for Journals by Title or ISSN
for Articles by Keywords
help

Publisher: Elsevier   (Total: 2970 journals)

 A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  

The end of the list has been reached or no journals were found for your choice.
Journal Cover Journal of Manipulative and Physiological Therapeutics
  [SJR: 0.841]   [H-I: 49]   [4 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0161-4754
   Published by Elsevier Homepage  [2970 journals]
  • Editorial Board
    • Abstract: Publication date: June 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 5




      PubDate: 2016-06-10T09:11:53Z
       
  • Table of Contents
    • Abstract: Publication date: June 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 5




      PubDate: 2016-06-10T09:11:53Z
       
  • Information for Readers
    • Abstract: Publication date: June 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 5




      PubDate: 2016-06-10T09:11:53Z
       
  • Trends in the Use and Characteristics of Chiropractic Services in the
           Department of Veterans Affairs
    • Abstract: Publication date: June 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 5
      Author(s): Anthony J. Lisi, Cynthia A. Brandt
      Objectives The purpose of this study was to analyze national trends and key features of the Department of Veterans Affairs’ (VA’s) chiropractic service delivery and chiropractic provider workforce since their initial inception. Methods This was a serial cross-sectional analysis of the VA administrative data sampled from the first record of chiropractic services in VA through September 30, 2015. Data were obtained from VA’s Corporate Data Warehouse and analyzed with descriptive statistics. Results From October 1, 2004, through September 30, 2015, the annual number of patients seen in VA chiropractic clinics increased from 4052 to 37349 (821.7%), and the annual number of chiropractic visits increased from 20072 to 159366 (693.9%). The typical VA chiropractic patient is male, is between the ages of 45 and 64, is seen for low back and/or neck conditions, and receives chiropractic spinal manipulation and evaluation and management services. The total number of VA chiropractic clinics grew from 27 to 65 (9.4% annually), and the number of chiropractor employees grew from 13 to 86 (21.3% annually). The typical VA chiropractor employee is a 45.9-year-old man, has worked in VA for 4.5 years, and receives annual compensation of $97860. VA also purchased care from private sector chiropractors starting in 2000, growing to 159533 chiropractic visits for 19435 patients at a cost of $11155654 annually. Conclusions Use of chiropractic services and the chiropractic workforce in VA have grown substantially over more than a decade since their introduction.


      PubDate: 2016-06-10T09:11:53Z
       
  • A Biomechanical Investigation of Selected Lumbopelvic Hip Tests:
           Implications for the Examination of Walking
    • Abstract: Publication date: Available online 27 May 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Robert Walter Bailey, Jim Richards, James Selfe
      Objectives The purpose of this study was to compare lumbopelvic hip ranges of motion during the Trendelenburg, Single Leg Squat, and Corkscrew Tests to walking and to describe the 3-dimensional lumbopelvic hip motion during the tests. This may help clinicians to select appropriate tests when examining gait. Methods An optoelectronic movement analysis tracking system was used to assess the lumbopelvic hip region of 14 healthy participants while performing Trendelenburg, Single Leg Squat, and Corkscrew Tests and walking. The lumbopelvic hip 3-dimensional ranges of movement for the clinical tests were compared with walking using a repeated-measures analysis of variance with pairwise comparisons. Results No significant differences were found between the pelvic obliquity during the Trendelenburg Test and walking (Trendelenburg Test: L, 11.3° ± 4.8°, R, 10.8° ± 5.0° vs walk: L, 8.3° ± 4.8°, R 8.3° ± 5.1°, L, P = .143, R, P = .068). Significant differences were found between the hip sagittal plane range of movement during the Single Leg Squat and walking (Single Leg Squat: L, 44.2° ±13.7°, R, 41.7° ±10.9° vs walk: 38.6° ±7.0°, R 37.8° ±5.1°, P < .05), the hip coronal plane range of movement (Single Leg Squat: L, 9.1° ±5.8°, R, 9.0° ± 4.6° vs walk: L, 9.4° ± 2.3°, R 9.5° ± 2.0°, P < .05), and the hip coronal plane range of movement during the Corkscrew Test and walking (Corkscrew: L, 5.7° ±3.3°, R, 5.7° ±3.2° vs walk: L, 9.4° ± 2.3°, R 9.5° ± 2.0°, P < .05). Conclusions The results of the present study showed that, in young asymptomatic participants with no known lumbopelvic hip pathology, the pelvic obliquity during the Trendelenburg Test and walking is similar. During the Single Leg Squat, the hip moved more in the sagittal plane and less in the coronal plane when compared with walking. There was more movement in the hip transverse plane movement during the Corkscrew Test than during walking. These results suggest that for the Trendelenburg Test to be interpreted as normal, the pelvis should achieve at least 10° of pelvic obliquity; during the Single Leg Squat, the hip should move through 43° in the sagittal plane and under 10° in the coronal plane; and for the Corkscrew Test to be interpreted as normal, the hip should move through 6° of rotation and the trunk through 27° of rotation.


      PubDate: 2016-05-31T08:28:31Z
       
  • The Accuracy of Locating Lumbar Vertebrae When Using Palpation Versus
           Ultrasonography
    • Abstract: Publication date: Available online 26 May 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Rune Mygind Mieritz, Gregory Neil Kawchuk
      Objectives The purpose of this study was to determine the accuracy of locating lumbar vertebrae using palpation vs ultrasonography. Methods In this study, ultrasonic imaging was used by 2 experienced clinicians to identify the third lumbar spinous process (target) of a female participant. The target was then located by 16 undergraduate chiropractic students using clinical palpation techniques learned in their academic program (with participant seated and prone) and ultrasonic imaging learned through a 5-minute training video. Presumed target locations identified by students were recorded by infrared motion capture equipment. The coordinates of the presumed target site were then compared statistically. Results There was no significant difference between the presumed target position identified by the students using sitting and prone palpation (P = .346). These positions were significantly different from the target location identified by expert clinicians using ultrasonic imaging (P < .0001 in both cases). The vertebra identified by ultrasonic imaging by the students was the same vertebra identified by the expert clinicians using ultrasound. This position error in the vertebra identified by palpation resulted in the students mistakenly identifying the L4 spinous process as the target vertebra. Conclusions This study found that ultrasonography provided more accurate identification of a lumbar spinal landmark when compared with palpation. In addition, our data suggest that ultrasonic imaging to identify spinal landmarks can be learned easily and can improve accuracy of landmark detection. Although the time to use ultrasonic imaging was greater than with palpation, these results suggest that this procedure could potentially be used in clinical practice to identify spinal landmarks.


      PubDate: 2016-05-26T08:00:48Z
       
  • Manual and Instrument Applied Cervical Manipulation for Mechanical Neck
           Pain: A Randomized Controlled Trial
    • Abstract: Publication date: Available online 12 May 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Lindsay M Gorrell, Kenneth Beath, Roger M Engel
      Objective The purpose of this study was to compare the effects of 2 different cervical manipulation techniques for mechanical neck pain (MNP). Methods Participants with MNP of at least 1 month’s duration (n = 65) were randomly allocated to 3 groups: (1) stretching (control), (2) stretching plus manually applied manipulation (MAM), and (3) stretching plus instrument-applied manipulation (IAM). MAM consisted of a single high-velocity, low-amplitude cervical chiropractic manipulation, whereas IAM involved the application of a single cervical manipulation using an (Activator IV) adjusting instrument. Preintervention and postintervention measurements were taken of all outcomes measures. Pain was the primary outcome and was measured using visual analogue scale and pressure pain thresholds. Secondary outcomes included cervical range of motion, hand grip-strength, and wrist blood pressure. Follow-up subjective pain scores were obtained via telephone text message 7 days postintervention. Results Subjective pain scores decreased at 7-day follow-up in the MAM group compared with control (P = .015). Cervical rotation bilaterally (ipsilateral: P = .002; contralateral: P = .015) and lateral flexion on the contralateral side to manipulation (P = .001) increased following MAM. Hand grip-strength on the contralateral side to manipulation (P = .013) increased following IAM. No moderate or severe adverse events were reported. Mild adverse events were reported on 6 occasions (control, 4; MAM, 1; IAM, 1). Conclusion This study demonstrates that a single cervical manipulation is capable of producing immediate and short-term benefits for MNP. The study also demonstrates that not all manipulative techniques have the same effect and that the differences may be mediated by neurological or biomechanical factors inherent to each technique.


