practices participated. Evaluative data were available from 32 participants who used the shoulder model 102 times and the neck model 126 times. For the shoulder model, the most frequent advantage (mentioned 14 times) was that it enabled physical therapists to estimate a motivated prognosis, that is, a prognosis based on the score of the model. The most frequent mentioned disadvantage was that participants expressed their doubts about the validity of the model because the model initially was developed for usage in a general practice setting. For the neck model, the most frequently mentioned advantage (29 times) was that the model was easy to interpret. The most important disadvantage (mentioned 14 times) was that the model only takes a few treatment options into account. Conclusions The physical therapists participating in this study reported that both models evaluated in this study were not easy to use in daily practice. Based on the findings of this study, we recommend that these models are modified to meet the practical needs of the therapist, before assessing their impact on daily clinical care and patient outcomes.


      PubDate: 2014-07-28T03:21:46Z
       
  • Assessment of Paraspinal Muscle Hardness in Subjects With a Mild Single
           Scoliosis Curve: A Preliminary Myotonometer Study
    • Abstract: Publication date: June 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5
      Author(s): Ángel Oliva-Pascual-Vaca , Alberto Marcos Heredia-Rizo , Alejandro Barbosa-Romero , Jesús Oliva-Pascual-Vaca , Cleofás Rodríguez-Blanco , Sergio Tejero-García
      Objective The purpose of this study was to evaluate the hardness of the paraspinal muscles in the convexity and concavity of patients with scoliosis curvatures and in the upper trapezius (UT) muscle in subjects with mild idiopathic scoliosis (IS) and to observe the correlation between the myotonometer (MYO) measurements and the value of body mass index (BMI) and the Cobb angle. Methods The sample included 13 patients with a single-curve mild IS (Risser sign ≤4) at thoracic, lumbar, or thoracolumbar level (mean Cobb angle of 11.53º). Seven females and 6 males were recruited, with a mean age of 12.84 ± 3.06 (9-18) years. A MYO was used to examine the differences in muscle hardness on both sides of the scoliosis curvature at several points: (a) apex of the curve, (b) upper and lower limits of the curve, and (c) the midpoint between the apex and the upper limit and between the apex and the lower limit. The UT was also explored. Results Although the MYO recorded lower values in all points on the concave side of the scoliosis, there were no significant differences in the comparison between sides (P > .05). No association was observed between BMI and MYO values, whereas the Cobb angle negatively correlated with muscle hardness only at 2 points on the convex side. Conclusion The preliminary findings show that, in subjects with a single-curve mild IS, muscular hardness in the UT and paraspinal muscles, as assessed using a MYO, was not found to differ between the concave and the convex sides at different reference levels.


      PubDate: 2014-07-28T03:21:46Z
       
  • Changes in Kinetic, Kinematic, and Temporal Parameters of Walking in
           People With Limited Ankle Dorsiflexion: Pre-Post Application of Modified
           Mobilization With Movement Using Talus Glide Taping
    • Abstract: Publication date: June 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5
      Author(s): Ji-yeon Yoon , Young-in Hwang , Duk-hyun An , Jae-seop Oh
      Objective The purpose of this study was to investigate the changes in passive ankle dorsiflexion range of motion (ROM), maximum plantar force, force-time integral, and time to heel off during walking between pre- and postapplication of modified mobilization with movement (MWM) using talus glide taping in people with limited ankle dorsiflexion. Methods Eighteen feet with limited ankle dorsiflexion in 13 people were examined. Participants performed 3 different walking tasks in the following order: walking before and immediately after applying the modified MWM using talus glide taping and walking after 5-minute walking with the modified MWM using talus glide taping. A floor-mat pressure measurement system (HR-mat) was used to measure maximum plantar force, force-time integral, and time to heel off; and passive ankle dorsiflexion ROM was measured using a standard goniometer. The significance of differences was assessed using repeated one-way analysis of variance. Results Passive ankle dorsiflexion ROM and time to heel off were significantly increased after 5-minute walking with the modified MWM using talus glide taping compared with walking before and immediately after applying the tape. Significantly increased maximum plantar force and force-time integral on the hindfoot and significantly decreased force-time integral on the forefoot during walking after 5-minute walking were observed with the modified MWM using talus glide taping compared with before applying the tape. No significant difference between before and immediately after applying the tape was observed in any variable. Conclusions Our results suggest that walking an additional 5-minute with the modified MWM using talus glide taping increased passive ankle dorsiflexion ROM and time to heel off and improved dynamic plantar loading during walking.


      PubDate: 2014-07-28T03:21:46Z
       
  • Cost Analysis Related to Dose-Response of Spinal Manipulative Therapy for
           Chronic Low Back Pain: Outcomes From a Randomized Controlled Trial
    • Abstract: Publication date: June 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5
      Author(s): Darcy A. Vavrek , Rajiv Sharma , Mitchell Haas
      Objective The purpose of this analysis is to report the incremental costs and benefits of different doses of spinal manipulative therapy (SMT) in patients with chronic low back pain (LBP). Methods We randomized 400 patients with chronic LBP to receive a dose of 0, 6, 12, or 18 sessions of SMT. Participants were scheduled for 18 visits for 6 weeks and received SMT or light massage control from a doctor of chiropractic. Societal costs in the year after study enrollment were estimated using patient reports of health care use and lost productivity. The main health outcomes were the number of pain-free days and disability-free days. Multiple regression was performed on outcomes and log-transformed cost data. Results Lost productivity accounts for most societal costs of chronic LBP. Cost of treatment and lost productivity ranged from $3398 for 12 SMT sessions to $3815 for 0 SMT sessions with no statistically significant differences between groups. Baseline patient characteristics related to increase in costs were greater age (P = .03), greater disability (P = .01), lower quality-adjusted life year scores (P = .01), and higher costs in the period preceding enrollment (P < .01). Pain-free and disability-free days were greater for all SMT doses compared with control, but only SMT 12 yielded a statistically significant benefit of 22.9 pain-free days (P = .03) and19.8 disability-free days (P = .04). No statistically significant group differences in quality-adjusted life years were noted. Conclusions A dose of 12 SMT sessions yielded a modest benefit in pain-free and disability-free days. Care of chronic LBP with SMT did not increase the costs of treatment plus lost productivity.


