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Journal Cover Journal of Manipulative and Physiological Therapeutics
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   Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 0161-4754
     Published by Elsevier Homepage  [2571 journals]   [SJR: 0.965]   [H-I: 45]
  • Reproducibility of the Kinematics in Rotational High-Velocity,
           Low-Amplitude Thrust of the Upper Cervical Spine: A Cadaveric Study
    • Abstract: Publication date: Available online 15 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Silvia Gianola , Erik Cattrysse , Steven Provyn , Peter Van Roy
      Objective This study aimed to investigate the reproducibility of the kinematics in rotational high-velocity, low-amplitude (HVLA) thrust of the upper cervical spine. Methods Twenty fresh human cervical specimens were studied in a test-retest situation with 2 manual therapists. Kinematics of C1-C2 and C0-C1 were examined during segmental rotational HVLA manipulation through an ultrasound-based tracking system. The thrust moment was analyzed by 3-dimensional aspects: the range of motion of axial rotation, flexion-extension, lateral banding, and the cross-correlation between the axial rotation and the coupled lateral banding components. Results During rotational HVLA thrust on C1-C2, the main axial rotation demonstrates an intraexaminer relationship varying from almost perfect to fair (intraclass correlation coefficient =0.71; intraclass correlation coefficient = 0.35) and a substantial interexaminer correlation of 0.73. Conclusions This study showed substantial levels of reliability for the main axial rotation component of segmental manual rotational HVLA thrust on C1-C2. Intra- and interrater reliability for flexion-extension, lateral bending, and cross-correlation was low.


      PubDate: 2014-11-18T16:18:24Z
       
  • The Effect of Cervical Spine Manipulation on Postural Sway in Patients
           With Nonspecific Neck Pain
    • Abstract: Publication date: Available online 18 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Alison R. Fisher , Catherine J. Bacon , Jamie V.H. Mannion
      Objective This crossover study aimed to determine whether a single high-velocity, low-amplitude manipulation of the cervical spine would affect postural sway in adults with nonspecific neck pain. Methods Ten participants received, in random order, 7 days apart, a high-velocity, low-amplitude manipulation applied to a dysfunctional spinal segment and a passive head-movement control. Four parameters of postural sway were measured before, immediately after, and at 5 and 10 minutes after each procedure. Results Results showed no differences between interventions in change in any of the parameters. When changes before and immediately after each procedure were analyzed separately, only the control showed a significant change in the length of center of pressure path (an increase from median, 118 mm; interquartlie range, 93-137 mm to an increase to 132 mm; 112-147; P = .02). Conclusion This study failed to show evidence that single manipulation of the cervical spine influenced postural sway. Given the ability of the postural control system to reweight the hierarchy of sensory information to compensate for inadequacies in any 1 component, it is possible that any improvements in the mechanisms controlling postural sway elicited by the manipulative intervention may have been concealed.


      PubDate: 2014-11-18T16:18:24Z
       
  • Intrarater and Interrater Reliability of Photographic Measurement of
           Upper-Body Standing Posture of Adolescents
    • Abstract: Publication date: Available online 12 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Rodrigo Miguel Ruivo , Pedro Pezarat-Correia , Ana Isabel Carita
      Objective The purposes of this study were to determine the intrarater and interrater reliability of a photographic measurement of the sagittal postures of the cervical spine and shoulder, quantitatively characterize the postural alignment of the head and shoulders in the sagittal plane of Portuguese adolescents 15 to 17 years old in natural erect standing, and analyze differences in postural angles between sexes. Methods This cross-sectional study was conducted in 2 secondary schools in Portugal where 275 adolescent students (146 females and 129 males) aged 15 to 17 years were evaluated. Sagittal head, cervical, and shoulder angles were measured with photogrammetry and the Postural Assessment Software. Results For interrater reliability, all of the intraclass correlation coefficient (ICC) values for the 3 angles were higher than 0.85. For intrarater reliability, the ICC values for the sagittal head angle, shoulder angle, and cervical angle were 0.83, 0.78, and 0.66, respectively. Mean values of sagittal head, cervical, and shoulder angles were 17.2° ± 5.7°, 47.4° ± 5.2°, and 51.4° ± 8.5°, respectively. Anterior head carriage was demonstrated by 68% of the adolescents, whereas 58% had protraction of the shoulder(s). Males had significantly higher mean cervical and sagittal head angles. Conclusions Forward head posture and protracted shoulders were common postural disorders in adolescents 15 to 17 years old, with females revealing a lower mean cervical angle. The intrarater and interrater evaluation of standing sagittal posture of the cervical spine and shoulders by photogrammetry was reliable.


      PubDate: 2014-11-13T16:07:18Z
       
  • Evaluation of Myofascial Trigger Points Using Infrared Thermography: A
           Critical Review of the Literature
    • Abstract: Publication date: Available online 11 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Almir Vieira Dibai-Filho , Rinaldo Roberto de Jesus Guirro
      Objective The aim of this study was to review recent studies published on the use of infrared thermography for the assessment of myofascial trigger points (MTrPs). Methods A search of the MEDLINE, CINAHL, PEDro, and SciELO databases was carried out between November 2012 and January 2013 for articles published in English, Portuguese, or Spanish from the year 2000 to 2012. Because of the nature of the included studies and the purpose of this review, the analysis of methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Results The search retrieved 11 articles, 2 of which were excluded based on language (German and Chinese). Three were duplicated in different databases, 1 did not use infrared thermography for diagnostic purposes, and the other did not use infrared thermography to measure the skin temperature. Thus, the final sample was made up of 4 observational investigations: 3 comparative studies and 1 accuracy study. Conclusion At present, there are few studies evaluating the accuracy and reliability of infrared thermography for the diagnosis and assessment of MTrPs. Of the few studies present, there is no agreement on skin temperature patterns in the presence of MTrPs.


      PubDate: 2014-11-13T16:07:18Z
       
  • Use of High-Resolution Ultrasound to Measure Changes in Plantar Fascia
           Thickness Resulting From Tissue Creep in Runners and Walkers
    • Abstract: Publication date: Available online 11 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Aaron B. Welk , Daniel W. Haun , Thomas B. Clark , Norman W. Kettner
      Objective This study sought to use high-resolution ultrasound to measure changes in plantar fascia thickness as a result of tissue creep generated by walking and running. Methods Independent samples of participants were obtained. Thirty-six walkers and 25 runners walked on a treadmill for 10 minutes or ran for 30 minutes, respectively. Standardized measures of the thickness of the plantar fascia were obtained in both groups using high-resolution ultrasound. Results The mean thickness of the plantar fascia was measured immediately before and after participation. The mean plantar fascia thickness was decreased by 0.06 ± 0.33 mm SD after running and 0.03 ± 0.22 mm SD after walking. The difference between groups was not significant. Conclusion Although the parameters of this study did not produce significant changes in the plantar fascia thickness, a slightly higher change in the mean thickness of the plantar fascia in the running group deserves further investigation.


