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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  [3175 journals]
  • Relationships Between Trunk Movement Patterns During Lifting Tasks
           Compared With Unloaded Extension From a Flexed Posture
    • Authors: Yuta Ogata; Masaya Anan; Makoto Takahashi; Takuya Takeda; Kenji Tanimoto; Tomonori Sawada; Koichi Shinkoda
      Pages: 189 - 198
      Abstract: Publication date: March–April 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 3
      Author(s): Yuta Ogata, Masaya Anan, Makoto Takahashi, Takuya Takeda, Kenji Tanimoto, Tomonori Sawada, Koichi Shinkoda
      Objectives The purpose of this study was to investigate between movement patterns of trunk extension from full unloaded flexion and lifting techniques, which could provide valuable information to physical therapists, doctors of chiropractic, and other manual therapists. Methods A within-participant study design was used. Whole-body kinematic and kinetic data during lifting and full trunk flexion were collected from 16 healthy male participants using a 3-dimensional motion analysis system (Vicon Motion Systems). To evaluate the relationships of joint movement between lifting and full trunk flexion, Pearson correlation coefficients were calculated. Results There was no significant correlation between the amount of change in the lumbar extension angle during the first half of the lifting trials and lumbar movement during unloaded trunk flexion and extension. However, the amount of change in the lumbar extension angle during lifting was significantly negatively correlated with hip movement during unloaded trunk flexion and extension (P < .05). Conclusions The findings that the maximum hip flexion angle during full trunk flexion had a greater influence on kinematics of lumbar–hip complex during lifting provides new insight into human movement during lifting. All study participants were healthy men; thus, findings are limited to this group.

      PubDate: 2018-04-15T21:14:28Z
      DOI: 10.1016/j.jmpt.2017.09.007
       
  • Clinical and Ultrasonic Evaluation of the Thumb: Comparison of Young
           Adults With and Without Thumb Pain With Text Messaging
    • Authors: Charu Eapen; Bhaskaranand Kumar; Anil K. Bhat; Anand Venugopal
      Pages: 199 - 207
      Abstract: Publication date: March–April 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 3
      Author(s): Charu Eapen, Bhaskaranand Kumar, Anil K. Bhat, Anand Venugopal
      Objective The aim of this study was to compare clinical and ultrasound findings of thumb joints in young adults with and without thumb pain associated with text messaging. Methods In this case-control study, 117 students with thumb pain associated with text messaging were evaluated clinically and with ultrasound analysis of the thumb. Age- and sex-matched controls received ultrasound evaluation to note any subclinical changes. Results Clinical examination in the cases identified tenderness most commonly in the metacarpophalangeal joints, followed by the carpometacarpal joints, and then the interphalangeal joints. Tenderness was noted in the web space and the anatomic snuff box. Hypermobility on the Beighton scale was recorded as 2. Grind tests were positive in 21% of participants. Grip strength did not differ, but lateral and tip pinch strength were significantly reduced in the cases compared with controls. Fluid was detected in the metacarpal joints by ultrasound but not in the carpometacarpal or interphalangeal joints. No changes were detected in the controls. Conclusion Clinical examination indicated involvement of all joints of the thumb, but ultrasound evaluation could identify changes only in metacarpal joints, indicating signs of possible subclinical changes taking place in the thumb in these participants as a result of repetitive use.