      PubDate: 2016-05-15T19:59:38Z
       
  • The Relationship Between Clinical Instability and Endurance Tests, Pain,
           and Disability in Nonspecific Low Back Pain
    • Abstract: Publication date: Available online 7 May 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Carla Vanti, Cristina Conti, Federica Faresin, Silvano Ferrari, Raffaella Piccarreta
      Objective The aims of this study were (1) to investigate the relationship between clinical tests detecting spinal instability and the perceived pain and disability in nonspecific low back pain and (2) to investigate the relationship between endurance and instability tests. Methods Four instability tests (aberrant movements, active straight leg raising, prone instability test, and passive lumbar extension test) and 2 endurance tests (prone bridge test [PBT] and supine bridge test [SBT]) were performed on 101 participants. Their results were compared with the Numerical Rating Scale and the Oswestry Disability Index evaluating pain and disability, respectively. Results A low to moderate significant relationship between pain, disability, and all tests with the exception of PBT was observed. A low to moderate significant relationship between endurance tests and instability tests was also shown. The results of PBT and SBT were significantly related to the duration of symptoms (P = .0014 and P = .0203, respectively). Conclusion The results of endurance and instability tests appear to be related to the amount of pain and the disability in nonspecific low back pain. The persistence of pain significantly reduces anterior and posterior core muscle endurance.


      PubDate: 2016-05-10T19:33:34Z
       
  • Variations in Patterns of Utilization and Charges for the Care of Low Back
           Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data
           Analysis
    • Abstract: Publication date: May 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 4
      Author(s): Eric L. Hurwitz, Dongmei Li, Jenni Guillen, Michael J. Schneider, Joel M. Stevans, Reed B. Phillips, Shawn P. Phelan, Eugene A. Lewis, Richard C. Armstrong, Maria Vassilaki
      Objectives The purpose of the study was to compare utilization and charges generated by medical doctors (MD), doctors of chiropractic (DC) and physical therapists (PT) by patterns of care for the treatment of low back pain in North Carolina. Methods This was an analysis of low-back-pain-related closed claim data from the North Carolina State Health Plan for Teachers and State Employees from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the North Carolina State Health Plan using International Classification of Diseases, 9th Revision diagnostic codes for uncomplicated low back pain (ULBP) and complicated low back pain (CLBP). Results Care patterns with single-provider types and no referrals incurred the least charges on average for both ULBP and CLBP. When care did not include referral providers or services, for ULBP, MD and DC care was on average $465 less than MD and PT care. For CLBP, MD and DC care averaged $965 more than MD and PT care. However, when care involved referral providers or services, MD and DC care was on average $1600 less when compared to MD and PT care for ULBP and $1885 less for CLBP. Risk-adjusted charges (available 2006-2009) for patients in the middle quintile of risk were significantly less for DC care patterns. Conclusions Chiropractic care alone or DC with MD care incurred appreciably fewer charges for ULBP than MD care with or without PT care. This finding was reversed for CLBP. Adjusted charges for both ULBP and CLBP patients were significantly lower for DC patients.


      PubDate: 2016-05-10T19:33:34Z
       
  • Axillary Ultrasound and Laser Combined with Postisometric Facilitation in
           Treatment of Shoulder Adhesive Capsulitis: A Randomized Clinical Trial
    • Abstract: Publication date: Available online 7 May 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Haytham M. Elhafez, Salam M. Elhafez
      Objectives The purpose of this study was to compare axillary ultrasound, laser, and postisometric facilitation technique with standard care in the management of shoulder adhesive capsulitis. Methods This is a randomized clinical trial study. Fifty-nine participants with shoulder adhesive capsulitis were selected and randomly assigned for eligibility. Forty-five participants were assigned into 3 equal groups of 15, and 14 participants were excluded from the study. The participants were blinded to their group allocation. Standard care group (A) received traditional physical therapy treatment in the form of pulsed ultrasound, scanning laser, supervised exercise program, and home exercise program; group B received the same physical therapy program as group A, except that the ultrasound and scanning laser were applied to the axillary region of the painful shoulder; and group C received the same modified physical therapy program as group B plus postisometric facilitation technique to the painful shoulder. All dependent variables were measured by the second author, who was blinded to the participant's intervention group. The first author administered treatment to all 3 groups. All participants received 12 sessions (3 times/wk for 4 weeks). Pain level and shoulder range of motion (ROM; flexion, abduction, and external rotation) were recorded 3 times (pretreatment, immediately posttreatment, and 4 weeks of treatment). Results Mixed-design multivariate analysis of variance indicated significant pain reduction with significant ROM increase in all groups posttreatment and after 4 weeks. Post hoc analysis for within groups revealed that shoulder ROM and pain levels improved significantly posttreatment compared with pretreatment ROM in all groups, with the greatest improvement in group C. Between-group analysis revealed that pain-free shoulder flexion, abduction, external rotation, and pain level improved significantly in group C compared with groups A and B immediately after treatment and after 4 weeks of follow-up (P < .05). Improvements reported in group B is more than in group A, and C is more than in groups A and B. Conclusions Combining axillary ultrasound and laser with postisometric facilitation had a greater effect in reducing pain and improving shoulder ROM in patients with shoulder adhesive capsulitis compared with axillary ultrasound and laser with traditional exercise.


      PubDate: 2016-05-10T19:33:34Z
       
  • Effect of Dry Needling on Spasticity, Shoulder Range of Motion, and
           Pressure Pain Sensitivity in Patients With Stroke: A Crossover Study
    • Abstract: Publication date: Available online 7 May 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Ana Mendigutia-Gómez, Carolina Martín-Hernández, Jaime Salom-Moreno, César Fernández-de-las-Peñas
      Objective The purpose of this study was to determine the effects of the inclusion of deep dry needling (DDN) in spastic shoulder muscles into a rehabilitation program on spasticity, pressure pain sensitivity, and shoulder range of motion in subjects who had experienced a stroke. Methods A controlled, repeated-measures, crossover, double-blinded, randomized trial was conducted. Twenty patients who have had a stroke were randomly assigned to receive rehabilitation alone or rehabilitation combined with DDN over the upper trapezius, infraspinatus, subscapularis, and pectoralis mayor muscles on the spastic shoulder. Subjects received both interventions separated at least 15 days apart. Each intervention was applied once per week over 3 weeks. Spasticity (Modified Ashworth Scale), pressure pain thresholds over the deltoid and infraspinatus muscles and C5-C6 zygapophyseal joint, and shoulder range of motion were collected 1 week before and 1 week after each intervention by a blinded assessor. Results Reduction in spasticity was similar after both conditions for the upper trapezius, pectoralis major, and subscapularis muscles. A greater number of individuals receiving DDN exhibited decreased spasticity within the infraspinatus muscle. The analysis of covariance showed that all pressure pain thresholds, shoulder abduction, and external rotation of the shoulder increased significantly more after DNN intervention (P < .05). Shoulder flexion showed similar changes after both conditions. Conclusions Our results suggest that inclusion of DDN into a multimodal rehabilitation program was effective for decreasing localized pressure sensitivity and improving shoulder range of motion in individuals who had experienced stroke; however, we did not observe significant differences in muscle spasticity.