      PubDate: 2014-11-13T16:07:18Z
       
  • Manipulative Therapy and Rehabilitation for Recurrent Ankle Sprain With
           Functional Instability: A Short-Term, Assessor-Blind, Parallel-Group
           Randomized Trial
    • Abstract: Publication date: Available online 6 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Danella Lubbe , Ekta Lakhani , James W. Brantingham , Gregory F. Parkin-Smith , Tammy K. Cassa , Gary A. Globe , Charmaine Korporaal
      Objective The purpose of this study was to compare manipulative therapy (MT) plus rehabilitation to rehabilitation alone for recurrent ankle sprain with functional instability (RASFI) to determine short-term outcomes. Methods This was an assessor-blind, parallel-group randomized comparative trial. Thirty-three eligible participants with RASFI were randomly allocated to receive rehabilitation alone or chiropractic MT plus rehabilitation. All participants undertook a daily rehabilitation program over the course of the 4-week treatment period. The participants receiving MT had 6 treatments over the same treatment period. The primary outcome measures were the Foot and Ankle Disability Index and the visual analogue pain scale, with the secondary outcome measure being joint motion palpation. Data were collected at baseline and during week 5. Missing scores were replaced using a multiple imputation method. Statistical analysis of the data composed of repeated-measures analysis of variance. Results Between-group analysis demonstrated a difference in scores at the final consultation for the visual analogue scale and frequency of joint motion restrictions (P ≤ .006) but not for the Foot and Ankle Disability Index (P = .26). Conclusions This study showed that the patients with RASFI who received chiropractic MT plus rehabilitation showed significant short-term reduction in pain and the number of joint restrictions in the short-term but not disability when compared with rehabilitation alone.


      PubDate: 2014-11-09T15:49:43Z
       
  • Comparison of 2 Methods of Measuring Spine Angular Kinematics During
           Dynamic Flexion Movements: Skin-Mounted Markers Compared With Markers
           Affixed to Rigid Bodies
    • Abstract: Publication date: Available online 30 October 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Samuel J Howarth
      Objective The purpose of this study was to compare the spine flexion angle time histories computed with the 2 described techniques (dot product [DP] and a modified joint coordinate system [JCS] approaches) that used vector algebra and used skin-mounted markers to the spine flexion angles derived using local coordinate systems constructed from rigid bodies affixed to the pelvis and thorax during spine flexion movements. Methods Discrepancies between the simplified marker setup and a criterion standard (CS) method for measuring spine kinematics were quantified. Sixteen participants performed full forward spine flexion. Three-dimensional kinematic data were obtained from markers affixed bilaterally over the greater trochanters, iliac crests, and 10th ribs. Time varying spine flexion angles were derived from the 3-, and 2-dimensional marker data using a DP and a modified JCS approach. Criterion standard spine kinematics were obtained from clusters of markers adhered to 2 rigid fins that were affixed over the pelvis and trunk. The DP and JCS methods were compared with the CS by computing root mean squared differences and correlations during the spine flexion trials. Descriptive measurements of missing kinematic data were also obtained. Results On average, root mean squared differences were 30.1% lower for the JCS method of deriving spine flexion angles. Correlations were also higher for the JCS method by 2.5%, compared with the DP method. Conclusion The findings suggest that the adapted JCS method is superior to the DP method for deriving spine flexion angles. This is especially true when only 2-dimensional coordinate data are available.


      PubDate: 2014-11-06T13:49:49Z
       
  • Adverse Events Due to Chiropractic and Other Manual Therapies for Infants
           and Children: A Review of the Literature
    • Abstract: Publication date: Available online 30 October 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Angela J. Todd , Matthew T. Carroll , Anske Robinson , Eleanor K.L. Mitchell
      Objective The purpose of this study was to review the literature for cases of adverse events in infants and children treated by chiropractors or other manual therapists, identifying treatment type and if a preexisting pathology was present. Method English language, peer-reviewed journals and non–peer-reviewed case reports discussing adverse events (ranging from minor to serious) were systematically searched from inception of the relevant searchable bibliographic databases through March 2014. Articles not referring to infants or children were excluded. Results Thirty-one articles met the selection criteria. A total of 12 articles reporting 15 serious adverse events were found. Three deaths occurred under the care of various providers (1 physical therapist, 1 unknown practitioner, and 1 craniosacral therapist) and 12 serious injuries were reported (7 chiropractors/doctors of chiropractic, 1 medical practitioner, 1 osteopath, 2 physical therapists, and 1 unknown practitioner). High-velocity, extension, and rotational spinal manipulation was reported in most cases, with 1 case involving forcibly applied craniosacral dural tension and another involving use of an adjusting instrument. Underlying preexisting pathology was identified in a majority of the cases. Conclusion Published cases of serious adverse events in infants and children receiving chiropractic, osteopathic, physiotherapy, or manual medical therapy are rare. The 3 deaths that have been reported were associated with various manual therapists; however, no deaths associated with chiropractic care were found in the literature to date. Because underlying preexisting pathology was associated in a majority of reported cases, performing a thorough history and examination to exclude anatomical or neurologic anomalies before applying any manual therapy may further reduce adverse events across all manual therapy professions.


      PubDate: 2014-11-06T13:49:49Z
       
  • Prevalence of Radiographic Findings in Individuals With Chronic Low Back
           Pain Screened for a Randomized Controlled Trial: Secondary Analysis and
           Clinical Implications
    • Abstract: Publication date: Available online 1 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Robert D. Vining , Eric Potocki , Ian McLean , Michael Seidman , A. Paige Morgenthal , James Boysen , Christine Goertz
      Objective The purpose of this study is to measure the prevalence of graded disc degeneration, spondylolisthesis, transitional segmentation, and the distribution of sacral slope in patients 21 to 65 years of age with chronic low back pain (CLBP). Methods This retrospective study analyzed 247 digital lumbar radiographic series obtained during a randomized controlled trial of chiropractic patients with CLBP. Chronic low back pain was defined as pain in the low back lasting 12 weeks or longer. Radiographic findings of disc degeneration, spondylolisthesis, and lumbosacral transitional segmentation were graded by 2 authors using established classification criteria. Sacral slope was measured with a digital tool contained within imaging software. Results Lumbosacral transitional segments graded I to IV (Castellvi classification) were present in 14% of cases. Lumbar disc degeneration was most prevalent at L3-4 (49%), followed by L4-5 (42%), L2-3 (41%), L5-S1 (37%), and L1-2 (29%). Isthmic spondylolisthesis was present in 5% of cases, with L5 the most common location. Degenerative spondylolisthesis demonstrated a prevalence of 18%, most commonly occurring at L4. The prevalence of degenerative spondylolisthesis was 51% for women aged 50 to 59 years and 24% for men in the same age range. Conclusions Moderate-severe disc degeneration, multilevel disc narrowing, and degenerative spondylolisthesis were common in individuals with CLBP with age more than 40 years. Isthmic spondylolisthesis was not more prevalent than what has been reported in other populations. Transitional segmentation was identified in a minority of participants, with some of these exhibiting accessory joints or fusion. Mean sacral slope in individuals with CLBP was not substantially different from mean slopes reported in other populations.


