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Journal of Manipulative and Physiological Therapeutics    [5 followers]  Follow    
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 0161-4754
     Published by Elsevier Homepage  [2556 journals]   [SJR: 0.965]   [H-I: 45]
  • 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
       
  • Influence of Foot Orthotics Upon Duration of Effects of Spinal
           Manipulation in Chronic Back Pain Patients: A Randomized Clinical Trial
    • Abstract: Publication date: Available online 9 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Anthony L. Rosner , Katharine M. Conable , Tracy Edelmann
      Objective The purpose of this study was to investigate the effects of 4 weeks of custom foot orthotics on pain, disability, recurrence of spinal fixation, and muscle dysfunction in adult low back pain patients receiving limited chiropractic care. Methods Adult volunteers with low back pain of greater than or equal to 1 month's duration were randomized to receive custom orthotics (group A) or a flat insole sham (group B) with limited chiropractic care in 5 visits over 4 weeks. Primary outcome measures are as follows: Quadruple Numerical Pain Rating Scale (for back), the Roland-Morris Disability Questionnaire, the number of muscles grade 4 or lower on manual muscle testing, and the number of spinal fixations detected by motion palpation and vertebral challenge at intake (B1), 2 weeks later before treatment began and orthotic use was initiated (B2) and before each subsequent treatment at approximately days 3, 10, 17, and 24 after B2. Secondary outcome measures are correlations of all primary outcomes. Results Both groups improved on all Numerical Pain Rating Scale, Roland-Morris Disability Questionnaire, and the number of muscles from intake (B1) to final visit. Only group B yielded significant improvements in the number of spinal fixations. No outcome measures showed statistical difference between groups at any time point; however, those who wore custom orthotics longer each day showed trends toward greater improvements in some outcome measures. Conclusions Both groups improved with chiropractic care including spinal manipulation; however, there were no statistical differences shown between sham and custom orthotic groups. Future studies should formally measure the time that orthotics or shams are worn in a weight-bearing capacity each day.


      PubDate: 2014-01-11T00:59:16Z
       
  • Comparison of Massage Based on the Tensegrity Principle and Classic
           Massage in Treating Chronic Shoulder Pain
    • Abstract: Publication date: Available online 8 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Graham Scarr



      PubDate: 2014-01-11T00:59:16Z
       
  • Letter Reply
    • Abstract: Publication date: Available online 8 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Krzysztof Kassolik , Waldemar Andrzejewski , Iwona Wilk , Donata Kurpas



      PubDate: 2014-01-11T00:59:16Z
       
  • Neural Responses to the Mechanical Parameters of a High-Velocity,
           Low-Amplitude Spinal Manipulation: Effect of Preload Parameters
    • Abstract: Publication date: Available online 3 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): William R. Reed , Cynthia R. Long , Gregory N. Kawchuk , Joel G. Pickar
      Objective The purpose of this study was to determine how the preload that precedes a high-velocity, low-amplitude spinal manipulation (HVLA-SM) affects muscle spindle input from lumbar paraspinal muscles both during and after the HVLA-SM. Methods Primary afferent activity from muscle spindles in lumbar paraspinal muscles were recorded from the L6 dorsal root in anesthetized cats. High-velocity, low-amplitude spinal manipulation of the L6 vertebra was preceded either by no preload or systematic changes in the preload magnitude, duration, and the presence or absence of a downward incisural point. Immediate effects of preload on muscle spindle responses to the HVLA-SM were determined by comparing mean instantaneous discharge frequencies (MIF) during the HVLA-SM's thrust phase with baseline. Longer lasting effects of preload on spindle responses to the HVLA-SM were determined by comparing MIF during slow ramp and hold movement of the L6 vertebra before and after the HVLA-SM. Results The smaller compared with the larger preload magnitude and the longer compared with the shorter preload duration significantly increased (P = .02 and P = .04, respectively) muscle spindle responses during the HVLA-SM thrust. The absence of preload had the greatest effect on the change in MIF. Interactions between preload magnitude, duration, and downward incisural point often produced statistically significant but arguably physiologically modest changes in the passive signaling properties of the muscle spindle after the manipulation. Conclusion Because preload parameters in this animal model were shown to affect neural responses to an HVLA-SM, preload characteristics should be taken into consideration when judging this intervention's therapeutic benefit in both clinical efficacy studies and in clinical practice.


      PubDate: 2014-01-07T04:00:52Z
       
  • Intertester Agreement and Validity of Identifying Lumbar Pain Provocative
           Movement Patterns Using Active and Passive Accessory Movement Tests
    • Abstract: Publication date: Available online 6 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Benjamin Hidalgo , Toby Hall , Henri Nielens , Christine Detrembleur
      Objective The purpose of this study was to evaluate the interexaminer agreement and validity of active and passive pain provocation tests in the lumbar spine. Methods Two blinded raters examined 36 participants, 18 of whom were asymptomatic and 18 reported subacute nonspecific low back pain (LBP). Two types of pain provocation tests were performed: (1) physiological movements in single (flexion/extension) and, when necessary, combined planes and (2) passive accessory intervertebral movement tests of each lumbar vertebra in prone with the lumbar spine in neutral, flexion, and extension position. Results The interobserver agreement in both groups was good to excellent for the identification of flexion (κ = 0.87-1) or extension (κ = 0.65-0.74) as the most painful pattern of spinal movement. In healthy participants, 0% was identified as having a flexion provocative pattern and 8.8% were identified as having an extension provocative pattern. In the LBP group, 20% were identified as having a flexion provocative pattern vs 60% with an extension provocative pattern. The average interexaminer agreement for passive accessory intervertebral movement tests in both groups was moderate to excellent (κ = 0.42-0.83). The examiners showed good sensitivity (0.67-0.87) and specificity (0.82-0.85) to distinguish participants with LBP using this combined examination procedure. Conclusion The use of a combination of pain provocative tests was found to have acceptable interexaminer reliability and good validity in identifying the main pain provocative movement pattern and the lumbar segmental level of involvement. These pain provocation tests were able to distinguish participants with LBP from asymptomatic participants and may help clinicians in directing manual therapy treatment.