      PubDate: 2014-07-28T03:21:46Z
       
  • Instantaneous Rate of Loading During Manual High-Velocity, Low-Amplitude
           Spinal Manipulations
    • Abstract: Publication date: June 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5
      Author(s): Maruti Ram Gudavalli
      Objective The objective of this study was to determine the instantaneous rate of loading during manual high-velocity, low-amplitude spinal manipulations (HVLA SMs) in the lumbar and thoracic regions and compare to the average rates of loading. Methods Force-time profiles were recorded using a hand force transducer placed between the hand of a doctor of chiropractic and the subject’s back during 14 HVLA SM thrusts on asymptomatic volunteers while 3 doctors of chiropractic delivered the spinal manipulations. Doctors also delivered 36 posterior to anterior thoracic manipulations on a mannequin. Data were collected at a sampling rate of 1000 Hz using Motion Monitor software. Force-time profile data were differentiated to obtain instantaneous rates of loading. The data were reduced using a custom-written MathCad program and analyzed descriptively. Results The instantaneous rates of loading were 1.7 to 1.8 times higher than average rates of loading, and instantaneous rates of unloading were 2.1 to 2.6 times the average rates of unloading during HVLA SMs. Maximum instantaneous rates of loading occurred 102 to 111 milliseconds prior to peak load. Maximum instantaneous rates of unloading occurred 121 to 154 milliseconds after the peak load. These data may be useful for further understanding of HVLA SMs. Conclusions The instantaneous rates of loading and where they occurred may be useful data for understanding and describing HVLA SMs.


      PubDate: 2014-07-28T03:21:46Z
       
  • The Role of Preload Forces in Spinal Manipulation: Experimental
           Investigation of Kinematic and Electromyographic Responses in Healthy
           Adults
    • Abstract: Publication date: June 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5
      Author(s): François Nougarou , Claude Dugas , Michel Loranger , Isabelle Pagé , Martin Descarreaux
      Objectives Previous studies have identified preload forces and an important feature of skillful execution of spinal manipulative therapy (SMT) as performed by manual therapists (eg, doctors of chiropractic and osteopathy). It has been suggested that applying a gradual force before the thrust increases the spinal unit stiffness, minimizing displacement during the thrust. Therefore, the main objective of this study was to assess the vertebral unit biomechanical and neuromuscular responses to a graded increase of preload forces. Methods Twenty-three participants underwent 4 different SMT force-time profiles delivered by a servo-controlled linear actuator motor and varying in their preload forces, respectively, set to 5, 50, 95, and 140N in 1 experimental session. Kinematic markers were place on T6, T7, and T8 and electromyographic electrodes were applied over paraspinal muscles on both sides of the spine. Results Increasing preload forces led to an increase in neuromuscular responses of thoracic paraspinal muscles and vertebral segmental displacements during the preload phase of SMT. Increasing the preload force also yielded a significant decrease in sagittal vertebral displacement and paraspinal muscle activity during and immediately after the thrust phase of spinal manipulation. Changes observed during the SMT thrust phase could be explained by the proportional increase in preload force or the related changes in rate of force application. Although only healthy participants were tested in this study, preload forces may be an important parameter underlying SMT mechanism of action. Future studies should investigate the clinical implications of varying SMT dosages. Conclusion The present results suggest that neuromuscular and biomechanical responses to SMT may be modulated by preload through changes in the rate of force application. Overall, the present results suggest that preload and rate of force application may be important parameters underlying SMT mechanism of action.


      PubDate: 2014-07-28T03:21:46Z
       
  • Editorial Board
    • Abstract: Publication date: June 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5




      PubDate: 2014-07-28T03:21:46Z
       
  • Table of Contents
    • Abstract: Publication date: June 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5




      PubDate: 2014-07-28T03:21:46Z
       
  • Information for Readers
    • Abstract: Publication date: June 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5




      PubDate: 2014-07-28T03:21:46Z
       
  • Effect of Spinal Manipulation Thrust Magnitude on Trunk Mechanical
           Activation Thresholds of Lateral Thalamic Neurons
    • Abstract: Publication date: June 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 5
      Author(s): William R. Reed , Joel G. Pickar , Randall S. Sozio , Cynthia R. Long
      Objectives High-velocity low-amplitude spinal manipulation (HVLA-SM), as performed by doctors who use manual therapy (eg, doctors of chiropractic and osteopathy), results in mechanical hypoalgesia in clinical settings. This hypoalgesic effect has previously been attributed to alterations in peripheral and/or central pain processing. The objective of this study was to determine whether thrust magnitude of a simulated HVLA-SM alters mechanical trunk response thresholds in wide dynamic range (WDR) and/or nociceptive specific (NS) lateral thalamic neurons. Methods Extracellular recordings were carried out in the thalamus of 15 anesthetized Wistar rats. Lateral thalamic neurons having receptive fields, which included the lumbar dorsal-lateral trunk, were characterized as either WDR (n=22) or NS (n=25). Response thresholds to electronic von Frey (rigid tip) mechanical trunk stimuli were determined in 3 directions (dorsal-ventral, 45° caudalward, and 45° cranialward) before and immediately after the dorsal-ventral delivery of a 100-millisecond HVLA-SM at 3 thrust magnitudes (control, 55%, 85% body weight). Results There was a significant difference in mechanical threshold between 85% body weight manipulation and control thrust magnitudes in the dorsal-ventral direction in NS neurons (P =.01). No changes were found in WDR neurons at either HVLA-SM thrust magnitude. Conclusions This study is the first to investigate the effect of HVLA-SM thrust magnitude on WDR and NS lateral thalamic mechanical response threshold. Our data suggest that, at the single lateral thalamic neuron level, there may be a minimal spinal manipulative thrust magnitude required to elicit an increase in trunk mechanical response thresholds.