      PubDate: 2018-04-15T21:14:28Z
      DOI: 10.1016/j.jmpt.2017.11.001
       
  • Immediate Effect of Acupuncture on Electromyographic Activity of the Upper
           Trapezius Muscle and Pain in Patients With Nonspecific Neck Pain: A
           Randomized, Single-Blinded, Sham-Controlled, Crossover Study
    • Authors: Simone Aparecida Penimpedo Calamita; Daniela Aparecida Biasotto-Gonzalez; Nívea Cristina De Melo; Marco Antônio Fumagalli; César Ferreira Amorim; Cid André Fidelis de Paula Gomes; Fabiano Politti
      Pages: 208 - 217
      Abstract: Publication date: March–April 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 3
      Author(s): Simone Aparecida Penimpedo Calamita, Daniela Aparecida Biasotto-Gonzalez, Nívea Cristina De Melo, Marco Antônio Fumagalli, César Ferreira Amorim, Cid André Fidelis de Paula Gomes, Fabiano Politti
      Objective The objective of this study was to assess changes in upper trapezius myoelectric activity and pain in patients with nonspecific neck pain after a single session of acupuncture (ACP). Methods A blinded randomized clinical trial was conducted. Fifteen patients with nonspecific neck pain and 15 healthy participants were enrolled in a randomized, single-blinded, crossover study. Each participant was subjected to a single session of ACP and sham acupuncture (SACP). The electromyography (EMG) signal of the upper trapezius muscle was recorded during different step contractions of shoulder elevation force (15%-30% maximal voluntary contraction) before and after ACP treatment. Results Significant effects were confirmed after the treatment (ACP and SACP) for Numeric Rating Scale scores (F1,28 = 51.61; P < .0001) and pain area (F1,2 = 32.03; P < .0001). Significant decreases in the EMG amplitude were identified for the nonspecific neck pain group (NPG) (F1,112 = 26.82; P < .0001) and the healthy participant group (HPG) (F1,112 = 21.69; P < .0001) after ACP treatment. No differences were identified between the ACP and SACP treatment protocols for Numeric Rating Scale score (NPG: F1,28 = 0.95; P = .33), pain area (NPG: F1,28 = 1.97; P = .17), or EMG amplitude (NPG: F1,112 = 0.47; P = .49; HPG: F1,112 = 0.75; P = .38). Conclusion The effect of ACP at acupoints triple energizer 5 and large intestine 11 triple energizer 5, or in close proximity, contributes to pain relief among patients with nonspecific neck pain. The electromyographic analysis indicated a greater resistance to muscle fatigue and decrease of activity of the upper trapezius muscle among healthy participants and patients with nonspecific neck pain.

      PubDate: 2018-04-15T21:14:28Z
      DOI: 10.1016/j.jmpt.2017.09.006
       
  • Test-Retest Reliability of Handgrip Strength as an Outcome Measure in
           Patients With Symptoms of Shoulder Impingement Syndrome
    • Authors: Christos Savva; Paraskevas Mougiaris; Christoforos Xadjimichael; Christos Karagiannis; Michalis Efstathiou
      Pages: 252 - 257
      Abstract: Publication date: March–April 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 3
      Author(s): Christos Savva, Paraskevas Mougiaris, Christoforos Xadjimichael, Christos Karagiannis, Michalis Efstathiou
      Objective The purpose of this study was to investigate the degree of test-retest reliability of grip strength measurement using a hand dynamometer in patients with shoulder impingement syndrome. Methods A total of 19 patients (10 women and 9 men; mean ± standard deviation age, 33.2 ± 12.9 years; range 18-59 years) with shoulder impingement syndrome were measured using a hand dynamometer by the same data collector in 2 different testing sessions with a 7-day interval. During each session, patients were encouraged to exert 3 maximal isometric contractions on the affected hand and the mean value of the 3 efforts (measured in kilogram-force [Kgf]) was used for data analysis. The intraclass correlation coefficient (ICC2,1) as well as the standard error of measurement (SEM) and Bland-Altman plot were used to estimate the degree of test-retest reliability and the measurement error, respectively. Results Grip strength data analysis revealed an ICC2,1 score of 0.94, which, based on the Shrout classification, is considered as excellent test-retest reliability of grip strength measurement. The small values of SEMs reported in both sessions (SEM1, 2.55 Kgf; SEM2, 2.39 Kgf) and the small width of the 95% limits of agreement in the Bland-Altman plot (ranging from −7.39 Kgf to 7.03 Kgf) reflected the measurement precision and the narrow variation of the differences during the 2 testing sessions. Conclusions Results from this study identified excellent test-retest reliability of grip strength measurement in shoulder impingement syndrome, indicating its potential use as an outcome measure in clinical practice.