      PubDate: 2014-01-07T04:00:52Z
       
  • 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
       
  • Intraexaminer and Interexaminer Reliability of Manual Palpation and
           Pressure Algometry of the Lower Limb Nerves in Asymptomatic Subjects
    • Abstract: Publication date: Available online 3 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Caitriona P. Fingleton , Lucy Dempsey , Keith Smart , Catherine M. Doody
      Objective Nerve palpation is a method of clinically identifying mechanosensitivity of neural tissue by means of pressure algometry and manual palpation. There are few investigations of the reliability of lower limb nerve palpation, and femoral nerve palpation has never been previously reported. The aim of this study was to investigate the reliability of nerve palpation of the femoral, sciatic, tibial, and common peroneal nerves and to report normative values for the femoral nerve. Methods The 4 lower limb nerves were palpated in 39 healthy volunteers using pressure algometry and manual digital palpation. Measurements were taken twice by 1 rater (intrarater reliability) and once by a second rater (interrater reliability). Results Intraclass correlation coefficients for pressure pain thresholds (PPTs) via pressure algometry of the femoral, common peroneal, tibial, and sciatic nerves were 0.69, 0.84, 0.64, and 0.9 for intrarater reliability, respectively, and 0.82, 0.7, 0.56, and 0.75 for interrater reliability. κ Values for manual palpation were 0.59, 0.55, 0.42, and 0.60 for intrarater reliability and 0.30, 0.49, 0.37, and 0.60 for interrater reliability. Males demonstrated significantly higher PPTs than females for the femoral, sciatic, and tibial nerves, and differences in PPTs were present between right and left sides. Conclusion Nerve palpation of the femoral, common peroneal, and sciatic nerves using pressure algometry demonstrated good to excellent reliability, whereas the tibial nerve PPTs showed moderate to good reliability. Manual palpation measurements demonstrated fair to moderate reliability.


      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
       
  • The Association Between Cervical Spine Manipulation and Carotid Artery
           Dissection: A Systematic Review of the Literature
    • Abstract: Publication date: Available online 3 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Chadwick L.R. Chung , Pierre Côté , Paula Stern , Georges L'Espérance
      Objective Controversy surrounds the safety of cervical spine manipulation. Ischemic stroke secondary to cervical spine manipulation is a hypothesized adverse event. In Canada, the seriousness of these events and their perceived association to cervical spine manipulation has led some members of the public to call for a ban of the procedure. The primary objective of this study was to determine the incidence of internal carotid artery (ICA) dissection after cervical spine manipulation in patients who experience neck pain and its associated disorders. The secondary objective was to determine whether cervical spine manipulation is associated with an increased risk of ICA dissection in patients with neck pain, upper back pain, or headaches. Methods We systematically searched MEDLINE, CINAHL, Alternative Health, AMED, Index to Chiropractic Literature, and EMBASE from 1970 to November 2012. Two independent reviewers used standardized criteria to screen the eligibility of articles. We considered cohort studies, case-control studies, and randomized clinical trials that addressed our objectives. We planned to critically appraise eligible articles using the Scottish Intercollegiate Guideline Network methodology. Results We did not find any epidemiologic studies that measured the incidence of cervical spine manipulation and ICA dissection. Similarly, we did not find any studies that determined whether cervical spine manipulation is associated with ICA dissection. Conclusions The incidence of ICA dissection after cervical spine manipulation is unknown. The relative risk of ICA dissection after cervical spine manipulation compared with other health care interventions for neck pain, back pain, or headache is also unknown. Although several case reports and case series raise the hypothesis of an association, we found no epidemiologic studies that validate this hypothesis.