      PubDate: 2014-07-28T03:21:46Z
       
  • Cost-Effectiveness of Manual Therapy for the Management of Musculoskeletal
           Conditions: A Systematic Review and Narrative Synthesis of Evidence From
           Randomized Controlled Trials
    • Abstract: Publication date: Available online 27 June 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Alexander Tsertsvadze , Christine Clar , Rachel Court , Aileen Clarke , Hema Mistry , Paul Sutcliffe
      Objectives The purpose of this study was to systematically review trial-based economic evaluations of manual therapy relative to other alternative interventions used for the management of musculoskeletal conditions. Methods A comprehensive literature search was undertaken in major medical, health-related, science and health economic electronic databases. Results Twenty-five publications were included (11 trial-based economic evaluations). The studies compared cost-effectiveness and/or cost-utility of manual therapy interventions to other treatment alternatives in reducing pain (spinal, shoulder, ankle). Manual therapy techniques (eg, osteopathic spinal manipulation, physiotherapy manipulation and mobilization techniques, and chiropractic manipulation with or without other treatments) were more cost-effective than usual general practitioner (GP) care alone or with exercise, spinal stabilization, GP advice, advice to remain active, or brief pain management for improving low back and shoulder pain/disability. Chiropractic manipulation was found to be less costly and more effective than alternative treatment compared with either physiotherapy or GP care in improving neck pain. Conclusions Preliminary evidence from this review shows some economic advantage of manual therapy relative to other interventions used for the management of musculoskeletal conditions, indicating that some manual therapy techniques may be more cost-effective than usual GP care, spinal stabilization, GP advice, advice to remain active, or brief pain management for improving low back and shoulder pain/disability. However, at present, there is a paucity of evidence on the cost-effectiveness and/or cost-utility evaluations for manual therapy interventions. Further improvements in the methodological conduct and reporting quality of economic evaluations of manual therapy are warranted in order to facilitate adequate evidence-based decisions among policy makers, health care practitioners, and patients.


      PubDate: 2014-07-28T03:21:46Z
       
  • Outcomes for Chronic Neck and Low Back Pain Patients After Manipulation
           Under Anesthesia: A Prospective Cohort Study
    • Abstract: Publication date: Available online 3 July 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Cynthia K. Peterson , B. Kim Humphreys , Regina Vollenweider , Michel Kressig , Rolf Nussbaumer
      Background The purpose of this study was to investigate outcomes of chronic patients unresponsive to previous spinal manipulative therapy subsequently treated with manipulation under anesthesia (MUA). Methods A prospective outcome cohort study was performed on 30 patients who had not improved with previous treatment and who underwent a single MUA by a doctor of chiropractic. The numeric rating scale for pain (NRS) and Bournemouth Questionnaire (BQ) were collected at 2weeks and 1day before MUA. At 2 and 4weeks after MUA, the Patient's Global Impression of Change, NRS, and BQ were collected. The intraclass correlation coefficient evaluated stability before treatment. Percentage of patients “improved” was calculated at 2 and 4weeks. Wilcoxon test compared pretreatment NRS and BQ scores with posttreatment scores. Mann-Whitney U test compared individual questions on the BQ between improved and not improved patients. Logistic regression compared BQ questions to “improvement.” Results Good stability of NRS and BQ scores before MUA (intraclass correlation coefficient=0.46-0.95) was found. At 2weeks, 52% of the patients reported improvement with 45.5% improved at 4weeks. Significant reductions in NRS scores at 4weeks (P =.01) and BQ scores at 2 (P =.008) and 4weeks (P =.001) were reported. Anxiety/stress levels were significantly different at 2 and 4weeks between improved and not improved patients (P =.007). None of the BQ questions were predictive of improvement. Conclusion Approximately half of patients previously unresponsive to conservative treatment reported clinically relevant improvement at 2 and 4weeks post-MUA.


      PubDate: 2014-07-28T03:21:46Z
       
  • Information for Readers
    • Abstract: Publication date: May 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 4




      PubDate: 2014-06-03T15:41:24Z
       
  • Table of Contents
    • Abstract: Publication date: May 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 4




      PubDate: 2014-06-03T15:41:24Z
       
  • Editorial Board
    • Abstract: Publication date: May 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 4




      PubDate: 2014-06-03T15:41:24Z
       
  • Immediate Changes in Neck Pain Intensity and Widespread Pressure Pain
           Sensitivity in Patients With Bilateral Chronic Mechanical Neck Pain: A
           Randomized Controlled Trial of Thoracic Thrust Manipulation vs
           Non–Thrust Mobilization
    • Abstract: Publication date: Available online 28 May 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jaime Salom-Moreno , Ricardo Ortega-Santiago , Joshua Aland Cleland , Maria Palacios-Ceña , Sebastian Truyols-Domínguez , César Fernández-de-las-Peñas
      Objective The purpose of this study was to compare the effects of thoracic thrust manipulation vs thoracic non–thrust mobilization in patients with bilateral chronic mechanical neck pain on pressure pain sensitivity and neck pain intensity. Methods Fifty-two patients (58% were female) were randomly assigned to a thoracic spine thrust manipulation group or of thoracic non–thrust mobilization group. Pressure pain thresholds (PPTs) over C5-C6 zygapophyseal joint, second metacarpal, and tibialis anterior muscle and neck pain intensity (11-point Numerical Pain Rate Scale) were collected at baseline and 10minutes after the intervention by an assessor blinded to group allocation. Mixed-model analyses of variance (ANOVAs) were used to examine the effects of the treatment on each outcome. The primary analysis was the group * time interaction. Results No significant interactions were found with the mixed-model ANOVAs for any PPT (C5-C6: P >.252; second metacarpal: P >.452; tibialis anterior: P >.273): both groups exhibited similar increases in PPT (all, P <.01), but within-group and between-group effect sizes were small (standardized mean score difference [SMD]<0.22). The ANOVA found that patients receiving thoracic spine thrust manipulation experienced a greater decrease in neck pain (between-group mean differen 1.4; 95% confidence interval, 0.8-2.1) than did those receiving thoracic spine non–thrust mobilization (P <.001). Within-group effect sizes were large for both groups (SMD>2.1), and between-group effect size was also large (SMD = 1.3) in favor of the manipulative group. Conclusions The results of this randomized clinical trial suggest that thoracic thrust manipulation and non–thrust mobilization induce similar changes in widespread PPT in individuals with mechanical neck pain; however, the changes were clinically small. We also found that thoracic thrust manipulation was more effective than thoracic non–thrust mobilization for decreasing intensity of neck pain for patients with bilateral chronic mechanical neck pain.