      PubDate: 2014-11-06T13:49:49Z
       
  • The Effect of Body Position on Pulmonary Function, Chest Wall Motion, and
           Discomfort in Young Healthy Participants
    • Abstract: Publication date: Available online 1 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Satoko Naitoh , Katsuyuki Tomita , Keita Sakai , Akira Yamasaki , Yuji Kawasaki , Eiji Shimizu
      Objective The purpose of this study was to investigate the effect of different recumbent positions on pulmonary function, chest wall motion, and feelings of discomfort in young nonobese healthy volunteers. Methods Twenty healthy volunteers (age, 28.0±1.4years; height, 167.5±10.1cm; weight, 62.3±10.2kg) were studied in the sitting position and in the following 6 recumbent positions: supine, left retroversion at a 45° tilt, left anteversion at a 45° tilt, right retroversion at a 45° tilt, right anteversion at a 45° tilt, and prone. After 5minutes of a selected position, pulmonary functions, including vital capacity (VC), forced expiratory volume in 1 second, maximal inspiratory and expiratory mouth pressures (MIP and MEP, respectively), and breathing pattern components at the chest wall were assessed. Discomfort was assessed using a modified Borg scale. Results When participants changed position from sitting to each of the 6 recumbent positions, forced expiratory volume in 1 second values decreased significantly (P < .05). None of the participants showed changes in the MIP or MEP in any of the 6 recumbent positions. Rib cage motion was restricted in all recumbent positions except supine, left anteversion at a 45° tilt, and prone. In all 6 recumbent positions, discomfort was experienced during the pulmonary tests. However, in the left retroversion at a 45° tilt position, no discomfort was experienced during the MIP and MEP assessments. Conclusion In young, nonobese, healthy volunteers, recumbent positions caused diminished pulmonary functions and induced feelings of discomfort.


      PubDate: 2014-11-06T13:49:49Z
       
  • Relationship Between Chiropractic Teaching Institutions and Practice
           Characteristics Among Canadian Doctors of Chiropractic: A Random Sample
           Survey
    • Abstract: Publication date: Available online 4 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Aaron A. Puhl , Christine J Reinhart , Jon B. Doan , Marion McGregor , H. Stephen Injeyan
      Objective The objectives of this study were to determine if faction membership among Canadian doctors of chiropractic (DCs) is associated with differences in educational program characteristics among English-speaking Canadian and United States chiropractic colleges and to determine if those differences are expressed in terms of surveyed attitudes and behaviors regarding treatment efficacy, radiographic imaging, vaccinations, and interprofessional referrals. This study also aims to identify if educational programs may be a potential source of multiple professional identities. Methods A randomly selected sample of Canadian DCs, stratified across the English-speaking provinces, was surveyed by mail. Survey items included school of graduation, self-categorization by chiropractic subgroup, perceptions of condition-specific treatment efficacy, use of plain film radiographic imaging, vaccination attitudes/behaviors, and patient referral patterns. Self-categorization by chiropractic subgroup included: the unorthodox faction (associates the chiropractic subluxation as an encumbrance to the expression of health) and the orthodox perspective (associates with musculoskeletal joint dysfunction, public health, and lifestyle concerns). For data analysis, chiropractic schools were divided into 2 groups according to location: English-speaking Canada and the US. The US was further clustered into liberal (“interested in mixing elements of modern and alternative therapies into the practice of chiropractic") and conservative categories (“chiropractors who believe in continuing the traditions of chiropractic"). Results Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. χ 2 Testing revealed significant differences in self-categorized faction membership associated with the clustering of colleges based on ideological viewpoints (χ 2 = 27.06; P = .000). Descriptive results revealed a relationship between school of origin and perceived treatment efficacy, use of radiographic imaging, and vaccination attitudes. No significant differences were found relative to interprofessional referral patterns. Conclusion Chiropractic program attended is a significant predictor of orthodox vs unorthodox faction membership and professional practice characteristics for Canadian DCs. This suggests that the current chiropractic education system may contribute to multiple professional identities.


      PubDate: 2014-11-06T13:49:49Z
       
  • Sensorimotor Control During Peripheral Muscle Vibration: An Experimental
           Study
    • Abstract: Publication date: Available online 4 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jean-Alexandre Boucher , Martin C. Normand , Éric Boisseau , Martin Descarreaux
      Objective The aims of this study were to determine whether the application of vibration on a postural lower limb muscle altered the sensorimotor control of its joint as measured by isometric force production parameters and to compare present findings with previous work conducted on trunk muscle. Methods Twenty healthy adults were asked to reproduce submaximal isometric plantar flexion under 3 different conditions: no vibration and vibration frequencies of 30 and 80 Hz on the soleus muscle. Time to peak torque, variable error, as well as constant error and absolute error in peak torque were calculated and compared across conditions. Results Under vibration, participants were significantly less accurate in the force reproduction task, as they mainly undershot the target torque. Applying an 80-Hz vibration resulted in a significantly higher negative constant error than lower-frequency vibration (30 Hz) or no-vibration condition. Decreases in isometric force production accuracy under vibration influence were also observed in a previous study conducted on trunk muscle. However, no difference in constant error was found between 30- and 80-Hz vibration conditions. Conclusion The results suggest that acute soleus muscle vibration interferes with plantar flexion torque generation by distorting proprioceptive information, leading to decreases in accuracy of a force reproduction task. Similar results in an isometric trunk extension force reproduction task were found with vibration applied on erector spinae muscle. However, high-frequency vibration applied on soleus muscle elicited higher force reproduction errors than low-frequency stimulation.


      PubDate: 2014-11-06T13:49:49Z
       
  • Regional Lumbar Motion and Patient-Rated Outcomes: A Secondary Analysis of
           Data From a Randomized Clinical Trial
    • Abstract: Publication date: Available online 4 November 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Rune M Mieritz , Gert Bronfort , Jan Hartvigsen
      Objective The purpose of this study was to examine the relationship in change scores between regional lumbar motion and patient-rated pain of the previous week and back-related function in chronic low back pain patients enrolled in a randomized clinical trial and treated with either exercise therapy or spinal manipulation using 6 different motion parameters. Methods Regional lumbar motions were sampled using a 6 degrees of freedom instrumented spatial linkage system in 199 participants at baseline and 12-week follow-up. The regional lumbar motion data were analyzed as a total cohort as well as relative to subgroup stratifications; back pain only vs back and leg pain, and treatment modality. For identifying clinically meaningful improvements in the measurements of back pain and back-related function, we used a 30% threshold. Results The relationship between change scores in patient-rated outcomes and objective measures of regional lumbar motion was found to be weak. In contrast, distribution of pain and treatment received affected associations between motion parameters and patient-rated outcomes. Thus, stronger correlation coefficients and significant differences between clinically relevant improved vs no clinical relevant change were found in some motion parameters in the subgroup with back pain only and the treatment group receiving spinal manipulation. Conclusion Overall, changes in regional lumbar motion were poorly associated with patient-rated outcomes measured by back-related function and back pain intensity scores. However, associations between regional lumbar motion vs patient-rated pain and back-related function were different in relative subgroups (back pain only vs back and leg pain and treatment).


      PubDate: 2014-11-06T13:49:49Z
       
  • Immediate Effects of Active Versus Passive Scapular Correction on Pain and
           Pressure Pain Threshold in Patients With Chronic Neck Pain
    • Abstract: Publication date: Available online 1 October 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Enrique Lluch , Maria Dolores Arguisuelas , Otilia Calvente Quesada , Estibaliz Martínez Noguera , Marta Peiró Puchades , José A. Pérez Rodríguez , Deborah Falla
      Objective The purpose of this study was to investigate the effect of active vs passive scapular correction on pain and pressure pain threshold at the most symptomatic cervical segment in patients with chronic neck pain. Methods Twenty-three volunteers with chronic, idiopathic neck pain were recruited (age, 38.9 ± 14.4 years; sex [man/woman], 3/20; Neck Disability Index, 28.1% ± 9.9%). Subjects were randomly allocated to 2 groups: active scapular correction or passive scapular correction. Pressure pain threshold and pain intensity rated on a numerical rating scale during a posteroanterior glide over the most symptomatic cervical segment were measured before and immediately after the active or passive scapular intervention. Results Only the active scapular correction produced a reduction in pain (pre, 6.3 ± 1.2; post, 3.7 ± 2.4; P < .05) and increase in pressure pain threshold (pre, 8.7 ± 4.2 kg/cm2; post, 10.1 ± 3.8 kg/cm2; P < .05) at the most painful cervical segment. Conclusions An active scapular correction exercise resulted in an immediate reduction of pain and pressure pain sensitivity in patients with chronic neck pain and scapular dysfunction.