      PubDate: 2016-05-10T19:33:34Z
       
  • Variations in Patterns of Utilization and Charges for the Care of Neck
           Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data
           Analysis
    • Abstract: Publication date: May 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 4
      Author(s): Eric L. Hurwitz, Dongmei Li, Jenni Guillen, Michael J. Schneider, Joel M. Stevans, Reed B. Phillips, Shawn P. Phelan, Eugene A. Lewis, Richard C. Armstrong, Maria Vassilaki
      Objectives The purpose of the study was to compare utilization and charges generated by medical doctors (MD), doctors of chiropractic (DC) and physical therapists (PT) by provider patterns of care for the treatment of neck pain in North Carolina. Methods This was an analysis of neck-pain-related closed claim data from the North Carolina State Health Plan for Teachers and State Employees (NCSHP) from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the NCSHP using ICD-9 diagnostic codes for uncomplicated neck pain (UNP) and complicated neck pain (CNP). Results Care patterns with single-provider types and no referrals incurred the least average charges for both UNP and CNP. When care did not include referral providers or services, for either UNP or CNP, MD care with PT was generally less expensive than MD care with DC care. However, when care involved referral providers or services, MD and PT care was on average more expensive than MD and DC care for either UNP or CNP. Risk-adjusted charges for patients in the middle quintile of risk (available 2006-2009) were lower for chiropractic patients with or without medical care or referral care to other providers. Conclusions Chiropractic care alone or DC with MD care incurred appreciably fewer charges for UNP or CNP compared to MD care with or without PT care, when care included referral providers or services. This finding was reversed when care did not include referral providers or services. Risk-adjusted charges for UNP and CNP patients were lower for DC care patterns.


      PubDate: 2016-05-10T19:33:34Z
       
  • Editorial Board
    • Abstract: Publication date: May 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 4




      PubDate: 2016-05-10T19:33:34Z
       
  • Table of Contents
    • Abstract: Publication date: May 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 4




      PubDate: 2016-05-10T19:33:34Z
       
  • Information for Readers
    • Abstract: Publication date: May 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 4




      PubDate: 2016-05-10T19:33:34Z
       
  • Variations in Patterns of Utilization and Charges for the Care of Headache
           in North Carolina, 2000-2009: A Statewide Claims’ Data Analysis
    • Abstract: Publication date: May 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 4
      Author(s): Eric L. Hurwitz, Maria Vassilaki, Dongmei Li, Michael J. Schneider, Joel M. Stevans, Reed B. Phillips, Shawn P. Phelan, Eugene A. Lewis, Richard C. Armstrong
      Objectives The purpose of the study was to compare patterns of utilization and charges generated by medical doctors (MDs), doctors of chiropractic (DCs), and physical therapists (PTs) for the treatment of headache in North Carolina. Methods Retrospective analysis of claims data from the North Carolina State Health Plan for Teachers and State Employees from 2000 to 2009. Data were extracted from Blue Cross Blue Shield of North Carolina for the North Carolina State Health Plan using International Classification of Diseases, Ninth Revision, diagnostic codes for headache. The claims were separated by individual provider type, combination of provider types, and referral patterns. Results The majority of patients and claims were in the MD-only or MD plus referral patterns. Chiropractic patterns represented less than 10% of patients. Care patterns with single-provider types and no referrals incurred the least charges on average for headache. When care did not include referral providers or services, MD with DC care was generally less expensive than MD care with PT. However, when combined with referral care, MD care with PT was generally less expensive. Compared with MD-only care, risk-adjusted charges (available 2006-2009) for patients in the middle risk quintile were significantly less for DC-only care. Conclusions Utilization and expenditures for headache treatment increased from 2000 to 2009 across all provider groups. MD care represented the majority of total allowed charges in this study. MD care and DC care, alone or in combination, were overall the least expensive patterns of headache care. Risk-adjusted charges were significantly less for DC-only care.


      PubDate: 2016-05-10T19:33:34Z
       
  • Effect of Spinal Manipulation of Upper Cervical Vertebrae on Blood
           Pressure: Results of a Pilot Sham-Controlled Trial
    • Abstract: Publication date: Available online 9 May 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Christine M. Goertz, Stacie A. Salsbury, Robert D. Vining, Cynthia R. Long, Katherine A. Pohlman, William B. Weeks, Gervasio A. Lamas
      Objective The purpose of this pilot sham-controlled clinical trial was to estimate the treatment effect and safety of toggle recoil spinal manipulation for blood pressure management. Methods Fifty-one participants with prehypertension or stage 1 hypertension (systolic blood pressure ranging from 135 to 159 mm Hg or diastolic blood pressure ranging from 85 to 99 mm Hg) were allocated by an adaptive design to 2 treatments: toggle recoil spinal manipulation or a sham procedure. Participants were seen by a doctor of chiropractic twice weekly for 6 weeks and remained on their antihypertensive medications, as prescribed, throughout the trial. Blood pressure was assessed at baseline and after study visits 1, 6 (week 3), and 12 (week 6), with the primary end point at week 6. Analysis of covariance was used to compare mean blood pressure changes from baseline between groups at each end point, controlling for sex, age, body mass index, and baseline blood pressure. Results Adjusted mean change from baseline to week 6 was greater in the sham group (systolic, −4.2 mm Hg; diastolic, −1.6 mm Hg) than in the spinal manipulation group (systolic, 0.6 mm Hg; diastolic, 0.7 mm Hg), but the difference was not statistically significant. No serious and few adverse events were noted. Conclusions Six weeks of toggle recoil spinal manipulation did not lower systolic or diastolic blood pressure when compared with a sham procedure. No serious adverse events from either treatment were reported. Our results do not support a larger clinical trial. Further research to understand the potential mechanisms of action involving upper cervical manipulation on blood pressure is warranted before additional clinical investigations are conducted.


      PubDate: 2016-05-10T19:33:34Z
       
  • Effect of Spinal Manipulation on Pelvic Floor Functional Changes in
           Pregnant and Nonpregnant Women: A Preliminary Study
    • Abstract: Publication date: Available online 6 May 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Heidi Haavik, Bernadette A. Murphy, Jennifer Kruger
      Objective The aim of this study was to investigate whether a single session of spinal manipulation of pregnant women can alter pelvic floor muscle function as measured using ultrasonographic imaging. Methods In this preliminary, prospective, comparative study, transperineal ultrasonographic imaging was used to assess pelvic floor anatomy and function in 11 primigravid women in their second trimester recruited via notice boards at obstetric caregivers, pregnancy keep-fit classes, and word of mouth and 15 nulliparous women recruited from a convenience sample of female students at the New Zealand College of Chiropractic. Following bladder voiding, 3-/4-dimensional transperineal ultrasonography was performed on all participants in the supine position. Levator hiatal area measurements at rest, on maximal pelvic floor contraction, and during maximum Valsalva maneuver were collected before and after either spinal manipulation or a control intervention. Results Levator hiatal area at rest increased significantly (P < .05) after spinal manipulation in the pregnant women, with no change postmanipulation in the nonpregnant women at rest or in any of the other measured parameters. Conclusion Spinal manipulation of pregnant women in their second trimester increased the levator hiatal area at rest and thus appears to relax the pelvic floor muscles. This did not occur in the nonpregnant control participants, suggesting that it may be pregnancy related.


      PubDate: 2016-05-06T19:25:49Z
       
  • Editorial Board
    • Abstract: Publication date: March–April 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 3




      PubDate: 2016-04-27T18:42:31Z
       
  • Table of Contents
    • Abstract: Publication date: March–April 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 3




      PubDate: 2016-04-27T18:42:31Z
       
  • Information for Readers
    • Abstract: Publication date: March–April 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 3




      PubDate: 2016-04-27T18:42:31Z
       
  • Methods of Muscle Activation Onset Timing Recorded During Spinal
           Manipulation
    • Abstract: Publication date: Available online 9 April 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Stuart J. Currie, Casey A. Myers, Ashok Krishnamurthy, Brian A. Enebo, Bradley S. Davidson
      Objective The purpose of this study was to determine electromyographic threshold parameters that most reliably characterize the muscular response to spinal manipulation and compare 2 methods that detect muscle activity onset delay: the double-threshold method and cross-correlation method. Methods Surface and indwelling electromyography were recorded during lumbar side-lying manipulations in 17 asymptomatic participants. Muscle activity onset delays in relation to the thrusting force were compared across methods and muscles using a generalized linear model. Results The threshold combinations that resulted in the lowest Detection Failures were the “8 SD–0 milliseconds” threshold (Detection Failures = 8) and the “8 SD–10 milliseconds” threshold (Detection Failures = 9). The average muscle activity onset delay for the double-threshold method across all participants was 149 ± 152 milliseconds for the multifidus and 252 ± 204 milliseconds for the erector spinae. The average onset delay for the cross-correlation method was 26 ± 101 for the multifidus and 67 ± 116 for the erector spinae. There were no statistical interactions, and a main effect of method demonstrated that the delays were higher when using the double-threshold method compared with cross-correlation. Conclusions The threshold parameters that best characterized activity onset delays were an 8-SD amplitude and a 10-millisecond duration threshold. The double-threshold method correlated well with visual supervision of muscle activity. The cross-correlation method provides several advantages in signal processing; however, supervision was required for some results, negating this advantage. These results help standardize methods when recording neuromuscular responses of spinal manipulation and improve comparisons within and across investigations.