      PubDate: 2014-01-07T04:00:52Z
       
  • Effect of Chiropractic Manipulation on Vertical Jump Height in Young
           Female Athletes with Talocrural Joint Dysfunction: A Single-Blind
           Randomized Clinical Pilot Trial
    • Abstract: Publication date: Available online 2 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Sofia Hedlund , Hans Nilsson , Markus Lenz , Tobias Sundberg
      Objective The main objective of this pilot study was to explore the effect of chiropractic high-velocity, low-amplitude (HVLA) manipulation on vertical jump height in young female athletes with talocrural joint dysfunction. Methods This was a randomized assessor-blind clinical pilot trial. Twenty-two female handball players with talocrural joint dysfunction were randomized to receive either HVLA manipulation (n = 11) or sham treatment (n = 11) once a week during a 3-week period. The main outcome was change in vertical jump height from baseline to follow-up within and between groups after 3 weeks. Results Nineteen athletes completed the study. After 3 weeks, the group receiving HVLA manipulation (n = 11) had a statistically significant mean (SD) improvement in vertical jump height of 1.07 (1.23) cm (P = .017). The sham treatment group (n = 8) improved their vertical jump height by 0.59 (2.03) cm (P = .436). The between groups' change was 0.47 cm (95% confidence interval, −1.31 to 2.26; P = .571) in favor of the group receiving HVLA manipulation. Blinding and sham procedures were feasible, and there were no reported adverse events. Conclusion The results of this pilot study show that a larger-scale study is feasible. Preliminary results suggest that chiropractic HVLA manipulation may increase vertical jump height in young female athletes with talocrural joint dysfunction. However, the clinical result in favor of HVLA manipulation compared with sham treatment needs statistical confirmation in a larger randomized clinical trial.


      PubDate: 2014-01-03T05:14:39Z
       
  • Thank You to JMPT Peer Reviewers for 2012
    • Abstract: Publication date: Available online 31 December 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Claire Johnson
      This article recognizes editorial board members and peer reviewers who completed manuscript reviews for the Journal of Manipulative and Physiological Therapeutics in the year 2012 and provides a summary of international representation of both published papers and peer reviewers.


      PubDate: 2014-01-03T05:14:39Z
       
  • Evaluation of Physical Function in Individuals 11 to 14 Years After
           Anterior Cervical Decompression and Fusion Surgery—A Comparison
           Between Patients and Healthy Reference Samples and Between 2 Surgical
           Techniques
    • Abstract: Publication date: Available online 2 January 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Anna M.K. Hermansen , Joshua A. Cleland , Ann-Sofi C. Kammerlind , Anneli L.C. Peolsson
      Objective The purpose of this study was to evaluate neck-related physical function in individuals 11 to 14 years after anterior cervical decompression and fusion (ACDF) surgery for degenerative cervical disk disease and to compare the long-term outcome of 2 surgical techniques, including the Cloward procedure and cervical intervertebral fusion cage. Methods In this cross-sectional study, 51 individuals, 11 years or more after ACDF, underwent testing of cervical active range of motion, hand-grip strength, static and dynamic balance, neck muscle endurance, and completed pain ratings. The participants' values were compared with values of age- and sex-matched healthy individuals to evaluate impairments. Correlations between different test scores and pain were performed. Group differences were analyzed between the 2 surgical techniques. Results Sixty-five percent and 82% exhibited impairment in ventral and dorsal neck muscle endurance, respectively. Impairment rates of 18% to 39% for cervical active range of motion, 27% to 43% for hand-grip strength, 37% for standing balance, and 35% for dynamic balance were recorded. Twenty-nine percent of the participants had impairment (>30 mm visual analog scale) in pain. There were no significant differences in physical function between the 2 surgical treatment groups (Cloward procedure or cervical intervertebral fusion cage) (P = .10-.92). Conclusions In those studied, a large percentage of patients who had anterior cervical decompression and fusion surgery have impairments in neck-related physical function when compared 11 to 14 years after surgery with age- and sex-matched healthy reference individuals. Neck-specific function, but not balance, was statistically correlated to pain. Neck muscle endurance was most affected, and balance impairments were also present in one-third of the individuals. There were no differences in long-term physical function between the 2 surgical techniques.


      PubDate: 2014-01-03T05:14:39Z
       
  • Award-Winning Articles and Posters From the World Federation of
           Chiropractic's 12th Biennial Congress 2013
    • Abstract: Publication date: January 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 1
      Author(s): Scott Haldeman , David Chapman-Smith
      This editorial reviews the original research submissions to the World Federation of Chiropractic’s 12th Biennial Congress held in Durban, South Africa from April 10 – 13, 2013, and the four award-winning scientific articles in the NCMIC Louis Sportelli Research Awards competition at the Congress which are published in this issue of the Journal of Manipulative and Physiological Therapeutics.


      PubDate: 2013-12-30T04:00:38Z
       
  • Bilateral Cervical Dysfunction in Patients With Unilateral Lateral
           Epicondylalgia Without Concomitant Cervical or Upper Limb Symptoms: A
           Cross-Sectional Case-Control Study
    • Abstract: Publication date: Available online 28 December 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Brooke K. Coombes , Leanne Bisset , Bill Vicenzino
      Objective The purposes of this study were to examine the prevalence and distribution of spinal and neurodynamic dysfunction in a population with unilateral lateral epicondylalgia (LE) without concomitant cervical or upper limb symptoms, compare with cervical examination in a healthy control population, and investigate potential associations with clinical and demographic factors. Methods This cross-sectional study included 165 patients with LE along with 62 healthy controls. Manual examination (C4-T2) was performed by an unblinded examiner with dysfunction defined as pain of 3 or higher on a numerical rating scale in the presence of a severe or moderate hypomobility or hypermobility. Neurodynamic testing (radial nerve) was classified positive if LE symptoms were reproduced and altered by sensitization maneuver. Repeated-measures analysis of variance was used to compare sides, segmental levels, and groups. Regression analysis was used to determine associations between variables. Results Thirty-six percent of patients had dysfunction of at least 1 spinal palpation site, and 41% had a positive neurodynamic test. Significant group-by-level (P = .02) and group-by-side (P = .04) interactions were found for spinal examination, with greater dysfunction bilaterally at C4-7 (P < .01) in LE compared with control arms. The number of positive palpation sites was associated with injury duration (P = .03), whereas neurodynamic response was associated with severity of resting pain (P = .04). Conclusions Cervical dysfunction is evident in individuals with LE without obvious neck pain and may reflect central sensitization mechanisms. Further study of the nature of the relationship between cervical dysfunction and LE is required.