      PubDate: 2014-10-06T14:52:15Z
       
  • Immediate Changes After Manual Therapy in Resting-State Functional
           Connectivity as Measured by Functional Magnetic Resonance Imaging in
           Participants With Induced Low Back Pain
    • Abstract: Publication date: Available online 3 October 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Charles W. Gay , Michael E. Robinson , Steven Z. George , William M. Perlstein , Mark D. Bishop
      Objective The purposes of this study were to use functional magnetic resonance imaging to investigate the immediate changes in functional connectivity (FC) between brain regions that process and modulate the pain experience after 3 different types of manual therapies (MT) and to identify reductions in experimentally induced myalgia and changes in local and remote pressure pain sensitivity. Methods Twenty-four participants (17 men; mean age ± SD, 21.6 ± 4.2 years) who completed an exercise-injury protocol to induce low back pain were randomized into 3 groups: chiropractic spinal manipulation (n = 6), spinal mobilization (n = 8), or therapeutic touch (n = 10). The primary outcome was the immediate change in FC as measured on functional magnetic resonance imaging between the following brain regions: somatosensory cortex, secondary somatosensory cortex, thalamus, anterior and posterior cingulate cortices, anterior and poster insula, and periaqueductal gray. Secondary outcomes were immediate changes in pain intensity, measured with a 101-point numeric rating scale, and pain sensitivity, measured with a handheld dynamometer. Repeated-measures analysis of variance models and correlation analyses were conducted to examine treatment effects and the relationship between within-person changes across outcome measures. Results Changes in FC were found between several brain regions that were common to all 3 MT interventions. Treatment-dependent changes in FC were also observed between several brain regions. Improvement was seen in pain intensity after all interventions (P < .05) with no difference between groups (P > .05). There were no observed changes in pain sensitivity, or an association between primary and secondary outcome measures. Conclusion These results suggest that MTs (chiropractic spinal manipulation, spinal mobilization, and therapeutic touch) have an immediate effect on the FC between brain regions involved in processing and modulating the pain experience. This suggests that neurophysiologic changes after MT may be an underlying mechanism of pain relief.


      PubDate: 2014-10-06T14:52:15Z
       
  • Occupational Low Back Pain in Primary and High School Teachers: Prevalence
           and Associated Factors
    • Abstract: Publication date: Available online 1 October 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Mohammad A. Mohseni Bandpei , Fatemeh Ehsani , Hamid Behtash , Marziyeh Ghanipour
      Objective The purposes of this study were to investigate the prevalence of and risk factors for low back pain (LBP) in teachers and to evaluate the association of individual and occupational characteristics with the prevalence of LBP. Methods In this cross-sectional study, 586 asymptomatic teachers were randomly selected from 22 primary and high schools in Semnan city of Iran. Data on the personal, occupational characteristics, pain intensity, and functional disability as well as the prevalence and risk factors of LBP were collected using different questionnaires. Results Point, last month, last 6 months, annual, and lifetime prevalence rates of LBP were 21.8%, 26.3%, 29.6%, 31.1%, and 36.5%, respectively. The highest prevalence was obtained for the high school teachers. The prevalence of LBP was significantly associated with age, body mass index, job satisfaction, and length of employment (P < .05 in all instances). Prolonged sitting and standing, working hours with computer, and correcting examination papers were the most aggravating factors, respectively. Rest and participation in physical activity were found to be the most relieving factors. Conclusion The prevalence of LBP in teachers appears to be high. High school teachers were more likely to experience LBP than primary school teachers. Factors such as age, body mass index, length of employment, job satisfaction, and work-related activities were significant factors associated with LBP in this teacher population.


      PubDate: 2014-10-06T14:52:15Z
       
  • Assessment of Scoliotic Deformity Using Spinous Processes: Comparison of
           Different Analysis Methods of an Ultrasonographic System
    • Abstract: Publication date: Available online 1 October 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Terry K. Koo , Jing-Yi Guo , Christina Ippolito , Jamie C. Bedle
      Objective The purpose of this study was to evaluate the performance of 5 analysis methods in quantifying scoliotic deformity, using the spatial positions of SP tips acquired by a custom-developed ultrasound-based system, with different curve fitting methods and angle metrics in terms of their correlation with Cobb angle, test-retest reliability, vulnerability to digitization errors, and accuracy of identifying end vertebrae and convexity direction. Methods Three spinal column dry bone specimens were randomly configured to 30 different scoliotic deformities. Raw spatial data of the SP tips were processed by the following 3 methods: (1) fifth-order polynomial fitting, (2) locally weighted polynomial regression (LOESS) with smoothing parameter (α) = .25, and (3) LOESS with α = .4. Angle between the 2 tangents along the spinal curve with the most positive and negative slopes (ie, posterior deformity angle) and summation of the angles formed by every 2 lines joining 3 neighboring SPs between the end vertebrae (ie, accumulating angle) were computed to quantify scoliotic deformity. Their performances were compared in terms of their correlation with Cobb angle, test-retest reliability, vulnerability to digitization errors, and accuracy of identifying end vertebrae. Results Posterior deformity angle calculated from the spinal curve constructed by LOESS with α = .4 excelled in every aspect of the comparison (ie, Cobb angle, test-retest reliability, vulnerability to digitization errors, and accuracy of identifying end vertebrae and convexity direction), making it the method of choice of those tested for processing the spatial data of the SP tips in this ultrasonography study using dry bone specimens. Conclusions The ultrasound-based system and the LOESS (0.4)–posterior deformity angle method developed for this study offer a viable technology for quantifying scoliotic deformity in a reliable and radiation-free manner. However, further validation using scoliosis subjects is needed before they can be used to quantify spinal deformity in the clinical setting.


      PubDate: 2014-10-06T14:52:15Z
       
  • Editorial Board
    • Abstract: Publication date: October 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 8




      PubDate: 2014-10-06T14:52:15Z
       
  • Table of Contents
    • Abstract: Publication date: October 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 8




      PubDate: 2014-10-06T14:52:15Z
       
  • Information for Readers
    • Abstract: Publication date: October 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 8




      PubDate: 2014-10-06T14:52:15Z
       
  • Pain, Disability, and Diagnostic Accuracy of Clinical Instability and
           Endurance Tests in Subjects With Lumbar Spondylolisthesis
    • Abstract: Publication date: Available online 1 October 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Silvano Ferrari , Carla Vanti , Raffaella Piccarreta , Marco Monticone
      Objective The aims of this study were (1) to investigate the relationship between the main clinical tests to detect spinal instability, the perceived pain and disability, and symptomatic spondylolisthesis (SPL) characteristics, (2) to investigate the relationship between endurance and instability tests, and (3) to measure the diagnostic accuracy of these tests in unstable SPL diagnosed against dynamic radiographs. Methods Four instability tests were evaluated on 119 subjects: aberrant movements, active straight leg raising (ASLR), prone instability test, and passive lumbar extension test (PLE); and 2 endurance tests, prone bridge test and supine bridge test (SBT). The results were compared with the numeric rating scale for pain and the Oswestry Disability Index for disability. These tests were used as index tests and compared with dynamic radiographs as reference standard on 64 subjects. Results A significant relationship between disability and all the clinical tests but ASLR was observed. The relation between tests and pain was weaker, not significant for prone instability test and aberrant movement and critical for ASLR (P = .05). There was a low relationship between endurance tests and instability tests. Only PLE showed a significant association with dynamic radiographs (P = .017). Conclusion Endurance and instability tests appear to be weakly related to the amount of pain but significantly related to the disability in symptomatic SPL. Of the tests evaluated, PLE exhibited the best ability to predict positive dynamic radiographs.