      PubDate: 2016-04-27T18:42:31Z
       
  • The Neuromuscular Response to Spinal Manipulation in the Presence of Pain
    • Abstract: Publication date: Available online 6 April 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Stuart J. Currie, Casey A. Myers, Catherine Durso, Brian A. Enebo, Bradley S. Davidson
      Objective The purpose of this study was to evaluate differences in muscle activity in participants with and without low back pain during a side-lying lumbar diversified spinal manipulation. Methods Surface and indwelling electromyography at eight muscle locations were recorded during lumbar side-lying manipulations in 20 asymptomatic participants and 20 participants with low back pain. The number of muscle responses and muscle activity onset delays in relation to the manipulation impulse were compared in the 2 pain groups using mixed linear regressions. Effect sizes for all comparisons were calculated using Cohen’s d. Results Muscle responses occurred in 61.6% ± 23.6% of the EMG locations in the asymptomatic group and 52.8% ± 26.3% of the symptomatic group. The difference was not statistically significant but there was a small effect of pain (d = 0.350). Muscle activity onset delays were longer for the symptomatic group at every EMG location except the right side indwelling L5 electrode, and a small effect of pain was present at the left L2, quadratus lumborum and trapezius surface electrodes (d = 0.311, 0.278, and 0.265) respectively. The indwelling electrodes demonstrated greater muscle responses (P ≤ .01) and shorter muscle activity onset delays (P < .01) than the surface electrodes. Conclusions The results revealed trends that indicate participants with low back pain have less muscle responses, and when muscle responses are present they occur with longer onset delays following the onset of a manipulation impulse.


      PubDate: 2016-04-09T10:10:08Z
       
  • Effects of Axial Torsion on Disc Height Distribution: An In Vivo Study
    • Abstract: Publication date: Available online 6 April 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Alejandro A. Espinoza Orías, Nicole M. Mammoser, John J. Triano, Howard S. An, Gunnar B.J. Andersson, Nozomu Inoue
      Objectives Axial rotation of the torso is commonly used during manipulation treatment of low back pain. Little is known about the effect of these positions on disc morphology. Rotation is a three-dimensional event that is inadequately represented with planar images in the clinic. True quantification of the intervertebral gap can be achieved with a disc height distribution. The objective of this study was to analyze disc height distribution patterns during torsion relevant to manipulation in vivo. Methods Eighty-one volunteers were computed tomography–scanned both in supine and in right 50° rotation positions. Virtual models of each intervertebral gap representing the disc were created with the inferior endplate of each “disc” set as the reference surface and separated into 5 anatomical zones: 4 peripheral and 1 central, corresponding to the footprint of the annulus fibrosus and nucleus pulposus, respectively. Whole-disc and individual anatomical zone disc height distributions were calculated in both positions and were compared against each other with analysis of variance, with significance set at P < .05. Results Mean neutral disc height was 7.32 mm (1.59 mm). With 50° rotation, a small but significant increase to 7.44 mm (1.52 mm) (P < .0002) was observed. The right side showed larger separation in most levels, except at L5/S1. The posterior and right zones increased in height upon axial rotation of the spine (P < .0001), whereas the left, anterior, and central decreased. Conclusions This study quantified important tensile/compressive changes disc height during torsion. The implications of these mutually opposing changes on spinal manipulation are still unknown.


      PubDate: 2016-04-09T10:10:08Z
       
  • Changes in Manipulative Peak Force Modulation and Time to Peak Thrust
           among First-Year Chiropractic Students Following a 12-Week Detraining
           Period
    • Abstract: Publication date: Available online 6 April 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): David J Starmer, Brett P Guist, Taylor R Tuff, Sarah C Warren, Matthew GR Williams
      Objective The purpose of this study was to analyze differences in peak force modulation and time-to-peak thrust in posterior-to-anterior (PA) high-velocity-low-amplitude (HVLA) manipulations in first-year chiropractic students prior to and following a 12-week detraining period. Methods Chiropractic students (n=125) performed 2 thrusts prior to and following a 12-week detraining period: total peak force targets were 400 and 600 N, on a force-sensing table using a PA hand contact of the participant’s choice (bilateral hypothenar, bilateral thenar, or cross bilateral). Force modulation was compared to defined target total peak force values of 600 and 400 N, and time-to-peak thrust was compared between data sets using 2-tailed paired t-tests. Results Total peak force for the 600 N intensity varied by 124.11 + 65.77 N during the pre-test and 123.29 + 61.43 N during the post-test compared to the defined target of 600 N (P = .90); total peak force for the 400 N intensity varied by 44.91 + 34.67 N during the pre-test and 44.60 + 32.63 N during the post-test compared to the defined target of 400 N (P = .57). Time-to-peak thrust for the 400 N total peak force was 137.094 + 42.47 milliseconds during the pre-test and 125.385 + 37.46 milliseconds during the post-test (P = .0004); time-to-peak thrust for the 600 N total peak force was 136.835 + 40.48 milliseconds during the pre-test and 125.385 + 33.78 milliseconds during the post-test (P = .03). Conclusions The results indicate no drop-off in the ability to modulate force for either thrust intensity, but did indicate a statistically significant change in time-to-peak thrust for the 400 N total peak force thrust intensity in first-year chiropractic students following a 12-week detraining period.


      PubDate: 2016-04-09T10:10:08Z
       
  • Effectiveness of Chiropractic Care to Improve Sensorimotor Function
           
    • Abstract: Publication date: Available online 2 April 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Kelly R. Holt, Heidi Haavik, Arier Chi Lun Lee, Bernadette Murphy, C. Raina Elley
      Objective This study assessed whether 12 weeks of chiropractic care was effective in improving sensorimotor function associated with fall risk, compared with no intervention, in community-dwelling older adults living in Auckland, New Zealand. Methods Sixty community-dwelling adults older than 65 years were enrolled in the study. Outcome measures were assessed at baseline, 4 weeks, and 12 weeks and included proprioception (ankle joint position sense), postural stability (static posturography), sensorimotor function (choice stepping reaction time), multisensory integration (sound-induced flash illusion), and health-related quality of life (SF-36). Results Over 12 weeks, the chiropractic group improved compared with the control group in choice stepping reaction time (119 milliseconds; 95% confidence interval [CI], 26-212 milliseconds; P = .01) and sound-induced flash illusion (13.5%; 95% CI, 2.9%-24.0%; P = .01). Ankle joint position sense improved across the 4- and 12-week assessments (0.20°; 95% CI, 0.01°-0.39°; P = .049). Improvements were also seen between weeks 4 and 12 in the SF-36 physical component of quality of life (2.4; 95% CI, 0.04-4.8; P = .04) compared with control. Conclusion Sensorimotor function and multisensory integration associated with fall risk and the physical component of quality of life improved in older adults receiving chiropractic care compared with control. Future research is needed to investigate the mechanisms of action that contributed to the observed changes in this study and whether chiropractic care has an impact on actual falls risk in older adults.