      PubDate: 2014-06-03T15:41:24Z
       
  • Evaluation of Peak Force of a Manually Operated Chiropractic Adjusting
           Instrument With an Adapter for Use in Animals
    • Abstract: Publication date: Available online 2 May 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Felipe Coutinho Kullmann Duarte , Carolina Kolberg , Rodrigo R. Barros , Vivian G.A. Silva , Günter Gehlen , Jakson M. Vassoler , Wania A. Partata
      Objective This study was designed to assess the peak force of a manually operated chiropractic adjusting instrument, the Activator Adjusting Instrument 4 (AAI 4), with an adapter for use in animals, which has a 3- to 4-fold smaller contact surface area than the original rubber tip. Methods Peak force was determined by thrusting the AAI 4 with the adapter or the original rubber tip onto a load cell. First, the AAI 4 was applied perpendicularly by a doctor of chiropractic onto the load cell. Then, the AAI 4 was fixed in a rigid framework and applied to the load cell. This procedure was done to prevent any load on the load cell before the thrust impulse. In 2 situations, trials were performed with the AAI 4 at all force settings (settings I, II, III, and IV, minimum to maximum, respectively). A total of 50000 samples per second over a period of 3 seconds were collected. Results In 2 experimental protocols, the use of the adapter in the AAI 4 increased the peak force only with setting I. The new value was around 80% of the maximum value found for the AAI 4. Nevertheless, the peak force values of the AAI 4 with the adapter and with the original rubber tip in setting IV were similar. Conclusion The adapter effectively determines the maximum peak force value at force setting I of AAI 4.


      PubDate: 2014-05-07T04:00:05Z
       
  • A Systematic Review of the Angular Values Obtained by Computerized
           Photogrammetry in Sagittal Plane: A Proposal for Reference Values
    • Abstract: Publication date: Available online 2 May 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Bruna Krawczky , Antonio G. Pacheco , Míriam R.M. Mainenti
      Objective Reference values for postural alignment in the coronal plane, as measured by computerized photogrammetry, have been established but not for the sagittal plane. The objective of this study is to propose reference values for angular measurements used for postural analysis in the sagittal plane for healthy adults. Methods Electronic databases (PubMed, BVS, Cochrane, Scielo, and Science Direct) were searched using the following key words: evaluation, posture, photogrammetry, and software. Articles published between 2006 and 2012 that used the PAS/SAPO (postural assessment software) were selected. Another inclusion criterion was the presentation of, at least, one of the following measurements: head horizontal alignment, pelvic horizontal alignment, hip angle, vertical alignment of the body, thoracic kyphosis, and lumbar lordosis. Angle samples of the selected articles were grouped 2 by 2 in relation to an overall average, which made possible total average, variance, and SD calculations. Results Six articles were included, and the following average angular values were found: 51.42° ± 4.87° (head horizontal alignment), −12.26° ± 5.81° (pelvic horizontal alignment), −6.40° ± 3.86° (hip angle), and 1.73° ± 0.94° (vertical alignment of the body). None of the articles contained the measurements for thoracic kyphosis and lumbar lordosis. Conclusion The reference values can be adopted as reference for postural assessment in future researches if the same anatomical points are considered.


      PubDate: 2014-05-07T04:00:05Z
       
  • Longitudinal Changes in Ventral and Dorsal Neck Muscle Layers During
           Loading Against Gravity in Healthy Volunteers Using Speckle Tracking
    • Abstract: Publication date: Available online 26 April 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Anneli Peolsson , Michael Peolsson
      Objective This study aimed to describe and compare the longitudinal mechanical activity, deformation, and deformation rate of the different layers of dorsal and ventral neck muscles in healthy volunteers during head lifts against gravity. Methods The cross-sectional study included 19 healthy volunteers (mean age, 28 years; SD, 7 years). Ultrasound with speckle-tracking analysis was used to investigate longitudinal mechanical activation, deformation, and deformation rate of dorsal and ventral neck muscles in real time during a head lift. Significance levels were set as P = .025 or P = .0125, depending on the number of comparisons. Results The dorsal neck muscles did not significantly differ in deformation (P > .04); however, the multifidus had a higher deformation rate than all other dorsal muscles (P < .003). The sternocleidomastoid had significantly higher deformation than the longus capitis (P = .005) and colli (P = .001) but a lower deformation rate than the longus colli (P = .02). Conclusion The sternocleidomastoid deformed more than the deeper muscles, but it did significantly slower than the longus colli. Among the dorsal muscles, the deepest (the multifidus) had the highest deformation rate.