      PubDate: 2014-10-06T14:52:15Z
       
  • Comparison Between Neck Pain Disability and Cervical Range of Motion in
           Patients With Episodic and Chronic Migraine: A Cross-Sectional Study
    • Abstract: Publication date: Available online 3 October 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Gabriela F. Carvalho , Thais C. Chaves , Maria C. Gonçalves , Lidiane L. Florencio , Carolina A. Braz , Fabíola Dach , Cesar Fernández de Las Peñas , Débora Bevilaqua-Grossi
      Objective The purpose of this study was to evaluate neck pain–related disability and cervical range of motion (CROM) in patients with episodic migraine (EM) and chronic migraine (CM) and to examine the correlation of both outcomes. Methods This cross-sectional study consisted of 91 patients with EM and 34 with CM. Cervical range of motion was measured with the CROM device, and pain during the cervical movement was recorded. Self-reported disability related to neck pain was assessed with the Neck Disability Index. Results Patients with CM showed higher Neck Disability Index scores and more moderate and severe disability (P = .01). Severe disability as a result of neck pain was associated with 7.6-fold risk of developing CM (P = .003). No significant differences in CROM were identified between groups. Moderate negative correlations between CROM and disability were found for 4 motions within the CM group (−0.60 < r < −0.39) and with 3 in the EM group (−0.48 < −0.45). Disability was positively and moderately correlated to pain evoked during CROM in both groups (0.34 < r <0.51). Conclusion This study found that neck pain was highly prevalent in patients with migraine. Neck pain–related disability increased with increased frequency of the migraine attacks and was associated with the risk of migraine chronicity. The correlation between CROM and neck pain disability was more evident in patients with CM and in patients with pain during cervical movement.


      PubDate: 2014-10-06T14:52:15Z
       
  • A Comparative Analysis of Static Balance Between Patients With Lumbar
           Spinal Canal Stenosis and Asymptomatic Participants
    • Abstract: Publication date: Available online 26 September 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Aleksandra Truszczyńska , Justyna Drzał-Grabiec , Zbigniew Trzaskoma , Kazimierz Rąpała , Adam Tarnowski , Krystyna Górniak
      Objective The aim of this study was to assess static balance in patients with lumbar spinal canal stenosis who qualified for surgical decompression of associated neural structures and compare them with asymptomatic participants. Methods This case-controlled study evaluated a sample of 50 patients with spinal canal stenosis (stenosis group) and 48 participants with no history of clinical symptoms of back pain. Static balance was assessed by conducting quantitative analysis of balance reaction parameters in quiet standing with the eyes closed. Results Higher values were observed in total length of center of pressure (COP) path, length of COP path in the anterior-posterior plane, mean amplitude of COP projection in the anterior-posterior plane, maximal amplitude between the 2 most distant points in the anterior-posterior plane, mean COP velocity, and sway area marked by the moving COP in the stenosis group compared with the asymptomatic group. Conclusions This study showed statistically significant differences in static balance parameters between patients with spinal canal stenosis compared with the asymptomatic group.


      PubDate: 2014-10-01T12:12:32Z
       
  • Chiropractic Use in the Medicare Population: Prevalence, Patterns, and
           Associations With 1-Year Changes in Health and Satisfaction With Care
    • Abstract: Publication date: Available online 16 September 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Paula A.M. Weigel , Jason M. Hockenberry , Fredric D. Wolinsky
      Objective The purpose of this study was to examine how chiropractic care compares to medical treatments on 1-year changes in self-reported function, health, and satisfaction with care measures in a representative sample of Medicare beneficiaries. Methods Logistic regression using generalized estimating equations is used to model the effect of chiropractic relative to medical care on decline in 5 functional measures and 2 measures of self-rated health among 12170 person-year observations. The same method is used to estimate the comparative effect of chiropractic on 6 satisfaction with care measures. Two analytic approaches are used, the first assuming no selection bias and the second using propensity score analyses to adjust for selection effects in the outcome models. Results The unadjusted models show that chiropractic is significantly protective against 1-year decline in activities of daily living, lifting, stooping, walking, self-rated health, and worsening health after 1 year. Persons using chiropractic are more satisfied with their follow-up care and with the information provided to them. In addition to the protective effects of chiropractic in the unadjusted model, the propensity score results indicate a significant protective effect of chiropractic against decline in reaching. Conclusion This study provides evidence of a protective effect of chiropractic care against 1-year declines in functional and self-rated health among Medicare beneficiaries with spine conditions, and indications that chiropractic users have higher satisfaction with follow-up care and information provided about what is wrong with them.


      PubDate: 2014-09-17T08:42:00Z
       
  • Changes in Spasticity, Widespread Pressure Pain Sensitivity, and
           Baropodometry After the Application of Dry Needling in Patients Who Have
           Had a Stroke: A Randomized Controlled Trial
    • Abstract: Publication date: Available online 8 September 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jaime Salom-Moreno , Zacarías Sánchez-Mila , Ricardo Ortega-Santiago , Maria Palacios-Ceña , Sebastian Truyol-Domínguez , César Fernández-de-las-Peñas
      Objective The purpose of this study was to determine the effects of deep dry needling (DDN) on spasticity, pressure sensitivity, and plantar pressure in patients who have had stroke. Methods A randomized controlled trial was conducted. Thirty-four patients who previously had a stroke were randomly assigned either an experimental group that received a single session of DDN over the gastrocnemius and tibialis anterior muscles on the spastic leg or a control group that received no intervention. Spasticity (evaluated with the Ashworth Scale); pressure pain thresholds over the deltoid muscle, second metacarpal, and tibialis anterior muscle; and plantar pressure (baropodometry) were collected by a blinded assessor before and 10 minutes after intervention. Results A greater number of individuals receiving DDN exhibited decreased spasticity after the intervention (P < .001). The analysis of covariance showed that pressure pain thresholds increased bilaterally in patients receiving DDN compared with those who did not receive the intervention (P < .001). The analysis of covariance also found that patients receiving DDN experienced bilateral increases of support surface in the forefoot, unilateral increase of the support surface in the rear foot of the treated (affected) side, and bilateral decreases in mean pressure (all, P < .02) as compared with those who did not receive DDN. Conclusions Our results suggest that a single session of DDN decreases spasticity and widespread pressure sensitivity in individuals with poststroke spasticity. Deep dry needling also induced changes in plantar pressure by increasing the support surface and decreasing the mean pressure.