      PubDate: 2016-04-05T22:55:01Z
       
  • The Effect of Chronic Pain Intensity on Sit-to-Stand Strategy in Patients
           With Herniated Lumbar Disks
    • Abstract: Publication date: Available online 31 March 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Tomasz Sipko, Edmund Glibowski, Katarzyna Barczyk-Pawelec, Michał Kuczyński
      Objective Recurrent symptoms of low back pain and its transition to a chronic state are associated with specific motor strategies used by people to avoid pain. The aim of the study was to determine the impact of chronic pain intensity on sit-to-stand (STS) strategy in chronic low back pain (CLBP) patients with herniated disks. Method Vertical ground reaction forces (counter, peak, and postpeak rebound) and their respective times of occurrence were measured on 2 Kistler force plates. Thirty-two healthy persons served as a control group. People with CLBP (n = 40) were divided into 2 subgroups according to the reported pain intensity at rest as measured by the numeric pain rating scale (NRS): low pain (NRS ≤ 3) and high pain (HP; NRS > 3). Results Both CLBP subgroups achieved shorter time to counter force but longer time to postpeak rebound force (P < .01). The time to peak force was extended in HP on the right side (P < .01). HP presented lower peak force on the right and lower postpeak rebound force on the left side (P < .001) compared with controls. Conclusion Patients with CLBP were characterized by an individual, compensatory STS movement strategy with shorter preparation and longer stabilization times. Avoidance behavior in STS execution was presented in HP individuals only, indicating that intensity of chronic pain was a significant factor in decreasing ground reaction peak force and increasing time to peak force.


      PubDate: 2016-04-02T01:14:23Z
       
  • Symptomatic, Magnetic Resonance Imaging–Confirmed Cervical Disk
           Herniation Patients: A Comparative-Effectiveness Prospective Observational
           Study of 2 Age- and Sex-Matched Cohorts Treated With Either Imaging-Guided
           Indirect Cervical Nerve Root Injections or Spinal Manipulative Therapy
    • Abstract: Publication date: Available online 31 March 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Cynthia K. Peterson, Christian W.A. Pfirrmann, Jürg Hodler, Serafin Leemann, Christof Schmid, Bernard Anklin, B. Kim Humphreys
      Objective The purpose of this study was to compare the outcomes of overall improvement, pain reduction, and treatment costs in matched patients with symptomatic, magnetic resonance imaging–confirmed cervical disk herniations treated with either spinal manipulative therapy (SMT) or imaging-guided cervical nerve root injection blocks (CNRI). Methods This prospective cohort comparative-effectiveness study included 104 patients with magnetic resonance imaging–confirmed symptomatic cervical disk herniation. Fifty-two patients treated with CNRI were age and sex matched with 52 patients treated with SMT. Baseline numerical rating scale (NRS) pain data were collected. Three months after treatment, NRS pain levels were recorded and overall “improvement” was assessed using the Patient Global Impression of Change scale. Only responses “much better” or “better” were considered “improved.” The proportion of patients “improved” was calculated for each treatment method and compared using the χ 2 test. The NRS and NRS change scores for the 2 groups were compared at baseline and 3 months using the unpaired t test. Acute and subacute/chronic patients in the 2 groups were compared for “improvement” using the χ 2 test. Results “Improvement” was reported in 86.5% of SMT patients and 49.0% of CNRI patients (P = .0001). Significantly more CNRI patients were in the subacute/chronic category (77%) compared with SMT patients (46%). A significant difference between the proportion of subacute/chronic CNRI patients (37.5%) and SMT patients (78.3%) reporting “improvement” was noted (P = .002). Conclusion Subacute/chronic patients treated with SMT were significantly more likely to report relevant “improvement” compared with CNRI patients. There was no difference in outcomes when comparing acute patients only.


      PubDate: 2016-04-02T01:14:23Z
       
  • Best Practices for Chiropractic Care of Children: A Consensus Update
    • Abstract: Publication date: Available online 31 March 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Cheryl Hawk, Michael J. Schneider, Sharon Vallone, Elise G. Hewitt
      Objective Chiropractic care is the most common complementary and integrative medicine practice used by children in the United States, and it is used frequently by children internationally as well. The purpose of this project was to update the 2009 recommendations on best practices for chiropractic care of children. Methods A formal consensus process was completed based on the existing recommendations and informed by the results of a systematic review of relevant literature from January 2009 through March 2015. The primary search question for the systematic review was, “What is the effectiveness of chiropractic care, including spinal manipulation, for conditions experienced by children (<18 years of age)'” A secondary search question was, “What are the adverse events associated with chiropractic care including spinal manipulation among children (<18 years of age)'” The consensus process was conducted electronically, by e-mail, using a multidisciplinary Delphi panel of 29 experts from 5 countries and using the RAND Corporation/University of California, Los Angeles, consensus methodology. Results Only 2 statements from the previous set of recommendations did not reach 80% consensus on the first round, and revised versions of both were agreed upon in a second round. Conclusions All of the seed statements in this best practices document achieved a high level of consensus and thus represent a general framework for what constitutes an evidence-based and reasonable approach to the chiropractic management of infants, children, and adolescents.


      PubDate: 2016-04-02T01:14:23Z
       
  • Comparison of Outcomes in MRI Confirmed Lumbar Disc Herniation Patients
           With and Without Modic Changes Treated With High Velocity, Low Amplitude
           Spinal Manipulation
    • Abstract: Publication date: Available online 1 April 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Michelé Annen, Cynthia Peterson, Serafin Leemann, Christof Schmid, Bernard Anklin, B. Kim Humphreys
      Objective The purpose of this study was to determine if there is a difference in outcomes between Modic positive and negative lumbar disc herniation (LDH) patients treated with spinal manipulative therapy (SMT). Methods This prospective outcomes study includes 72 MRI confirmed symptomatic LDH patients treated with SMT. Numerical rating scale (NRS) pain and Oswestry disability data were collected at baseline. NRS, patient global impression of change to assess overall improvement, and Oswestry data were collected at 2 weeks, 1, 3, 6 months and 1 year. MRI scans were analyzed for Modic change present/absent and classified as Modic I or II when present. Chi-squared test compared the proportion of patients reporting relevant 'improvement' between patients with and without Modic changes and those with Modic I vs. II. NRS and Oswestry scores were compared at baseline and change scores at all follow-up time points using the unpaired Student t test. Results 76.5% of Modic positive patients reported ‘improvement’ compared to 53.3% of Modic negative patients (P = .09) at 2 weeks. Modic positive patients had larger decreases in leg pain (P = .02) and disability scores (P = .012) at 2 weeks. Modic positive patients had larger reductions in disability levels at 3 (P = .049) and 6 months (P = .001). A significant difference (P = .001) between patients with Modic I vs. Modic II was found at 1 year, where Modic II patients did significantly better. Conclusion Modic positive patients reported higher levels of clinically relevant improvement 2 weeks, 3 and 6 months compared to Modic negative patients. However, at 1 year Modic I patients were significantly less likely to report ‘improvement’, suggesting they may be prone to relapse.


      PubDate: 2016-04-02T01:14:23Z
       
  • Evidence on the Ability of A Pneumatic Decompression Belt to Restore
           Spinal Height Following an Acute Bout of Exercise
    • Abstract: Publication date: Available online 1 April 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jordan Cannon, David Emond, Stuart M. McGill
      Objective The purpose of this study was to evaluate the ability of a pneumatic decompression belt to restore spinal height lost following an acute bout of exercise that induced compression. Methods This study implemented a test-retest repeated measures design in which twelve participants (male = 10, female = 2) age, 21.5 ± 1.0 years; height, 179.0 ± 7.70 cm; weight, 84.0 ±11.5 kg; were recruited from a university population and acted as their own control. All participants were healthy with no previous history of disabling back pain, and were frequent weight trainers. A stadiometer was used to measure spinal height at baseline, then following an acute bout of exercise and then again following the intervention (use of a pneumatic decompression belt for 20 minutes) or control (lying supine for 20 minutes). A 2-way repeated measures ANOVA was performed on the change in spinal height in order to evaluate differences between measurement phases and intervention conditions. Results The use of the decompression belt increased spinal height gain (4.3 ± 3.0 mm) significantly more than the control condition (1.8 ± 1.2 mm) following an acute bout of weightlifting exercises known to elicit high compressive loads on the lumbar spine. Conclusion The pneumatic decompression belt restored spinal height faster than a non-belt wearing condition in young healthy asymptomatic participants.