      PubDate: 2014-04-27T02:07:32Z
       
  • Effect of Posterior Pelvic Tilt Taping in Women With Sacroiliac Joint Pain
           During Active Straight Leg Raising Who Habitually Wore High-Heeled Shoes:
           A Preliminary Study
    • Abstract: Publication date: Available online 26 April 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jung-hoon Lee , Won-gyu Yoo , Mi-hyun Kim , Jae-seop Oh , Kyung-soon Lee , Jin-tae Han
      Objective The purpose of this study was to assess whether a 1-day application of posterior pelvic tilt taping (PPTT) using a kinesiology tape would decrease anterior pelvic tilt and active straight leg raising test scores in women with sacroiliac joint who habitually wore high-heeled shoes. Methods Sixteen women (mean age, 23.63 ± 3.18 years) were enrolled in this study. Anterior pelvic tilt was measured using a palpation meter before PPTT application, immediately after PPTT application, 1 day after PPTT application, and immediately after PPTT removal after 1 day of application. Active straight leg raising scores were measured at the same periods. Posterior pelvic tilt taping was applied in the target position (posterior pelvic tilt position). Results The anterior pelvic tilt was decreased during and after 1 day of PPTT application (before and after kinesiology tape removal) compared with the initial angle (all P < .05). Active straight leg raising scores were decreased during and 1 day after PPTT application (before and after kinesiology tape removal) compared with the initial score (all P < .05). Conclusion The results of this preliminary study suggests that PPTT may temporarily decrease anterior pelvic tilt and active straight leg raising score in women with sacroiliac joint pain who habitually wear high-heeled shoes.


      PubDate: 2014-04-27T02:07:32Z
       
  • Function in Patients With Cervical Radiculopathy or Chronic
           Whiplash-Associated Disorders Compared With Healthy Volunteers
    • Abstract: Publication date: Available online 18 April 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Anneli Peolsson , Maria Landén Ludvigsson , Johanna Wibault , Åsa Dedering , Gunnel Peterson
      Objective The purposes of this study were to examine whether any differences in function and health exist between patients with cervical radiculopathy (CR) due to disk disease scheduled for surgery and patients with chronic whiplash-associated disorders (WADs) and to compare measures of patients' physical function with those obtained from healthy volunteers. Methods This is a cross-sectional study of patients with CR (n = 198) and patients with chronic WAD (n = 215). Patient data were compared with raw data previously obtained from healthy people. Physical measures included cervical active range of motion, neck muscle endurance, and hand grip strength. Self-rated measures included pain intensity (visual analog scale), neck disability (Neck Disability Index), self-efficacy (Self-Efficacy Scale), and health-related quality of life (EuroQol 5-dimensional self-classifier). Results Patient groups exhibited significantly lower performance than the healthy group in all physical measures (P < .0005) except for neck muscle endurance in flexion for women (P > .09). There was a general trend toward worse results in the CR group than the WAD group, with significant differences in neck active range of motion, left hand strength for women, pain intensity, Neck Disability Index, EuroQol 5-dimensional self-classifier, and Self-Efficacy Scale (P < .0001). Conclusions Patients had worse values than healthy individuals in almost all physical measures. There was a trend toward worse results for CR than WAD patients.


      PubDate: 2014-04-22T09:58:13Z
       
  • Table of Contents
    • Abstract: Publication date: March–April 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 3




      PubDate: 2014-04-07T01:48:37Z
       
  • Editorial Board
    • Abstract: Publication date: March–April 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 3




      PubDate: 2014-04-07T01:48:37Z
       
  • Information for Readers
    • Abstract: Publication date: March–April 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 3




      PubDate: 2014-04-07T01:48:37Z
       
  • Consumer Characteristics and Perceptions of Chiropractic and Chiropractic
           Services in Australia: Results from a Cross-Sectional Survey
    • Abstract: Publication date: Available online 26 March 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Benjamin T. Brown , Rod Bonello , Ramon Fernandez-Caamano , Sharyn Eaton , Petra L. Graham , Hilary Green
      Objective The purpose of this study was to describe patient characteristics and summarize their perceptions of chiropractic in Australia. Methods This study is part of a broader study aiming to extend the knowledge of the role of chiropractic within the current health care environment. A 33-item, paper-based, cross-sectional survey of a sample of patients from 100 systematically sampled chiropractic clinics from all the states and territories of Australia was conducted. The survey focused on patient demographics, socioeconomic status, perceived health status, and perceptions of chiropractic and chiropractic services. Results A total of 486 responses were received (24.3% response rate). Respondents were predominantly female patients (67.1%) of the 45- to 64-year age group. Approximately half of the respondents reported a pretax annual income exceeding $40000. Most patients sought chiropractic services because of musculoskeletal disorders (68.7%) and for general health (21.2%), and personal beliefs motivated most respondents (70.2%) to visit a chiropractor. Most respondents would seek the chiropractic services again (97.5%) and were satisfied with the service received. Conclusions The results of this study show that the typical chiropractic patient in Australia is a middle-aged woman with a moderate to high income. Although only a small proportion of the Australian population sees a chiropractor, this group seems to be satisfied with the service.