      PubDate: 2014-09-13T07:52:34Z
       
  • Real-Time Monitoring of Stresses and Displacements in Cervical Nuclei
           Pulposi During Cervical Spine Manipulation: A Finite Element Model
           Analysis
    • Abstract: Publication date: Available online 8 September 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Li-Ping Wu , Yuan-Qiao Huang , Das Manas , Yong-yuan Chen , Ji-hong Fan , Hua-gui Mo
      Objective The objective of this study was to research the distribution of stresses and displacements in cervical nuclei pulposi during simulated cervical spine manipulation (CSM). Methods A 3-dimensional finite element model of C3/4~C6/7 was established. The detailed mechanical parameters of CSM were analyzed and simulated. During the process, the changes in stresses and displacements of cervical nuclei pulposi within the model were displayed simultaneously and dynamically. Results Cervical spine manipulation with right rotation was targeted at the C4 spinous process of the model. During traction, levels of stresses and displacements of the nuclei pulposi exhibited an initial decrease followed by an increase. The major stresses and displacements affected the C3/4 nucleus pulposus during rotation in CSM, when its morphology gradually changed from circular to elliptical. The highest stress (48.53 kPa) occurred at its right superior edge, on rotating 40° to the right. It protruded toward the right superior, creating a gap in its left inferior aspect. The highest displacement, also at 40° right, occurred at its left superior edge and measured 0.7966 mm. Dimensions of stresses and displacements reduced quickly on rapid return to neutral position. Conclusion The morphology of the C3/4 nucleus pulposus changed during CSM with right rotation, and it created a gap in its left inferior aspect. Biomechanically, it is more safe and rational to rotate toward the healthy side than the prolapsed side of the intervertebral disk during CSM. Upon ensuring due safety, the closer the application force is to the diseased intervertebral disk, the better is the effect of CSM.


      PubDate: 2014-09-13T07:52:34Z
       
  • Exploring Patient Satisfaction: A Secondary Analysis of a Randomized
           Clinical Trial of Spinal Manipulation, Home Exercise, and Medication for
           Acute and Subacute Neck Pain
    • Abstract: Publication date: Available online 8 September 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Brent D. Leininger , Roni Evans , Gert Bronfort
      Objective The purpose of this study was to assess satisfaction with specific aspects of care for acute neck pain and explore the relationship between satisfaction with care, neck pain, and global satisfaction. Methods This study was a secondary analysis of patient satisfaction from a randomized trial of spinal manipulation therapy (SMT) delivered by doctors of chiropractic, home exercise and advice (HEA) delivered by exercise therapists, and medication (MED) prescribed by a medical doctors for acute/subacute neck pain. Differences in satisfaction with specific aspects of care were analyzed using a linear mixed model. The relationship between specific aspects of care and (1) change in neck pain (primary outcome of the randomized trial) and (2) global satisfaction were assessed using Pearson's correlation and multiple linear regression. Results Individuals receiving SMT or HEA were more satisfied with the information and general care received than MED group participants. Spinal manipulation therapy and HEA groups reported similar satisfaction with information provided during treatment; however, the SMT group was more satisfied with general care. Satisfaction with general care (r = −0.75 to −0.77; R 2 = 0.55-0.56) had a stronger relationship with global satisfaction compared with satisfaction with information provided (r = −0.65 to 0.67; R 2 = 0.39-0.46). The relationship between satisfaction with care and neck pain was weak (r = 0.17-0.38; R 2 = 0.08-0.21). Conclusions Individuals with acute/subacute neck pain were more satisfied with specific aspects of care received during spinal manipulation therapy or home exercise interventions compared to receiving medication. The relationship between neck pain and satisfaction with care was weak.


      PubDate: 2014-09-13T07:52:34Z
       
  • Lumbar Spinal Stenosis and Lower Extremity Motor Control: The Impact of
           Walking-Induced Strain on a Performance-Based Outcome Measure
    • Abstract: Publication date: Available online 8 September 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Steven R. Passmore , Michael Johnson , Valerie Pelleck , Erica Ramos , Yasmine Amad , Cheryl M. Glazebrook
      Objective The primary objective of this study was to quantify the lower extremity movements and capabilities of a population with lumbar spinal stenosis (LSS) compared with healthy age-matched controls under conditions of strain and no strain. The secondary objective was to identify challenging movement conditions for a population with LSS, on a lower limb aiming task with different levels of difficulty, compared with healthy age-matched controls under conditions of strain and no strain. Methods Using a nonrandomized, controlled, before-and-after design, LSS patients (n = 16) and healthy controls (n = 16) performed 2 blocks of great toe–pointing movements to a series of projected squares. Following block 1, participants completed a 12-minute progressive exercise treadmill test. Pointing movements were analyzed using 3D motion analysis. Behavioral and kinematic measures evaluated performance. Results Both groups' reaction times (RTs) lengthened as task difficulty increased. An interaction revealed that LSS patients were more adversely impacted by task difficulty, F (3,372) = 4.207; P = .006. The progressive exercise treadmill test facilitated RT for both groups, F (1,124) = 5.105; P = .026. Control participants showed less variability in time-to-peak velocity poststrain, a benefit not shared by LSS patients, t (31) = 2.149; P = .040. Conclusion A lower extremity movement task captured differences under strain between healthy and LSS populations. The lower extremity Fitts' Law task accurately measured differences between healthy and LSS participants. For the subjects in this study, strain was sufficient to prevent LSS patients from demonstrating improvement in the variability of the ballistic phase of movement execution, whereas LSS patients' movement performance remained unchanged. This study also showed that regardless of strain, as task difficulty increased, LSS patients were more adversely impacted in the planning and execution of their lower limb movements than healthy control participants. The lower extremity motor control task (Fitts' task) can be used as a performance-based outcome measure to measure differences between healthy and LSS populations.


      PubDate: 2014-09-13T07:52:34Z
       
  • Effect of Spinal Manipulation Thrust Duration on Trunk Mechanical
           Activation Thresholds of Nociceptive-Specific Lateral Thalamic Neurons
    • Abstract: Publication date: Available online 12 September 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): William R. Reed , Randall Sozio , Joel G. Pickar , Stephen M. Onifer
      Objective The objective of this preliminary study was to determine if high-velocity, low-amplitude spinal manipulation (HVLA-SM) thrust duration alters mechanical trunk activation thresholds of nociceptive-specific (NS) lateral thalamic neurons. Methods Extracellular recordings were obtained from 18 NS neurons located in 2 lateral thalamic nuclei (ventrolateral [n = 12] and posterior [n = 6]) in normal anesthetized Wistar rats. Response thresholds to electronic von Frey anesthesiometer (rigid tip) mechanical trunk stimuli applied in 3 lumbar directions (dorsal-ventral, 45° caudal, and 45° cranial) were determined before and immediately after the delivery of 3 HVLA-SM thrust durations (time control 0, 100, and 400 milliseconds). Mean changes in mechanical trunk activation thresholds were compared using a mixed model analysis of variance. Results High-velocity, low-amplitude spinal manipulation duration did not significantly alter NS lateral thalamic neurons' mechanical trunk responses to any of the 3 directions tested with the anesthesiometer. Conclusions This study is the first to examine the effect of HVLA-SM thrust duration on NS lateral thalamic mechanical response thresholds. High-velocity, low-amplitude spinal manipulation thrust duration did not affect mechanical trunk thresholds.