      PubDate: 2016-04-02T01:14:23Z
       
  • Symptomatic, MRI Confirmed, Lumbar Disc Herniations: A Comparison of
           Outcomes Depending on the Type and Anatomical Axial Location of the Hernia
           
    • Abstract: Publication date: Available online 28 March 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Marco Ehrler, Cynthia Peterson, Serafin Leemann, Christof Schmid, Bernard Anklin, B. Kim Humphreys
      Objective The purpose of this study was to evaluate whether specific MRI features, such as axial location and type of herniation, are associated with outcomes of symptomatic lumbar disc herniation patients treated with spinal manipulation therapy (SMT). Methods MRI and treatment outcome data from 68 patients were included in this prospective outcomes study. Pain numerical rating scale (NRS) and Oswestry physical disability questionnaire (OPDQ) levels were measured at baseline. The Patients Global Impression of Change scale, the NRS and the OPDQ were collected at 2 weeks, 1, 3, 6 months and 1 year. One radiologist and 2 chiropractic medicine master’s degree students analyzed the MRI scans blinded to treatment outcomes. κ statistics assessed inter-rater reliability of MRI diagnosis. The proportion of patients reporting relevant improvement at each time point was compared based on MRI findings using the chi-square test. The t test and ANOVA compared the NRS and OPDQ change scores between patients with various MRI abnormalities. Results A higher proportion of patients with disc sequestration reported relevant improvement at each time point but this did not quite reach statistical significance. Patients with disc sequestration had significantly higher reduction in leg pain at 1 month compared to those with extrusion (P = .02). Reliability of MRI diagnosis ranged from substantial to perfect (K = .733-1.0). Conclusions Patients with sequestered herniations treated with SMT to the level of herniation reported significantly higher levels of leg pain reduction at 1 month and a higher proportion reported improvement at all data collection time points but this did not reach statistical significance.


      PubDate: 2016-03-29T00:46:38Z
       
  • Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic
           and Opioid Use in Younger Medicare Beneficiaries
    • Abstract: Publication date: Available online 28 March 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): William B Weeks, Christine M Goertz
      Objective The purpose of this study was to determine whether the per-capita supply of doctors of chiropractic (DCs) or Medicare spending on chiropractic care was associated with opioid use among younger, disabled Medicare beneficiaries. Methods Using 2011 data, at the hospital referral region level, we correlated the per-capita supply of DCs and spending on chiropractic manipulative therapy (CMT) with several measures of per-capita opioid use by younger, disabled Medicare beneficiaries. Results Per-capita supply of DCs and spending on CMT were strongly inversely correlated with the percentage of younger Medicare beneficiaries who had at least 1, as well as with 6 or more, opioid prescription fills. Neither measure was correlated with mean daily morphine equivalents per opioid user or per chronic opioid user. Conclusions A higher per-capita supply of DCs and Medicare spending on CMT were inversely associated with younger, disabled Medicare beneficiaries obtaining an opioid prescription. However, neither measure was associated with opioid dosage among patients who obtained opioid prescriptions.


      PubDate: 2016-03-29T00:46:38Z
       
  • Exploring the Definition of Acute Low Back Pain: A Prospective
           Observational Cohort Study Comparing Outcomes of Chiropractic Patients
           With 0-2, 2-4, and 4-12 Weeks of Symptoms
    • Abstract: Publication date: Available online 28 March 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Karin E. Mantel, Cynthia K. Peterson, B. Kim Humphreys
      Objective The purpose of this study was to compare improvement rates in patients with low back pain (LBP) undergoing chiropractic treatment with 0-2 weeks vs 2-4 and 4-12 weeks of symptoms. Methods This was a prospective cohort outcome study with 1-year follow-up including adult acute (symptoms 0-4 weeks) LBP patients. The numerical rating scale for pain (NRS) and Oswestry questionnaire were completed at baseline, 1 week, 1 month, and 3 months after starting treatment. The Patient Global Impression of Change (PGIC) scale was completed at all follow-up time points. At 6 months and 1 year, NRS and PGIC data were collected. The proportion of patients reporting relevant “improvement” (PGIC scale) was compared between patients having 0-2 and 2-4 weeks of symptoms using the χ 2 test at all data collection time points. The unpaired t test compared NRS and Oswestry change scores between these 2 groups. Results Patients with 0-2 weeks of symptoms were significantly more likely to “improve” at 1 week, 1 month, and 6 months compared with those with 2-4 weeks of symptoms (P < .015). Patients with 0-2 weeks of symptoms reported significantly higher NRS and Oswestry change scores at all data collection time points. Outcomes for patients with 2-4 weeks of symptoms were similar to patients having 4-12 weeks of symptoms. Conclusion The time period 0-4 weeks as the definition of “acute” should be challenged. Patients with 2-4 weeks of symptoms had outcomes similar to patients with subacute (4-12 weeks) symptoms and not with patients reporting 0-2 weeks of symptoms.


      PubDate: 2016-03-29T00:46:38Z
       
  • Development of a Linked Segment Model to Derive Patient Low Back Reaction
           
    • Abstract: Publication date: Available online 28 March 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Samuel J Howarth, Kevin D’Angelo, John J Triano
      Objective The purpose of this paper is to present the experimental setup, the development, and implementation of a new scalable model capable of efficiently handling data required to determine low back kinetics during high-velocity low-amplitude spinal manipulation (HVLA-SM). Methods The model was implemented in Visual3D software. All contact forces and moments between the patient and the external environment (2 clinician hand contact forces, 1 contact force between the patient and the treatment table), the patient upper body kinematics, and inertial properties were used as input. Spine kinetics and kinematics were determined from a single HVLA-SM applied to one healthy participant in a right side-lying posture to demonstrate the model’s utility. The net applied force was used to separate the spine kinetic and kinematic time-series data from the HVLA-SM into preload as well as early and late impulse phases. Results Time-series data obtained from the HVLA-SM procedure showed that the participant’s spine underwent left axial rotation, combined with extension, and a reduction in left lateral bending during the procedure. All components of the reaction force, as well as the axial twist and flexion/extension reaction moments demonstrated a sinusoidal pattern during the early and late impulse phases. During the early impulse phase, the participant’s spine experienced a leftward axial twisting moment of 37.0 Nm followed by a rightward moment of −45.8 Nm. The lateral bend reaction moment exhibited a bimodal pattern during the early and late impulse phases. Conclusion This model was the first attempt to directly measure all contact forces acting on the participant/patient’s upper body, and integrate them with spine kinematic data to determine patient low back reaction forces and moments during HVLA-SM in a side-lying posture. Advantages of this model include the brevity of data collection (<1 hour), and adaptability for different patient anthropometries and clinician-patient contacts.


      PubDate: 2016-03-29T00:46:38Z
       
  • Systematic Augmented Feedback and Dependency in Spinal Manipulation
           Learning: a Randomized Comparative Study
    • Abstract: Publication date: Available online 22 March 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Arnaud Lardon, Charlène Cheron, Isabelle Pagé, Claude Dugas, Martin Descarreaux
      Objective The purpose of the study was to evaluate if systematic augmented feedback during short sessions of spinal manipulation (SM) training creates a dependency compared with short training session characterized by progressive withdrawal of augmented feedback. Methods Forty fourth- and fifth-year chiropractic students enrolled in a 5-year chiropractic program were randomized into 2 groups. The 2 groups performed the same number of SM with a 300-N peak force target on an instrumented device. Baseline assessment consisted of 10 trials without feedback. Three training blocks of 10 SMs were then performed with visual and verbal feedback. For the control group, feedback was always provided. For the experimental group, augmented feedback was provided for each trial of the first training block, 50% of the second block, and 20% of the last training block. A postintervention assessment of 10 trials without feedback was performed, and a retention assessment was conducted 20 minutes later. Results No group main effect was found on biomechanical parameters and error variables. A main effect of learning for the absolute error was observed, suggesting that short sessions of feedback training improve participants’ accuracy. Conclusion The results of the study suggest that feedback scheduling does not influence SM motor performance and learning in clinically experienced students.