      PubDate: 2014-03-28T07:09:03Z
       
  • Multimodal Treatment of Distal Sensorimotor Polyneuropathy in Diabetic
           Patients: A Randomized Clinical Trial
    • Abstract: Publication date: Available online 20 March 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Giovanni Taveggia , Jorge H. Villafañe , Francesca Vavassori , Cristina Lecchi , Alberto Borboni , Stefano Negrini
      Objective The purpose of this study was to evaluate the effectiveness of the application of analyzing treadmill, muscle strengthening, and balance training compared with a standard care intervention in patients with diabetic neuropathy. Methods Twenty-seven patients, 63% female (mean ± standard deviations age, 72 ±9 years), with diabetic neuropathy randomly assigned to receive a multimodal manual treatment approach including analyzing treadmill with feedback focused, isokinetic dynamometric muscle strengthening, and balance retraining on dynamic balance platform or a standard care intervention for activities targeted to improve endurance, manual exercises of muscle strengthening, stretching exercises, gait, and balance exercises (5 weekly over 4 weeks). This study was designed as a double-blind, randomized clinical trial. Measures were assessed at pretreatment, 4 weeks posttreatment, and 2-month follow-up. Results No important baseline differences were observed between groups. At the end of the treatment period, the experimental group showed a significant increase in gait endurance in a 6-minute walk test, 65.6 m (F[2.0] = 9.636; P = .001). In addition, the 6-minute walk test increased after the intervention, and an even greater difference was found at follow-up (P = .005) for the standard care group. The Functional Independence Measure in both groups increased (P < .01) and continued until the follow-up in the standard care group (P = .003). Conclusions The results suggest that the experimental rehabilitation program showed positive effects on the gait endurance after 4 weeks of treatment, whereas it did not produce significant improvements of the gait speed. Both the treatments produced significant improvement of functionalities of the patient.


      PubDate: 2014-03-23T02:56:39Z
       
  • Quantification of Prone Thoracic Manipulation Using Inertial
           Sensor–Derived Accelerations
    • Abstract: Publication date: Available online 20 March 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jonathan Mark Williams , Antonio Cuesta-Vargas
      Objective The aim of this study was to determine the linear acceleration, time-to-peak acceleration, and effect of hand position comparing 2 clinicians completing a thoracic manipulation. Methods Thirteen volunteers received a right- and left-“handed” prone thoracic manipulation while accelerations were recorded by an inertial sensor. Peak thrust acceleration and time-to-peak thrust were measured. Results There were differences in thrust acceleration between right- and left-handed techniques for one therapist. The mean peak thrust acceleration was different between therapists, with the more practiced therapist demonstrating greater peak thrust accelerations. Time-to-peak acceleration also revealed between therapist differences, with the more practiced therapist demonstrating shorter time-to-peak acceleration. Cavitation data suggested that manipulations with greater accelerations were more likely to result in cavitation. Conclusion The results of this study suggest that with greater frequency of use, therapists are likely to achieve greater accelerations and shorter time-to-peak accelerations. Furthermore, this study showed that an inertial sensor can be used to quantify important variables during thoracic manipulation and are able to detect intertherapist differences in technique.


      PubDate: 2014-03-23T02:56:39Z
       
  • Effect of Dual-Tasking on Dynamic Postural Control in Individuals With and
           Without Nonspecific Low Back Pain
    • Abstract: Publication date: Available online 15 March 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Shiva Sherafat , Mahyar Salavati , Ismail Ebrahimi Takamjani , Behnam Akhbari , Shahrzad Mohammadi Rad , Masood Mazaheri , Hossein Negahben , Pezhman Lali
      Objective The purpose of this study was to compare the effect of dual tasking on postural and cognitive performance between participants with and without nonspecific chronic low back pain. Methods In this 3-factor mixed-design study, dynamic postural stability was assessed in 15 patients with chronic nonspecific low back pain and 15 age-, sex-, and size-matched asymptomatic participants. Bilateral stance on a Biodex Balance System was investigated at 3 levels of postural task difficulty (different platform stabilities levels with eyes open and closed) and 2 levels of cognitive task difficulty (with or without auditory Stroop test). We measured anterior-posterior, medial-lateral, and overall indices for postural performance. Average reaction time and error ratio of a modified auditory Stroop test were calculated as measures of the cognitive task performance. Results Mixed-design 3-way analyses of variance revealed significant interactions. Post hoc 2-way analyses of variance showed significant group by cognitive task difficulty for anterior-posterior (P < .001), medial-lateral (P = .003), and overall stability indices (P < .001) on a stiffness level of 5 with eyes closed. At this level, there were significant differences between single- and dual-task conditions for anterior-posterior (P < .001), medial-lateral (P = .02), and overall stability indices (P < .001) only in the chronic low back pain group. Also, at the most difficult postural conditions, participants with chronic low back pain increased their error ratio (P = .002), whereas matched asymptomatic individuals increased their reaction time (P < .01) of the auditory Stroop test. Conclusion Postural task performance is attenuated by cognitive loading at a moderate level of postural task difficulty. Therefore, to observe the effect of attentional demands of postural control, task difficulty should be considered.


      PubDate: 2014-03-17T20:07:06Z
       
  • The Shoulder Medial Rotation Test: An Intertester and Intratester
           Reliability Study in Overhead Athletes With Chronic Shoulder Pain
    • Abstract: Publication date: Available online 17 March 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Enrique Lluch , Josep Benítez , Lirios Dueñas , José Casaña , Yasser Alakhdar , Jo Nijs , Filip Struyf
      Objective The purpose of this study was to examine intertester and intratester reliability of the shoulder medial rotation test (MRT) and reliability differences depending on examiner expertise. Methods Seventeen athletes with chronic shoulder pain participated in the study. Four independent observers with different experience levels simultaneously rated MRT performance as “correct” or “incorrect,” after a standardized assessment protocol, the same day (for intertester reliability) and in a 7-day interval (for intratester reliability). Results The intrarater reliability was admissible for 2 experts and one novice, with κ values ranging between 0.32 to 0.76 and poor for one novice (κ <0). Interrater agreement for all 4 assessors demonstrated slight agreement (κ = 0.06; 95% confidence interval: 0.06-0.47), increasing to fair agreement (κ = 0.33; 95% confidence interval: 0.21-0.69) when comparing the MRT findings between the 2 experienced assessors. Practice with the MRT in novices only marginally improved their level of agreement. Conclusions Reliability of the MRT for detecting movement control of the shoulder girdle was fair at best for experienced examiners and poor overall. Dexterity and repetitive performance of the test is necessary for correct interpretation of the MRT.