      PubDate: 2013-12-30T04:00:38Z
       
  • Editorial Board
    • Abstract: Publication date: January 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 1




      PubDate: 2013-12-30T04:00:38Z
       
  • Table of Contents
    • Abstract: Publication date: January 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 1




      PubDate: 2013-12-30T04:00:38Z
       
  • Information for Readers
    • Abstract: Publication date: January 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 1




      PubDate: 2013-12-30T04:00:38Z
       
  • Evidence-Based Guidelines for the Chiropractic Treatment of Adults With
           Neck Pain
    • Abstract: Publication date: Available online 19 November 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Roland Bryans , Philip Decina , Martin Descarreaux , Mireille Duranleau , Henri Marcoux , Brock Potter , Richard P. Ruegg , Lynn Shaw , Robert Watkin , Eleanor White
      Objective The purpose of this study was to develop evidence-based treatment recommendations for the treatment of nonspecific (mechanical) neck pain in adults. Methods Systematic literature searches of controlled clinical trials published through December 2011 relevant to chiropractic practice were conducted using the databases MEDLINE, EMBASE, EMCARE, Index to Chiropractic Literature, and the Cochrane Library. The number, quality, and consistency of findings were considered to assign an overall strength of evidence (strong, moderate, weak, or conflicting) and to formulate treatment recommendations. Results Forty-one randomized controlled trials meeting the inclusion criteria and scoring a low risk of bias were used to develop 11 treatment recommendations. Strong recommendations were made for the treatment of chronic neck pain with manipulation, manual therapy, and exercise in combination with other modalities. Strong recommendations were also made for the treatment of chronic neck pain with stretching, strengthening, and endurance exercises alone. Moderate recommendations were made for the treatment of acute neck pain with manipulation and mobilization in combination with other modalities. Moderate recommendations were made for the treatment of chronic neck pain with mobilization as well as massage in combination with other therapies. A weak recommendation was made for the treatment of acute neck pain with exercise alone and the treatment of chronic neck pain with manipulation alone. Thoracic manipulation and trigger point therapy could not be recommended for the treatment of acute neck pain. Transcutaneous nerve stimulation, thoracic manipulation, laser, and traction could not be recommended for the treatment of chronic neck pain. Conclusions Interventions commonly used in chiropractic care improve outcomes for the treatment of acute and chronic neck pain. Increased benefit has been shown in several instances where a multimodal approach to neck pain has been used.


      PubDate: 2013-11-19T23:05:22Z
       
  • Neural Responses of Posterior to Anterior Movement on Lumbar Vertebrae: A
           Functional Magnetic Resonance Imaging Study
    • Abstract: Publication date: Available online 12 November 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Michael L. Meier , Sabina Hotz-Boendermaker , Bart Boendermaker , Roger Luechinger , Barry Kim Humphreys
      Objective The purpose of this study was to develop and test a clinically relevant method to mechanically stimulate lumbar functional spinal units while recording brain activity by means of functional magnetic resonance imaging (MRI). Methods Subjects were investigated in the prone position with their face lying on a modified stabilization pillow. To minimize head motion, the pillow was fixed to the MRI headrest, and supporting straps were attached around the shoulders. An experienced manual therapist applied controlled, nonpainful pressure stimuli to 10 healthy subjects at 3 different lumbar vertebrae (L1, L3, and L5). Pressure applied to the thumb was used as a control. The stimulation consisted of posterior to anterior (PA) pressure movement. The therapist followed a randomized stimulation protocol projected onto a screen in the MRI room. Blood oxygenation level–dependent responses were analyzed in relation to the lumbar and the thumb stimulations. The study was conducted by the Chiropractic Department, Faculty of Medicine, University of Zürich, Switzerland. Results No participant reported any discomfort due to the prone-lying position or use of the pillow. Importantly, PA-induced pressure produced only minimal head movements. Stimulation of the lumbar spinous processes revealed bilateral neural responses in medial parts of the postcentral gyrus (S1). Additional activity was observed in the secondary somatosensory cortex (S2), posterior parts of the insular cortex, different parts of the cingulate cortex, and the cerebellum. Thumb stimulations revealed activation only in lateral parts of the contralateral S1. Conclusion The current study demonstrates the feasibility of the application of PA pressure on lumbar spinous processes in an MRI environment. This approach may serve as a promising tool for further investigations regarding neuroplastic changes in chronic low back pain subjects.