      PubDate: 2016-03-24T00:31:46Z
       
  • Editorial Board
    • Abstract: Publication date: February 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 2




      PubDate: 2016-03-11T23:01:00Z
       
  • Table of Contents
    • Abstract: Publication date: February 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 2




      PubDate: 2016-03-11T23:01:00Z
       
  • Information for Readers
    • Abstract: Publication date: February 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 2




      PubDate: 2016-03-11T23:01:00Z
       
  • The Effectiveness of Multimodal Care for Soft Tissue Injuries of the Lower
           Extremity: A Systematic Review by the Ontario Protocol for Traffic Injury
           Management (OPTIMa) Collaboration
    • Abstract: Publication date: February 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 2
      Author(s): Deborah A. Sutton, Margareta Nordin, Pierre Côté, Kristi Randhawa, Hainan Yu, Jessica J. Wong, Paula Stern, Sharanya Varatharajan, Danielle Southerst, Heather M. Shearer, Maja Stupar, Chadwick Chung, Rachel Goldgrub, Linda J. Carroll, Anne Taylor-Vaisey
      Objective The purpose of this systematic review was to evaluate the effectiveness of multimodal care for the management of soft tissue injuries of the lower extremity. Methods We systematically searched MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Random pairs of independent reviewers screened studies for relevance and critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. We included studies with a low risk of bias in our best evidence synthesis. Results We screened 6794 articles. Six studies had a low risk of bias and addressed the following: plantar heel pain (n = 2), adductor-related groin pain (n = 1), and patellofemoral pain (n = 3). The evidence suggests that multimodal care for the management of persistent plantar heel pain may include mobilization and stretching exercise. An intensive, clinic-based, group exercise program (strengthening, stretching, balance, agility) is more effective than multimodal care for the management of adductor-related groin pain in male athletes. There is inconclusive evidence to support the use of multimodal care for the management of persistent patellofemoral pain. Our search did not identify any low risk of bias studies examining multimodal care for the management of other soft tissue injuries of the lower extremity. Conclusion A multimodal program of care for the management of persistent plantar heel pain may include mobilization and stretching exercise. Multimodal care for adductor-related groin pain is not recommended based on the current evidence. There is inconclusive evidence to support the use of multimodal care for the management of persistent patellofemoral pain.


      PubDate: 2016-03-11T23:01:00Z
       
  • The Effectiveness of Multimodal Care for the Management of Soft Tissue
           Injuries of the Shoulder: A Systematic Review by the Ontario Protocol for
           Traffic Injury Management (OPTIMa) Collaboration
    • Abstract: Publication date: February 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 2
      Author(s): Rachel Goldgrub, Pierre Côté, Deborah Sutton, Jessica J. Wong, Hainan Yu, Kristi Randhawa, Sharanya Varatharajan, Danielle Southerst, Silvano Mior, Heather M. Shearer, Craig Jacobs, Maja Stupar, Chadwick L. Chung, Sean Abdulla, Robert Balogh, Shilpa Dogra, Margareta Nordin, Anne Taylor-Vaisey
      Objective The purpose of this systematic review was to evaluate the effectiveness of multimodal care for the management of soft tissue injuries of the shoulder. Methods We conducted a systematic review and searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Two independent reviewers critically appraised studies using the Scottish Intercollegiate Guidelines Network criteria. We used best evidence synthesis to synthesize evidence from studies with low risk of bias. Results We screened 5885 articles, and 19 were eligible for critical appraisal. Ten randomized controlled trials had low risk of bias. For persistent subacromial impingement syndrome, multimodal care leads to similar outcomes as sham therapy, radial extracorporeal shock-wave therapy, or surgery. For subacromial impingement syndrome, multimodal care may be associated with small and nonclinically important improvement in pain and function compared with corticosteroid injections. For rotator cuff tendinitis, dietary-based multimodal care may be more effective than conventional multimodal care (exercise, soft tissue and manual therapy, and placebo tablets). For nonspecific shoulder pain, multimodal care may be more effective than wait list or usual care by a general practitioner, but it leads to similar outcomes as exercise or corticosteroid injections. Conclusions The current evidence suggests that combining multiple interventions into 1 program of care does not lead to superior outcomes for patients with subacromial impingement syndrome or nonspecific shoulder pain. One randomized controlled trial suggested that dietary-based multimodal care (dietary advice, acupuncture, and enzyme tablets) may provide better outcomes over conventional multimodal care. However, these results need to be replicated.


      PubDate: 2016-03-11T23:01:00Z
       
  • The Effectiveness of Exercise on Recovery and Clinical Outcomes in
           Patients With Soft Tissue Injuries of the Hip, Thigh, or Knee: A
           Systematic Review by the Ontario Protocol for Traffic Injury Management
           (OPTIMa) Collaboration
    • Abstract: Publication date: February 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 2
      Author(s): Courtney K. Brown, Danielle Southerst, Pierre Côté, Heather M. Shearer, Kristi Randhawa, Jessica J. Wong, Hainan Yu, Sharanya Varatharajan, Deborah Sutton, Paula J. Stern, Kevin D’Angelo, Sarah Dion, Jocelyn Cox, Rachel Goldgrub, Maja Stupar, Linda J. Carroll, Anne Taylor-Vaisey
      Objective The purpose of this systematic review was to determine the effectiveness of exercise for the management of soft tissue injuries of the hip, thigh, and knee. Methods We conducted a systematic review and searched MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, and CINAHL Plus with Full Text from January 1, 1990, to April 8, 2015, for randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effect of exercise on pain intensity, self-rated recovery, functional recovery, health-related quality of life, psychological outcomes, and adverse events. Random pairs of independent reviewers screened titles and abstracts and assessed risk of bias using the Scottish Intercollegiate Guidelines Network criteria. Best evidence synthesis methodology was used. Results We screened 9494 citations. Eight RCTs were critically appraised, and 3 had low risk of bias and were included in our synthesis. One RCT found statistically significant improvements in pain and function favoring clinic-based progressive combined exercises over a “wait and see” approach for patellofemoral pain syndrome. A second RCT suggests that supervised closed kinetic chain exercises may lead to greater symptom improvement than open chain exercises for patellofemoral pain syndrome. One RCT suggests that clinic-based group exercises may be more effective than multimodal physiotherapy in male athletes with persistent groin pain. Conclusion We found limited high-quality evidence to support the use of exercise for the management of soft tissue injuries of the lower extremity. The evidence suggests that clinic-based exercise programs may benefit patients with patellofemoral pain syndrome and persistent groin pain. Further high-quality research is needed.


      PubDate: 2016-03-11T23:01:00Z
       
  • Characteristics of US Adults Who Have Positive and Negative Perceptions of
           Doctors of Chiropractic and Chiropractic Care
    • Abstract: Publication date: Available online 3 March 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): William B. Weeks, Christine M. Goertz, William C. Meeker, Dennis M. Marchiori
      Objective The purpose of this study was to compare characteristics, likelihood to use, and actual use of chiropractic care for US survey respondents with positive and negative perceptions of doctors of chiropractic (DCs) and chiropractic care. Methods From a 2015 nationally representative survey of 5422 adults (response rate, 29%), we used respondents' answers to identify those with positive and negative perceptions of DCs or chiropractic care. We used the χ 2 test to compare other survey responses for these groups. Results Positive perceptions of DCs were more common than those for chiropractic care, whereas negative perceptions of chiropractic care were more common than those for DCs. Respondents with negative perceptions of DCs or chiropractic care were less likely to know whether chiropractic care was covered by their insurance, more likely to want to see a medical doctor first if they were experiencing neck or back pain, less likely to indicate that they would see a DC for neck or back pain, and less likely to have ever seen a DC as a patient, particularly in the recent past. Positive perceptions of chiropractic care and negative perceptions of DCs appear to have greater influence on DC utilization rates than their converses. Conclusion We found that US adults generally perceive DCs in a positive manner but that a relatively high proportion has negative perceptions of chiropractic care, particularly the costs and number of visits required by such care. Characteristics of respondents with positive and negative perceptions were similar, but those with positive perceptions were more likely to plan to use—and to have already received—chiropractic care.