      PubDate: 2014-03-17T20:07:06Z
       
  • Test-Retest Reliability of Handgrip Strength Measurement Using a Hydraulic
           Hand Dynamometer in Patients With Cervical Radiculopathy
    • Abstract: Publication date: Available online 11 March 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Christos Savva , Giannis Giakas , Michalis Efstathiou , Christos Karagiannis
      Objective The purpose of this study was to evaluate the test-retest reliability of handgrip strength measurement using a hydraulic hand dynamometer in patients with cervical radiculopathy (CR). Methods A convenience sample of 19 participants (14 men and 5 women; mean ± SD age, 50.5 ± 12 years) with CR was measured using a Jamar hydraulic hand dynamometer by the same rater on 2 different testing sessions with an interval of 7 days between sessions. Data collection procedures followed standardized grip strength testing guidelines established by the American Society of Hand Therapists. During the repeated measures, patients were advised to rest their upper limb in the standardized arm position and encouraged to exert 3 maximum gripping efforts. The mean value of the 3 efforts (measured in kilogram force [Kgf]) was used for data analysis. The intraclass correlation coefficient, SEM, and the Bland-Altman plot were used to estimate test-retest reliability and measurement precision. Results Grip strength measurement in CR demonstrated an intraclass correlation coefficient of 0.976, suggesting excellent test-retest reliability. The small SEM in both testing sessions (SEM1, 2.41 Kgf; SEM2, 2.51 Kgf) as well as the narrow width of the 95% limits of agreements (95% limits of agreement, −4.9 to 4.4 Kgf) in the Bland-Altman plot reflected precise measurements of grip strength in both occasions. Conclusions Excellent test-retest reliability for grip strength measurement was measured in patients with CR, demonstrating that a hydraulic hand dynamometer could be used as an outcome measure for these patients.


      PubDate: 2014-03-13T11:44:09Z
       
  • Outcomes of Acute and Chronic Patients With Magnetic Resonance
           Imaging–Confirmed Symptomatic Lumbar Disc Herniations Receiving
           High-Velocity, Low-Amplitude, Spinal Manipulative Therapy: A Prospective
           Observational Cohort Study With One-Year Follow-Up
    • Abstract: Publication date: Available online 11 March 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Serafin Leemann , Cynthia K. Peterson , Christof Schmid , Bernard Anklin , B. Kim Humphreys
      Objective The purposes of this study were to evaluate patients with low-back pain (LBP) and leg pain due to magnetic resonance imaging–confirmed disc herniation who are treated with high-velocity, low-amplitude spinal manipulation in terms of their short-, medium-, and long-term outcomes of self-reported global impression of change and pain levels at various time points up to 1 year and to determine if outcomes differ between acute and chronic patients using a prospective, cohort design. Methods This prospective cohort outcomes study includes 148 patients (between ages of 18 and 65 years) with LBP, leg pain, and physical examination abnormalities with concordant lumbar disc herniations. Baseline numerical rating scale (NRS) data for LBP, leg pain, and the Oswestry questionnaire were obtained. The specific lumbar spinal manipulation was dependent upon whether the disc herniation was intraforaminal or paramedian as seen on the magnetic resonance images and was performed by a doctor of chiropractic. Outcomes included the patient’s global impression of change scale for overall improvement, the NRS for LBP, leg pain, and the Oswestry questionnaire at 2 weeks, 1, 3, and 6 months, and 1 year after the first treatment. The proportion of patients reporting “improvement” on the patient’s global impression of change scale was calculated for all patients and acute vs chronic patients. Pretreatment and posttreatment NRS scores were compared using the paired t test. Baseline and follow-up Oswestry scores were compared using the Wilcoxon test. Numerical rating scale and Oswestry scores for acute vs chronic patients were compared using the unpaired t test for NRS scores and the Mann-Whitney U test for Oswestry scores. Logistic regression analysis compared baseline variables with “improvement.” Results Significant improvement for all outcomes at all time points was reported (P < .0001). At 3 months, 90.5% of patients were “improved” with 88.0% “improved” at 1 year. Although acute patients improved faster by 3 months, 81.8% of chronic patients reported “improvement” with 89.2% “improved” at 1 year. There were no adverse events reported. Conclusions A large percentage of acute and importantly chronic lumbar disc herniation patients treated with chiropractic spinal manipulation reported clinically relevant improvement.


      PubDate: 2014-03-13T11:44:09Z
       
  • Reliability of the Goutallier Classification in Quantifying Muscle Fatty
           Degeneration in the Lumbar Multifidus Using Magnetic Resonance Imaging
    • Abstract: Publication date: Available online 11 March 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Patrick J. Battaglia , Yumi Maeda , Aaron Welk , Brad Hough , Norman Kettner
      Objective The purpose of this study was to investigate the reliability of the Goutallier classification system (GCS) for grading muscle fatty degeneration in the lumbar multifidus (LM) using magnetic resonance imaging (MRI) examinations. Methods Lumbar spine MRI scans were obtained retrospectively from the radiology department imaging system. Two examiners (a chiropractic diagnostic imaging resident and a board certified chiropractic radiologist with 30 years of experience) independently graded each LM at the L4/5 and L5/S1 intervertebral level. ImageJ pixel analysis software (version 1.47; National Institutes of Health, Bethesda, MD) was used independently by 2 observers to quantify the percent fat of the LM and allow correlation between LM percent fat and GCS grade. Twenty-five subject MRIs were randomly selected. Magnetic resonance imaging scans were included if they were obtained using a 1.5 T imaging system and were excluded if there was evidence of spinal infection, tumor, fracture, or postoperative changes. For all tests, P < .05 was defined as significant. Results Intraobserver reliability grading LM fat ranged from a weighted κ (κ w) of 0.71 to 0.93. Mean interobserver reliability grading LM fat was κ w, 0.76 to κ w, 0.85. There was a significant (P < .001) correlation between LM percent fat and GCS grade. Furthermore, interobserver reliability in determining percent fat was between intraclass correlation coefficient, 0.73 to intraclass correlation coefficient, 0.90. Conclusions In this study, the GCS was reliable in grading LM fatty degeneration and correlated positively with a quantified percent fat value. In addition, ImageJ software (National Institutes of Health) was reliable between raters when quantifying LM percent fat.