      PubDate: 2013-11-15T09:13:19Z
       
  • Changes in Vertebral Artery Blood Flow Following Various Head Positions
           and Cervical Spine Manipulation
    • Abstract: Publication date: Available online 15 November 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jairus J. Quesnele , John J. Triano , Michael D. Noseworthy , Greg D. Wells
      Objective The objective of the study was to investigate the cerebrovascular hemodynamic response of cervical spine positions including rotation and cervical spine manipulation in vivo using magnetic resonance imaging technology on the vertebral artery (VA). Methods This pilot study was conducted as a blinded examiner cohort with 4 randomized clinical tasks. Ten healthy male participants aged 24 to 30 years (mean, 26.8 years) volunteered to participate in the study. None of the participants had a history of disabling neck, arm, or headache pain within the last 6 months. They did not have any current or history of neurologic symptoms. In a neutral head position, physiologic measures of VA blood flow and velocity at the C1-2 spinal level were obtained using phase-contrast magnetic resonance imaging after 3 different head positions and a chiropractic upper cervical spinal manipulation. A total of 30 flow-encoded phase-contrast images were collected over the cardiac cycle, in each of the 4 conditions, and were used to provide a blood flow profile for one complete cardiac cycle. Differences between flow (in milliliters per second) and velocity (in centimeters per second) variables were evaluated using repeated-measures analysis of variance. Results The side-to-side difference between ipsilateral and contralateral VA velocities was not significant for either velocities (P = .14) or flows (P = .19) throughout the conditions. There were no other interactions or trends toward a difference for any of the other blood flow or velocity variables. Conclusions There were no significant changes in blood flow or velocity in the vertebral arteries of healthy young male adults after various head positions and cervical spine manipulations.


      PubDate: 2013-11-15T09:13:19Z
       
  • Examination of the Relationship Between Theory-Driven Policies and Allowed
           Lost-Time Back Claims in Workers' Compensation: A System Dynamics Model
    • Abstract: Publication date: Available online 12 November 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jessica J. Wong , Marion McGregor , Silvano A. Mior , Patrick Loisel
      Objective The purpose of this study was to develop a model that evaluates the impact of policy changes on the number of workers' compensation lost-time back claims in Ontario, Canada, over a 30-year timeframe. The model was used to test the hypothesis that a theory- and policy-driven model would be sufficient in reproducing historical claims data in a robust manner and that policy changes would have a major impact on modeled data. Methods The model was developed using system dynamics methods in the Vensim simulation program. The theoretical effects of policies for compensation benefit levels and experience rating fees were modeled. The model was built and validated using historical claims data from 1980 to 2009. Sensitivity analysis was used to evaluate the modeled data at extreme end points of variable input and timeframes. The degree of predictive value of the modeled data was measured by the coefficient of determination, root mean square error, and Theil's inequality coefficients. Results Correlation between modeled data and actual data was found to be meaningful (R 2 = 0.934), and the modeled data were stable at extreme end points. Among the effects explored, policy changes were found to be relatively minor drivers of back claims data, accounting for a 13% improvement in error. Simulation results suggested that unemployment, number of no-lost-time claims, number of injuries per worker, and recovery rate from back injuries outside of claims management to be sensitive drivers of back claims data. Conclusion A robust systems-based model was developed and tested for use in future policy research in Ontario's workers' compensation. The study findings suggest that certain areas within and outside the workers' compensation system need to be considered when evaluating and changing policies around back claims.


      PubDate: 2013-11-15T09:13:19Z
       
  • Editorial Board
    • Abstract: Publication date: November–December 2013
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 36, Issue 9




      PubDate: 2013-11-12T02:26:28Z
       
  • Table of Contents
    • Abstract: Publication date: November–December 2013
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 36, Issue 9




      PubDate: 2013-11-12T02:26:28Z
       
  • Information for Readers
    • Abstract: Publication date: November–December 2013
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 36, Issue 9




      PubDate: 2013-11-12T02:26:28Z
       
  • The Effect of Chronic Pain Intensity on the Stability Limits in Patients
           With Low Back Pain
    • Abstract: Publication date: November–December 2013
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 36, Issue 9
      Author(s): Tomasz Sipko , Michał Kuczyński
      Objective The purpose of this study was to evaluate if the intensity of recurrent chronic pain would modify postural performance in reaching the functional limits of stability (LOS) in chronic low back pain (CLBP) patients. Methods Three groups of subjects were investigated. Healthy persons comprised the asymptomatic group (n = 32) while CLBP patients (n = 36) were divided into 2 subgroups, according to the reported intensity of resting pain on a numerical rating scale: patients with low (LP) and high pain (HP) levels. The maximal displacement of the center of pressure (COP) indexing the LOS magnitude and the COP mean velocity indexing the performance in reaching LOS were calculated on a Kistler force plate during forward and backward voluntary body lean with eyes open (EO) or closed (EC). Results The forward LOS was lower in both the LP (P < .01) and HP (P < .01) subgroups than in the asymptomatic under EO and EC conditions, while no differences between the LP and HP groups were found. The backward LOS was lower in the HP group than in asymptomatic but only with EC (P = .01). Eye closure caused an increase in forward (P = .02) and backward (P = .001) COP velocity in the LP group and forward COP velocity in the asymptomatic (P = .04) only. With EC, the only intergroup difference was lower forward COP velocity in the HP than LP group (P = .04). Conclusion Subjects with CLBP had reduced forward LOS regardless the pain level. However, the higher level of pain was associated with slower execution of voluntary leaning tasks, with EC only.