      PubDate: 2014-09-13T07:52:34Z
       
  • The Risk of Bias and Sample Size of Trials of Spinal Manipulative Therapy
           for Low Back and Neck Pain: Analysis and Recommendations
    • Abstract: Publication date: Available online 5 September 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Sidney M. Rubinstein , Rik van Eekelen , Teddy Oosterhuis , Michiel R. de Boer , Raymond W.J.G. Ostelo , Maurits W. van Tulder
      Objective The purpose of this study was to evaluate changes in methodological quality and sample size in randomized controlled trials (RCTs) of spinal manipulative therapy (SMT) for neck and low back pain over a specified period. A secondary purpose was to make recommendations for improvement for future SMT trials based upon our findings. Methods Randomized controlled trials that examined the effect of SMT in adults with neck and/or low back pain and reported at least 1 patient-reported outcome measure were included. Studies were identified from recent Cochrane reviews of SMT, and an update of the literature was conducted (March 2013). Risk of bias was assessed using the 12-item criteria recommended by the Cochrane Back Review Group. In addition, sample size was examined. The relationship between the overall risk of bias and sample size over time was evaluated using regression analyses, and RCTs were grouped into periods (epochs) of approximately 5 years. Results In total, 105 RCTs were included, of which 41 (39%) were considered to have a low risk of bias. There is significant improvement in the mean risk of bias over time (P < .05), which is the most profound for items related to selection bias and, to a lesser extent, attrition and selective outcome reporting bias. Furthermore, although there is no significant increase in sample size over time (overall P = .8), the proportion of studies that performed an a priori sample size calculation is increasing statistically (odds ratio, 2.1; confidence interval, 1.5-3.0). Sensitivity analyses suggest no appreciable difference between studies for neck or low back pain for risk of bias or sample size. Conclusion Methodological quality of RCTs of SMT for neck and low back pain is improving, whereas overall sample size has shown only small and nonsignificant increases. There is an increasing trend among studies to conduct sample size calculations, which relate to statistical power. Based upon these findings, 7 areas of improvement for future SMT trials are suggested.


      PubDate: 2014-09-08T06:39:24Z
       
  • Information for Readers
    • Abstract: Publication date: September 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 7




      PubDate: 2014-09-08T06:39:24Z
       
  • Reliability of Surface Electromyography in the Assessment of Paraspinal
           Muscle Fatigue: An Updated Systematic Review
    • Abstract: Publication date: September 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 7
      Author(s): Mohammad A. Mohseni Bandpei , Nahid Rahmani , Basir Majdoleslam , Iraj Abdollahi , Shabnam Shah Ali , Ashfaq Ahmad
      Objective The purpose of this study was to review the literature to determine whether surface electromyography (EMG) is a reliable tool to assess paraspinal muscle fatigue in healthy subjects and in patients with low back pain (LBP). Methods A literature search for the period of 2000 to 2012 was performed, using PubMed, ProQuest, Science Direct, EMBASE, OVID, CINAHL, and MEDLINE databases. Electromyography, reliability, median frequency, paraspinal muscle, endurance, low back pain, and muscle fatigue were used as keywords. Results The literature search yielded 178 studies using the above keywords. Twelve articles were selected according to the inclusion criteria of the study. In 7 of the 12 studies, the surface EMG was only applied in healthy subjects, and in 5 studies, the reliability of surface EMG was investigated in patients with LBP or a comparison with a control group. In all of these studies, median frequency was shown to be a reliable EMG parameter to assess paraspinal muscles fatigue. There was a wide variation among studies in terms of methodology, surface EMG parameters, electrode location, procedure, and homogeneity of the study population. Conclusions The results suggest that there seems to be a convincing body of evidence to support the merit of surface EMG in the assessment of paraspinal muscle fatigue in healthy subject and in patients with LBP.


      PubDate: 2014-09-08T06:39:24Z
       
  • Table of Contents
    • Abstract: Publication date: September 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 7




      PubDate: 2014-09-08T06:39:24Z
       
  • Editorial Board
    • Abstract: Publication date: September 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 7




      PubDate: 2014-09-08T06:39:24Z
       
  • Spinal Height Change in Response to Sustained and Repetitive Prone Lumbar
           Extension After a Period of Spinal Unloading
    • Abstract: Publication date: Available online 4 September 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): M'Lyn Lazzarini , Jean-Michel Brismée , S. Christopher Owens , Gregory S. Dedrick , Phillip S. Sizer
      Objective The purpose of this study was to investigate if differences in spinal height changes in healthy individuals were observed after a period of spinal unloading using repetitive as compared with sustained lumbar extension exercises. Methods This study used a pretest, posttest, crossover design. Asymptomatic participants were recruited using convenience sampling. Thirty-two participants (15 male; 17 female) without back pain were included in the data analysis (mean, 24.4 years; range, 20-41 years). Participants performed sustained or repetitive prone lumbar extension exercises after 1 hour of sustained spinal unloading. Spinal height was measured using a stadiometer before and after the repetitive and sustained prone lumbar extension exercises. Results Paired t tests revealed no significant difference in spine height after repetitive (P = .774) or sustained (P = .545) prone lumbar extension after a period of spinal unloading. No significant difference between spinal height changes occurred between sustained (mean [SD], −0.28 [2.59] mm) and repetitive (mean [SD], −0.12 [2.42] mm) lumbar extension (P = .756). Conclusion In this group of asymptomatic individuals, sustained and repetitive lumbar extension exercises did not appear to affect spinal height after a period of spinal unloading.


      PubDate: 2014-09-08T06:39:24Z
       
  • Immediate Effects of Manual Traction on Radiographically Determined Joint
           Space Width in the Hip Joint
    • Abstract: Publication date: Available online 4 September 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Tomonori Sato , Naomi Sato , Kenji Masui , Yukinobu Hirano
      Objective The purpose of this study was to investigate the immediate effects of manual traction of the hip joint on joint space width (JSW) on asymptomatic subjects. Methods Asymptomatic, healthy male volunteers (n = 15), aged 25 to 34 years were included in this study. Three radiographs were obtained with the subjects in the supine position, before and after loading with 10% of his body weight, and after manual traction on only the right hip joint. Joint space width was measured by a radiologist at the point described by Jacobson and Sonne-Holm. Results There were significant changes in JSW on the right hip joint and left hip joint between the baseline (before loading) and immediately after loading. We also observed a significantly increased JSW on only the right hip joint between periods that followed loading and manual traction on the right hip joint. There was no significant change in JSW on the left hip joint between periods that followed loading and manual traction on the right hip joint. Conclusions The results of this study suggest that a significant increase in JSW in young, healthy male patients can occur immediately after manual traction of the hip joint.