      PubDate: 2014-03-13T11:44:09Z
       
  • The Comparative Effect of Episodes of Chiropractic and Medical Treatment
           on the Health of Older Adults
    • Abstract: Publication date: Available online 11 March 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Paula A Weigel , Jason Hockenberry , Suzanne E. Bentler , Fredric D. Wolinsky
      Objectives The comparative effect of chiropractic vs medical care on health, as used in everyday practice settings by older adults, is not well understood. The purpose of this study is to examine how chiropractic compares to medical treatment in episodes of care for uncomplicated back conditions. Episodes of care patterns between treatment groups are described, and effects on health outcomes among an older group of Medicare beneficiaries over a 2-year period are estimated. Methods Survey data from the nationally representative Survey on Assets and Health Dynamics among the Oldest Old were linked to participants' Medicare Part B claims under a restricted Data Use Agreement with the Centers for Medicare and Medicaid Services. Logistic regression was used to model the effect of chiropractic use in an episode of care relative to medical treatment on declines in function and well-being among a clinically homogenous older adult population. Two analytic approaches were used, the first assumed no selection bias and the second using propensity score analyses to adjust for selection effects in the outcome models. Results Episodes of care between treatment groups varied in duration and provider visit pattern. Among the unadjusted models, there was no significant difference between chiropractic and medical episodes of care. The propensity score results indicate a significant protective effect of chiropractic against declines in activities of daily living (ADLs), instrumental ADLs, and self-rated health (adjusted odds ratio [AOR], 0.49; AOR, 0.62; and AOR, 0.59, respectively). There was no difference between treatment types on declines in lower body function or depressive symptoms. Conclusion The findings from this study suggest that chiropractic use in episodes of care for uncomplicated back conditions has protective effects against declines in ADLs, instrumental ADLs, and self-rated health for older Medicare beneficiaries over a 2-year period.


      PubDate: 2014-03-13T11:44:09Z
       
  • Table Of Contents
    • Abstract: Publication date: February 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 2




      PubDate: 2014-01-31T23:23:32Z
       
  • Information for Readers
    • Abstract: Publication date: February 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 2




      PubDate: 2014-01-31T23:23:32Z
       
  • Editorial Board
    • Abstract: Publication date: February 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 2




      PubDate: 2014-01-31T23:23:32Z
       
  • Effects of Massage Therapy and Occlusal Splint Therapy on Mandibular Range
           of Motion in Individuals With Temporomandibular Disorder: A Randomized
           Clinical Trial
    • Abstract: Publication date: Available online 3 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Cid André Fidelis de Paula Gomes , Fabiano Politti , Daniel Ventura Andrade , Dowglas Fernando Magalhães de Sousa , Carolina Marciela Herpich , Almir Vieira Dibai-Filho , Tabajara de Oliveira Gonzalez , Daniela Aparecida Biasotto-Gonzalez
      Objective The purpose of this study was to investigate the effects of massage therapy compared with occlusal splint therapy on mandibular range of motion (ROM) in individuals with temporomandibular disorder (TMD) and compare the results with ROM obtained in a group of individuals without this disorder. Methods A blinded randomized clinical trial was conducted. Twenty-eight volunteers with TMD were randomly distributed into either a massage therapy group or an occlusal splint group. Both treatments were provided for 4 weeks. Fourteen individuals without TMD were consecutively allocated to a comparison group. Fonseca anamnestic index was used to characterize TMD and allocate the volunteers to either of the intervention groups or asymptomatic comparison group. Mandibular ROM was evaluated before and after treatment using a digital caliper. Two-way repeated-measures analysis of variance with a post hoc Bonferroni testing was used for intergroup and intragroup comparisons (level of significance was set to 5%). Cohen d was used to calculate the effect size. Results In the intragroup analysis, significant increases in ROM were found for all measures in both the massage and occlusal splint groups (P < .05). A small to moderate clinical effect of treatment with the occlusal splint was found regarding right and left lateral excursion in comparison with the massage therapy and asymptomatic comparison groups (0.2 < d < 0.5). Conclusion Massage therapy on the masticatory muscles and the use of an occlusal splint lead to an increase in mandibular ROM similar to that of the asymptomatic comparison group with regard to maximum active mouth opening and both right and left excursion in individuals with TMD.


      PubDate: 2014-01-07T04:00:52Z
       
  • Prevalence and Associated Risk Factors of Burnout Among US Doctors of
           Chiropractic
    • Abstract: Publication date: Available online 3 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Shawn P. Williams , Genevieve P. Zipp
      Objective The purpose of this study was to establish the frequency of burnout among doctors of chiropractic in the United States. Methods Using a nonprobability convenience sampling methodology, we e-mailed the Maslach Burnout Inventory–Human Services Survey and a sociodemographic questionnaire to a randomized sample of licensed doctors of chiropractic (n = 8000). Results The survey return rate was 16.06%. Twenty-one percent of the participants had high emotional exhaustion (EE), 8% had low personal accomplishment, and 8% had high depersonalization. Discussion Significant differences (P < .001) were found in the level of EE, depersonalization, and personal accomplishment as a function of sex, time dedicated to clinical care and administrative duties, source of reimbursement, the type of practice setting, the nature of practitioners' therapeutic focus, the location of chiropractic college, self-perception of burnout, the effect of suffering from a work-related injury, the varying chiropractic philosophical perspectives, and the public's opinion of chiropractic. Conclusion Although doctors of chiropractic in the United States who responded to the survey had a relatively low frequency of burnout, higher levels of EE remain workplace issues for this professional group.


      PubDate: 2014-01-07T04:00:52Z
       
 
 
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