      PubDate: 2013-11-12T02:26:28Z
       
  • Concordance of Upper Limb Neurodynamic Tests with Medical Examination and
           Magnetic Resonance Imaging in Patients with Cervical Radiculopathy: A
           Diagnostic Cohort Study
    • Abstract: Publication date: Available online 23 October 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Martina Apelby-Albrecht , Linda Andersson , Ingrid W. Kleiva , Kristian Kvåle , Eva Skillgate , Anna Josephson
      Objective The purpose of this study was to investigate the concordance of the upper limb neurodynamic tests (ULNTs) with a chosen reference standard, consisting of medical examination and magnetic resonance imaging (MRI), in patients with cervical radiculopathy. Methods This diagnostic cohort study included 51 consecutive patients referred to a center for spinal surgery for clinical investigation of cervical and/or arm pain in Sweden during the period of November 2007 to February 2008. The patients were exposed to the 4 different tests of ULNT. One diagnosis based on each of the tests separately and one based on the tests combined were compared with a chosen reference standard consisting of MRI, anamnestic features, and clinical examination. Results The ULNT (1-3 used combined) had a sensitivity of 0.97 and a specificity of 0.69. The results of ULNT (1-3 used combined) corresponded in 88.2% with the reference standard. Individually, the ULNT 1 (median) showed the highest validity, and ULNT 2b (radial), the lowest. Conclusion Upper limb neurodynamic test (combined) showed a substantial agreement with findings from medical examination including MRI. These results indicate the importance of ULNT (combined) to complement the clinical examination of patients with radiculopathy.


      PubDate: 2013-10-26T23:45:17Z
       
  • Effects of Unilateral Facet Fixation and Facetectomy on Muscle Spindle
           Responsiveness During Simulated Spinal Manipulation in an Animal Model
    • Abstract: Publication date: Available online 23 October 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): William R. Reed , Cynthia R. Long , Joel G. Pickar
      Objectives Manual therapy practitioners commonly assess lumbar intervertebral mobility before deciding treatment regimens. Changes in mechanoreceptor activity during the manipulative thrust are theorized to be an underlying mechanism of spinal manipulation (SM) efficacy. The objective of this study was to determine if facet fixation or facetectomy at a single lumbar level alters muscle spindle activity during 5 SM thrust durations in an animal model. Methods Spinal stiffness was determined using the slope of a force-displacement curve. Changes in the mean instantaneous frequency of spindle discharge were measured during simulated SM of the L6 vertebra in the same 20 afferents for laminectomy-only and 19 laminectomy and facet screw conditions; only 5 also had data for the laminectomy and facetectomy condition. Neural responses were compared across conditions and 5 thrust durations (≤250 milliseconds) using linear-mixed models. Results Significant decreases in afferent activity between the laminectomy-only and laminectomy and facet screw conditions were seen during 75-millisecond (P < .001), 100-millisecond (P = .04), and 150-millisecond (P = .02) SM thrust durations. Significant increases in spindle activity between the laminectomy-only and laminectomy and facetectomy conditions were seen during the 75-millisecond (P < .001) and 100-millisecond (P < .001) thrust durations. Conclusion Intervertebral mobility at a single segmental level alters paraspinal sensory response during clinically relevant high-velocity, low-amplitude SM thrust durations (≤150 milliseconds). The relationship between intervertebral joint mobility and alterations of primary afferent activity during and after various manual therapy interventions may be used to help to identify patient subpopulations who respond to different types of manual therapy and better inform practitioners (eg, chiropractic and osteopathic) delivering the therapeutic intervention.


      PubDate: 2013-10-26T23:45:17Z
       
  • Effects of Deep Cervical Flexor Training on Pressure Pain Thresholds Over
           Myofascial Trigger Points in Patients With Chronic Neck Pain
    • Abstract: Publication date: Available online 21 October 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Enrique Lluch , Maria Dolores Arguisuelas , Pablo S. Coloma , Francisco Palma , Alejandro Rey , Deborah Falla
      Objective The purpose of this study was to assess the effects of a low-load training program for the deep cervical flexors (DCFs) on pain, disability, and pressure pain threshold (PPT) over cervical myofascial trigger points (MTrPs) in patients with chronic neck pain. Methods Thirty patients with chronic idiopathic neck pain participated in a 6-week program of specific training for the DCF, which consisted of active craniocervical flexion performed twice per day (10-20 minutes) for the duration of the trial. Perceived pain and disability (Neck Disability Index, 0-50) and PPT over MTrPs of the upper trapezius, levator scapulae, and splenius capitis muscles were measured at the beginning and end of the training period. Results After completion of training, there was a significant reduction in Neck Disability Index values (before, 18.2 ± 12.1; after, 13.5 ± 10.6; P < .01). However, no significant changes in PPT were observed over the MTrPs. Conclusion Patients performing DCF training for 6 weeks demonstrated reductions in pain and disability but did not show changes in pressure pain sensitivity over MTrPs in the splenius capitis, levator scapulae, or upper trapezius muscles.