      PubDate: 2016-03-06T22:32:30Z
       
  • Patients’ Experiences With Vehicle Collision to Inform the
           Development of Clinical Practice Guidelines: A Narrative Inquiry
    • Abstract: Publication date: Available online 28 February 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Gail M. Lindsay, Silvano A. Mior, Pierre Côté, Linda J. Carroll, Heather M. Shearer
      Objective The purpose of this narrative inquiry was to explore the experiences of persons who were injured in traffic collisions and seek their recommendations for the development of clinical practice guideline (CPG) for the management of minor traffic injuries. Methods Patients receiving care for traffic injuries were recruited from 4 clinics in Ontario, Canada resulting in 11 adult participants (5 men, 6 women). Eight were injured while driving cars, 1 was injured on a motorcycle, 2 were pedestrians, and none caused the collision. Using narrative inquiry methodology, initial interviews were audiotaped, and follow-up interviews were held within 2 weeks to extend the story of experience created from the first interview. Narrative plotlines across the 11 stories were identified, and a composite story inclusive of all recommendations was developed by the authors. The research findings and composite narrative were used to inform the CPG Expert Panel in the development of new CPGs. Results Four recommended directions were identified from the narrative inquiry process and applied. First, terminology that caused stigma was a concern. This resulted in modified language (“injured persons”) being adopted by the Expert Panel, and a new nomenclature categorizing layers of injury was identified. Second, participants valued being engaged as partners with health care practitioners. This resulted in inclusion of shared decision-making as a foundational recommendation connecting CPGs and care planning. Third, emotional distress was recognized as a factor in recovery. Therefore, the importance of early detection and the ongoing evaluation of risk factors for delayed recovery were included in all CPGs. Fourth, participants shared that they were unfamiliar with the health care system and insurance industry before their accident. Thus, repeatedly orienting injured persons to the system was advised. Conclusion A narrative inquiry of 11 patients’ experiences with traffic collision and their recommendations for clinical guidelines informed the Ontario Protocol for Traffic Injury Management Collaboration in the development of new Minor Injury Guidelines. The values and findings of the qualitative inquiry were interwoven into each clinical pathway and embedded within the final guideline report submitted to government.


      PubDate: 2016-02-29T22:13:09Z
       
  • Editorial Board
    • Abstract: Publication date: January 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 1




      PubDate: 2016-02-24T21:55:32Z
       
  • Table of Contents
    • Abstract: Publication date: January 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 1




      PubDate: 2016-02-24T21:55:32Z
       
  • Information for Readers
    • Abstract: Publication date: January 2016
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 39, Issue 1




      PubDate: 2016-02-24T21:55:32Z
       
  • Exploratory Analysis of Clinical Predictors of Outcomes of Nonsurgical
           Treatment in Patients With Lumbar Spinal Stenosis
    • Abstract: Publication date: Available online 19 February 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Michael J Schneider, Lauren Terhorst, Donald Murphy, Joel M. Stevans, Rachel Hoffman, Jerrilyn A Cambron
      Objective The purpose of this study was to explore potential baseline physical examination and demographic predictors of clinical outcomes in patients with lumbar spinal stenosis. Methods This was a secondary analysis of data obtained from a pilot randomized controlled trial. Primary and secondary outcome measures were the Swiss Spinal Stenosis (SSS) Questionnaire and visual analog scale (VAS) for leg pain. Multiple regression models were used to assess 2 different outcomes: SSS at completion of care and VAS at completion of care. Separate regression models were built for each of the 2 outcomes to identify the best subset of variables that predicted improvement. Predictors with a significant contribution were retained in a final “best” model. Results Three variables were identified as having an association with SSS score at completion of care: baseline SSS score, qualitative description of leg pain, and age (adjusted R 2 = 33.2). Four variables were identified as having an association with VAS score at completion of care: baseline VAS score, qualitative description of leg pain, body mass index, and age (adjusted R2 = 38.3). Conclusion This study provides preliminary evidence supporting an association between certain baseline characteristics and nonsurgical clinical outcomes in patients with lumbar spinal stenosis.


      PubDate: 2016-02-20T21:29:34Z
       
  • The Association Between Use of Chiropractic Care and Costs of Care Among
           Older Medicare Patients With Chronic Low Back Pain and Multiple
           Comorbidities
    • Abstract: Publication date: Available online 19 February 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): William B Weeks, Brent Leininger, James M Whedon, Jon D Lurie, Tor D Tosteson, Rand Swenson, Alistair J O’Malley, Christine M Goertz
      Objective The purpose of this study was to determine whether use of chiropractic manipulative treatment (CMT) was associated with lower healthcare costs among multiply-comorbid Medicare beneficiaries with an episode of chronic low back pain (cLBP). Methods We conducted an observational, retrospective study of 2006 to 2012 Medicare fee-for-service reimbursements for 72326 multiply-comorbid patients aged 66 and older with cLBP episodes and 1 of 4 treatment exposures: chiropractic manipulative treatment (CMT) alone, CMT followed or preceded by conventional medical care, or conventional medical care alone. We used propensity score weighting to address selection bias. Results After propensity score weighting, total and per-episode day Part A, Part B, and Part D Medicare reimbursements during the cLBP treatment episode were lowest for patients who used CMT alone; these patients had higher rates of healthcare use for low back pain but lower rates of back surgery in the year following the treatment episode. Expenditures were greatest for patients receiving medical care alone; order was irrelevant when both CMT and medical treatment were provided. Patients who used only CMT had the lowest annual growth rates in almost all Medicare expenditure categories. While patients who used only CMT had the lowest Part A and Part B expenditures per episode day, we found no indication of lower psychiatric or pain medication expenditures associated with CMT. Conclusions This study found that older multiply-comorbid patients who used only CMT during their cLBP episodes had lower overall costs of care, shorter episodes, and lower cost of care per episode day than patients in the other treatment groups. Further, costs of care for the episode and per episode day were lower for patients who used a combination of CMT and conventional medical care than for patients who did not use any CMT. These findings support initial CMT use in the treatment of, and possibly broader chiropractic management of, older multiply-comorbid cLBP patients.


      PubDate: 2016-02-20T21:29:34Z
       
  • Validity of Commonly Used Clinical Tests to Diagnose and Screen for Spinal
           Pain in Adolescents: A School-Based Cohort Study in 1300 Danes Aged
           11–15 Years
    • Abstract: Publication date: Available online 17 February 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Ellen Aartun, Jan Hartvigsen, Lise Hestbaek
      Objective The overall aim of this study was to determine the ability of 2 selected clinical tests to detect or predict neck pain, mid back pain, and low back pain in a school-based cohort of Danish 11- to 15-year-olds. Methods A school-based 2-year prospective cohort study was conducted. Data were collected at the age of 11 to 13 (n = 1224) and 2 years later (n = 963). Spinal pain (neck pain, mid back pain, and low back pain) was assessed by an electronic survey completed during school time, and reference standard was defined as both lifetime prevalence and frequent pain as a proxy of severity. The tests included assessments of scoliosis, hypermobility, global mobility, intersegmental mobility, end range pain, and isometric endurance of back extensors. Sensitivity, specificity, negative and positive predictive values, and odds ratios were calculated for each test individually, and area under the receiver operating characteristic curve was calculated for evaluation of all tests combined. Results The sensitivity was low, and specificity was high for all tests at both baseline (age, 11-13 years) and follow-up (age, 13-15 years). When all tests were evaluated collectively in 1 model, the area under the receiver operating characteristic curve ranged from 0.60 to 0.65. None of the selected tests could predict incidence cases of neck pain, mid back pain, or low back pain. Conclusion Clinical tests commonly used in spinal screening in adolescents could not detect present spinal pain or predict future spinal pain. However, some statistically significant associations between spinal pain and tests involving a pain response from the participant were found.


      PubDate: 2016-02-20T21:29:34Z
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 54.81.148.144
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-2015