      PubDate: 2014-09-08T06:39:24Z
       
  • Information for Readers
    • Abstract: Publication date: July–August 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 6




      PubDate: 2014-09-04T06:06:50Z
       
  • Editorial Board
    • Abstract: Publication date: July–August 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 6




      PubDate: 2014-09-04T06:06:50Z
       
  • Table of Contents
    • Abstract: Publication date: July–August 2014
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 37, Issue 6




      PubDate: 2014-09-04T06:06:50Z
       
  • Functions of the Temporomandibular System in Extracranial Chronic Pain
           
    • Abstract: Publication date: Available online 21 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Michael J. Fischer , Michael Stephan , Heike Kielstein , Henning Rahne , Boya Nugraha , Christoph Gutenbrunner , Jin Y. Ro , Peter Svensson
      Objective Mastication may be able to activate endogenous pain inhibitory mechanisms and therefore lead to modulation of nociceptive processing. The purpose of this study was to examine the possible effect of food consistency on noxious input from the spinal system. Methods Three groups of adult male Sprague-Dawley rats were given an injection of complete Freund adjuvant in a hind paw 10 days after eating soft or hard food (one group received a saline injection—the control group [C]; the other group (D) received no injection). Nocifensive behavior was assessed with the use of the hot plate and tail flick assays at 1, 3, 6, and 12 hours and at 6.5 days after injection for groups A/B, and c-Fos activity was assessed in the brain after testing. Groups C/D had hot plate testing at 1 hour and 6.5 days. The data were analyzed by general linear modeling and 1-way analysis of variance. Results There was a small increase in the hot plate percent maximum possible effect (MPE) from −45.7 to −61.1 in group A over the length of the experiment, but a very small decrease for group B over the same period (−33.5 to −28.8). For the saline control group, there was a small increase toward 0 %MPE over the same time frame (−15.0 to 1.7). The %MPE differences were significant between groups A and C (P < .0005), but not significant between the other groups (F = 13.34, df = 2, P = .001, observed power = 99%). Using the pooled results (all time points), the differences between all groups were significant (P < .0005). There were no significant differences in the tail flick test. c-Fos was mainly observed in the raphe pallidus area with significant differences between groups A and B at 3 and 6 hours after injection of CFA (P = .027 and .022, respectively). Conclusions The results of this study indicate that food consistency (hardness) influences nocifensive behavior in this animal model via a descending pathway operating at the supraspinal level.


      PubDate: 2014-09-04T06:06:50Z
       
  • A Preliminary Study to Evaluate Postural Improvement in Subjects With
           Scoliosis: Active Therapeutic Movement Version 2 Device and Home Exercises
           Using the Mulligan’s Mobilization-With-Movement Concept
    • Abstract: Publication date: Available online 21 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Clare Lewis , Rafael Diaz , Geoff Lopez , Nicholas Marki , Ben Olivio
      Objective The purpose of this preliminary study was to determine if the use of Active Therapeutic Movement Version 2 (ATM2) device and home exercises using the Mulligan’s mobilization-with-movement concept by subjects with scoliosis would result in postural improvement and to document any changes in trunk range of motion and quality of life. Methods Forty-three subjects between the ages of 12 to 75 years were recruited for the study. Each subject underwent a low back evaluation along with specific measurements for their scoliosis. Subjects participated in a 4-week intervention, 2 times a week consisting of treatment utilizing the ATM2 and were also given a home exercise program to mimic the specific movement(s) they performed on the ATM2. Photographic assessment of posture was taken before and after the intervention. Subjects were surveyed during the initial assessment and again at the final intervention using the following outcome measures: Fear Avoidance Belief Questionnaire, Short-Form Health Survey-36, Oswestry Disability Index, and a Numeric Pain Rating Scale. Results Results were significant for most of the variables measured. Subjects gained improvement in spinal ranges of motion for all directions except for flexion and extension (most subjects had reference range of flexion and extension at the beginning of the study). Most subjects had improved pelvic alignment after the intervention. Before and after photographs demonstrated improved posture. Subjective measurements of pain, disability, and quality of life improved. Conclusions Results of this preliminary study showed improvement for selected variables. The use of ATM2 and home exercises using the Mulligan’s mobilization-with-movement concept by subjects with scoliosis appears to be a potentially viable conservative treatment alternative to address various findings associated with scoliosis, including posture improvement.


      PubDate: 2014-09-04T06:06:50Z
       
  • Ultrasound Imaging of the Trapeziometacarpal Articular Cavity to
           Investigate the Presence of Intraarticular Gas Bubbles After Chiropractic
           Manipulation
    • Abstract: Publication date: Available online 10 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Allan R. Jones , Christopher J. Yelverton , Charmaine Bester
      Objective The purpose of this study was to investigate the presence of intraarticular gas bubbles in the trapeziometacarpal joint cavity after chiropractic manipulation with audible cavitation and to assess the state of the gas bubbles after a 20-minute refractory period. Methods This investigation included 18 asymptomatic male and female participants between the ages of 21 and 26 years. High-resolution (15 MHz) sonograms of the trapeziometacarpal articular cavity were obtained by an experienced musculoskeletal ultrasonographer at 3 intervals: premanipulation, within 30 seconds postmanipulation, and at 20 minutes postmanipulation. The sonograms were saved as digital copies for subsequent reports that were correlated with reports compiled during dynamic visualization of the articular cavity. Data were extracted from the reports for analysis. Results The premanipulative sonograms showed that 27.78% of joints contained minute gas bubbles, also known as microcavities, within the synovial fluid before the joint was manipulated. The remaining 72.22% of joints contained no intraarticular microcavities. All of the postmanipulative sonograms revealed numerous large conspicuous gas bubbles within the synovial fluid. The postrefractory sonograms showed that, in 66.66% of the synovial fluid, gas bubbles were still visible, whereas the remaining 33.34% had no presence of gas bubbles or microcavities, and the synovial fluid had returned to its premanipulative state. Conclusion The findings of this study suggest that synovial fluid may contain intraarticular microcavities even before a manipulation is performed. Numerous large intraarticular gas bubbles are formed during manipulation due to cavitation of the synovial fluid and were observed in the absence of an axial distractive load at the time of imaging. In most cases, these gas bubbles remained within the joint for longer than 20 minutes.


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


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


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


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


      PubDate: 2014-08-10T04:10:35Z
       
  • A Qualitative Exploration of Key Informant Perspectives Regarding the
           Nature and Impact of Contemporary Legislation on Professional Development:
           A Grounded Theory Study of Chiropractic in Denmark
    • Abstract: Publication date: Available online 2 August 2014
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Corrie Myburgh
      Objective The purpose of this study was to construct a substantive framework of the manner in which the Danish government interacts with the Danish chiropractic profession and influences professional practice. Methods An exploratory, qualitative study was performed using a substantive grounded theory (GT) approach. Unstructured, face-to-face, individual interviews were conducted during the years 2012 and 2013 and thematically analyzed. Six people were interviewed for this study including a gatekeeper and witness to legislative history, a previous chiropractic political representative and witness to legislative history, a previous Department of Health negotiator and previous administrator of chiropractic affairs and witness to legislative history, a current administrator of chiropractic affairs, an active chiropractic political representative and witness to legislative history, and a chief negotiator for Danish Regional Health Care Services. Results Open and axial coding yielded 2 themes centering on licensing chiropractors in Denmark and the resultant developmental issues encountered. Through further selective coding, the GT core construct, “chiropractic practice in the Danish heath care system” emerged. The GT highlights the tension between the strategic political importance of legislation and the restrictive nature of the overly specific act currently regulating chiropractic practice. Moreover, the GT also revealed the perceived negative effect that the National Board of Health may exert on clinical practice due to its conservative interpretation of the act. Conclusions The Danish government is perceived to act as a countervailing power related to chiropractic practice. The derived substantive GT suggests that the Danish government's dualistic action relative to the Danish chiropractic community may inhibit the spontaneous evolution of contemporary Danish chiropractic practice. Although historically narrow legislation may limit chiropractic practice, conservative interpretations by the Danish National Board of Health may also play an important role.


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


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


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


      PubDate: 2014-07-28T03:21:46Z
       
 
 
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