      PubDate: 2013-10-23T05:04:48Z
       
  • Referral to Massage Therapy in Primary Health Care: A Survey of Medical
           General Practitioners in Rural and Regional New South Wales, Australia
    • Abstract: Publication date: Available online 22 October 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jon L. Wardle , David W. Sibbritt , Jon Adams
      Objectives Massage therapists are an important part of the health care setting in rural and regional Australia and are the largest complementary and alternative medicine (CAM) profession based on both practitioner numbers and use. The purpose of this study was to survey medical general practitioners (GPs) in rural and regional New South Wales, Australia, to identify their knowledge, attitudes, relationships, and patterns of referral to massage therapy in primary health care. Methods A 27-item questionnaire was sent to all 1486 GPs currently practicing in rural and regional Divisions of General Practice in New South Wales, Australia. The survey had 5 general areas: the GP's personal use and knowledge of massage, the GP's professional relationships with massage practice and massage practitioners, the GP's specific opinions on massage, the GP's information-seeking behavior in relation to massage, and the GP's assumptions on massage use by patients in their local areas. Results A total of 585 questionnaires were returned completed, with 49 survey questionnaires returned as “no longer at this address” (response rate of 40.7%). More than three-quarters of GPs (76.6%) referred to massage therapy at least a few times per year, with 12.5% of GPs referring at least once per week. The GP being in a nonremote location (odds ratio [OR], 14.28; 95% confidence interval [CI], 3.7-50.0), graduating from an Australian medical school (OR, 2.03; 95% CI, 1.09-3.70), perceiving a lack of other treatment options (OR, 2.64; 95% CI, 1.15-6.01), perceiving good patient access to a wide variety of medical specialists (OR, 11.1; 95% CI, 1.7-50.0), believing in the efficacy of massage therapy (OR, 2.75; 95% CI, 1.58-4.78), experiencing positive results from patients using massage therapy previously (OR, 13.95; 95% CI, 5.96-32.64), or having prescribed any CAM previously (OR, 1.83; 95% CI, 1.03-3.27) were all independently predictive of increased referral to massage therapy among the GPs in this study. Conclusions There appears to be substantial interface between massage therapy and GPs in rural and regional Australia. There are high levels of support for massage therapies among Australian GPs, relative to other CAM professions, with low levels of opposition to the incorporation of these therapies in patient care.


      PubDate: 2013-10-23T05:04:48Z
       
  • Physiological Responses to Spinal Manipulation Therapy: Investigation of
           the Relationship Between Electromyographic Responses and Peak Force
    • Abstract: Publication date: Available online 22 October 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): François Nougarou , Claude Dugas , Constance Deslauriers , Isabelle Pagé , Martin Descarreaux
      Objective It is believed that systematic modulation of spinal manipulative therapy (SMT) parameters should yield varying levels of physiological responses and eventually a range of clinical responses. However, investigation of SMT dose–physiological response relationship is recent and has mostly been conducted using animal or cadaveric models. The main objective of the present study is to investigate SMT dose–physiological response relation in humans by determining how different levels of force can modify electromyographic (EMG) responses to spinal manipulation. Methods Twenty-six participants were subjected to 2 trials of 4 different SMT force-time profiles using a servo-controlled linear actuator motor. Normalized EMG activity of paraspinal muscles (left and right muscles at level T6 and T8) was recorded during and after SMT, and EMG values were compared across the varying levels of force. Results Increasing the level of force yielded an increase in paraspinal muscle EMG activity during the thrust phase of SMT but also in the two 250-millisecond time windows after the spinal manipulation impulse. These muscle activations quickly attenuated (500 milliseconds after spinal manipulation impulse). Conclusion The study confirmed the presence of a local paraspinal EMG response after SMT and highlighted the linear relationship between the SMT peak force and paraspinal muscle activation.


      PubDate: 2013-10-23T05:04:48Z
       
  • Trunk Neuromuscular Responses to a Single Whole-Body Vibration Session in
           Patients With Chronic Low Back Pain: A Cross-Sectional Study
    • Abstract: Publication date: Available online 22 October 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jean-Alexandre Boucher , Jacques Abboud , Jean-Daniel Dubois , Elise Legault , Martin Descarreaux , Yves Henchoz
      Objective Whole-body vibration (WBV) exercise is progressively adopted as an alternative therapeutic modality for enhancing muscle force and muscle activity via neurogenic potentiation. So far, possible changes in the recruitment patterns of the trunk musculature after WBV remain undetermined. The main objective of this study was to evaluate the short-term effects of a single WBV session on trunk neuromuscular responses in patients with chronic low back pain (cLBP) and healthy participants. Methods Twenty patients with cLBP and 21 healthy participants performed 10 trunk flexion-extensions before and after a single WBV session consisting of five 1-minute vibration sets. Surface electromyography (EMG) of erector spinae at L2-L3 and L4-L5 and lumbopelvic kinematic variables were collected during the trials. Data were analyzed using 2-way mixed analysis of variance models. Results The WBV session led to increased lumbar EMG activity during the flexion and extension phases but yielded no change in the quiet standing and fully flexed phases. Kinematic data showed a decreased contribution to the movement of the lumbar region in the second extension quartile. These effects were not different between patients with cLBP and healthy participants. Conclusions Increased lumbar EMG activity after a single WBV session most probably results from potentiation effects of WBV on lumbar muscles reflex responses. Decreased EMG activity in full trunk flexion, usually observed in healthy individuals, was still present after WBV, suggesting that the ability of the spine stabilizing mechanisms to transfer the extension torque from muscles to passive structures was not affected.


      PubDate: 2013-10-23T05:04:48Z
       
  • Reliability of the Craniocervical Posture Assessment: Visual and Angular
           Measurements using Photographs and Radiographs
    • Abstract: Publication date: Available online 18 October 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Inae C. Gadotti , Susan Armijo-Olivo , Anelise Silveira , David Magee
      Objective The purposes of this study were to determine the intrarater and interrater reliability of the craniocervical posture in a sagittal view using quantitative measurements on photographs and radiographs and to determine the agreement of the visual assessment of posture between raters. Methods One photograph and 1 radiograph of the sagittal craniocervical posture were simultaneously taken from 39 healthy female subjects. Three angles were measured on the photographs and 10 angles on the radiographs of 22 subjects using Alcimage software (Alcimage; Uberlândia, MG, Brazil). Two repeated measurements were performed by 2 raters. The measurements were compared within and between raters to test the intrarater and interrater reliability, respectively. Intraclass correlation coefficient and SEM were used. κ Agreement was calculated for the visual assessment of 39 subjects using photographs and radiographs between 2 raters. Results Good to excellent intrarater and interrater intraclass correlation coefficient values were found on both photographs and radiographs. Interrater SEM was large and clinically significant for cervical lordosis photogrammetry and for 1 angle measuring cervical lordosis on radiographs. Interrater κ agreement for the visual assessment using photographs was poor (κ = 0.37). Conclusion The raters were reliable to measure angles in photographs and radiographs to quantify craniocervical posture with exception of 2 angles measuring lordosis of the cervical spine when compared between raters. The visual assessment of posture between raters was not reliable.


      PubDate: 2013-10-18T23:43:19Z
       
  • Association of Postural Balance and Isometric Muscle Strength in Early-
           and Middle-School-Age Boys
    • Abstract: Publication date: Available online 18 October 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Alaa I. Ibrahim , Qassim I. Muaidi , Mohammed S. Abdelsalam , Ziad M. Hawamdeh , Adel A. Alhusaini
      Objective The purpose of this study was to evaluate the isometric muscle strength (IMS) and dynamic balance in early- and middle-school-age boys and to assess the strength of association between the dynamic balance scores and 6 different IMS indexes. Methods This is a cross-sectional study of a convenience sample of 94 boys who were 6 to 10 years of age and classified into an early school age (6-8 years) group (n = 50) and a middle school age (8-10 years) group (n = 44). Balance was tested using a Biodex Balance System. Anteroposterior Stability Index, Mediolateral Stability Index, and Overall Stability Index were recorded. IMS of 11 muscle groups was measured with a handheld dynamometer and categorized into 6 different muscle strength indices. Results The mean (SD) values of anteroposterior, mediolateral, and overall stability indexes observed for all study boys were 1.9 ± 1.0, 1.2 ± 0.7, and 2.5 ± 1.2 respectively. In the middle school age group, strong positive relationships were detected between the overall stability index and trunk, lower limb, anti-gravity, pro-gravity, and total strength indexes (r = –0.86/P < .001, r = –0.91/P < .001, r = –0.88/P < .001, r = –0.83/P < .001, and r = –0.84/P < .001 respectively), while no significant relationship was detected with the upper limb strength index (r = 0.159/P = .303). In the early school age group, moderate positive relationships were detected between the overall stability index and anti-gravity, lower limb, and total strength indexes (r = –0.404/P = .004, r = –0.356/P = .011, and r = –0.350/P = .013 respectively). Conclusion Dynamic balance did not appear to be mature by the age of 10 years. Better balance skills were recorded in the mediolateral direction than in the anteroposterior direction. In the middle school age group, the overall stability index had positive relationships with almost all examined muscle strength indexes excepting the upper limb strength index.


      PubDate: 2013-10-18T23:43:19Z
       
  • Chiropractic Use and Changes in Health Among Older Medicare Beneficiaries:
           A Comparative Effectiveness Observational Study
    • Abstract: Publication date: Available online 18 October 2013
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Paula Anne Weigel , Jason Hockenberry , Suzanne Bentler , Fredric D. Wolinsky
      Objective The purpose of this study was to investigate the effect of chiropractic on 5 outcomes among Medicare beneficiaries: increased difficulties performing activities of daily living (ADLs), instrumental ADLs (IADLs), and lower body functions, as well as lower self-rated health and increased depressive symptoms. Methods Among all beneficiaries, we estimated the effect of chiropractic use on changes in health outcomes among those who used chiropractic compared with those who did not, and among beneficiaries with back conditions, we estimated the effect of chiropractic use relative to medical care, both during a 2- to 15-year period. Two analytic approaches were used—one assumed no selection bias, whereas the other adjusted for potential selection bias using propensity score methods. Results Among all beneficiaries, propensity score analyses indicated that chiropractic use led to comparable outcomes for ADLs, IADLs, and depressive symptoms, although there were increased risks associated with chiropractic for declines in lower body function and self-rated health. Propensity score analyses among beneficiaries with back conditions indicated that chiropractic use led to comparable outcomes for ADLs, IADLs, lower body function, and depressive symptoms, although there was an increased risk associated with chiropractic use for declines in self-rated health. Conclusion The evidence in this study suggests that chiropractic treatment has comparable effects on functional outcomes when compared with medical treatment for all Medicare beneficiaries, but increased risk for declines in self-rated health among beneficiaries with back conditions.


      PubDate: 2013-10-18T23:43:19Z
       
  • Editorial Board
    • Abstract: Publication date: October 2013
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 36, Issue 8




      PubDate: 2013-09-28T01:21:05Z
       
 
 
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