      PubDate: 2018-04-15T21:14:28Z
      DOI: 10.1016/j.jmpt.2017.09.005
       
  • Effect of Sacroiliac Joint Mobilization on the Level of Soft Tissue Pain
           Threshold in Asymptomatic Women
    • Authors: Tomasz Sipko; Adam Paluszak; Agnieszka Siudy
      Pages: 258 - 264
      Abstract: Publication date: March–April 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 3
      Author(s): Tomasz Sipko, Adam Paluszak, Agnieszka Siudy
      Objective This study aimed to evaluate the effect of sacroiliac joint (SIJ) mobilization and/or self-mobilization on the level of soft tissue pain threshold in 21- to 23-year-old asymptomatic women (n = 20). Methods The FPIX Wagner Algometer was applied to compute the pressure pain threshold (PPT) over the right and left side of the iliolumbar ligament and lumbar erector spinae (L3). Measurements were taken of the right SIJ before and after a randomized protocol of oscillating mobilization, self-mobilization, and placebo treatment. Results A main effect of intervention (mobilization, self-mobilization, placebo) was confirmed by analysis of variance, with increases in PPT over the iliolumbar ligament (F = 13.04, P < .05) and erector spinae (F = 12.28, P < .05) on the mobilized side. The Wilcoxon test indicated that SIJ mobilization increased PPT over the iliolumbar ligament (P < .05) and erector spinae (P < .05) on both sides. Self-mobilization increased erector spinae PPT on the exercised side (P < .05), whereas the placebo did not cause any changes in PPT (P > .05). Conclusion The study provides evidence of local and global pain modulation resulting from oscillatory mobilization of the SIJ in women without pain symptoms. Self-mobilization of the SIJ has limited analgesic application.

      PubDate: 2018-04-15T21:14:28Z
      DOI: 10.1016/j.jmpt.2017.09.004
       
  • Association of Subclinical Neck Pain With Altered Multisensory Integration
           at Baseline and 4-Week Follow-up Relative to Asymptomatic Controls
    • Authors: Bassem Farid; Paul Yielder; Michael Holmes; Heidi Haavik; Bernadette A. Murphy
      Pages: 81 - 91
      Abstract: Publication date: February 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 2
      Author(s): Bassem Farid, Paul Yielder, Michael Holmes, Heidi Haavik, Bernadette A. Murphy
      Objective The purpose of this study was to test whether people with subclinical neck pain (SCNP) had altered visual, auditory, and multisensory response times, and whether these findings were consistent over time. Methods Twenty-five volunteers (12 SCNP and 13 asymptomatic controls) were recruited from a Canadian university student population. A 2-alternative forced-choice discrimination task with multisensory redundancy was used to measure response times to the presentation of visual (color filled circles), auditory (verbalization of the color words, eg, red or blue), and multisensory (simultaneous audiovisual) stimuli at baseline and 4 weeks later. Results The SCNP group was slower at both visual and multisensory tasks (P = .046, P = .020, respectively), with no change over 4 weeks. Auditory response times improved slightly but significantly after 4 weeks (P = .050) with no group difference. Conclusions This is the first study to report that people with SCNP have slower visual and multisensory response times than asymptomatic individuals. These differences persist over 4 weeks, suggesting that the multisensory technique is reliable and that these differences in the SCNP group do not improve on their own in the absence of treatment.

      PubDate: 2018-02-25T18:19:28Z
      DOI: 10.1016/j.jmpt.2017.09.003
       
  • The Effect of 2 Different Exercise Programs on Pain Intensity and Muscle
           Dimensions in Patients With Chronic Low Back Pain: A Randomized Controlled
           Trial
    • Authors: Narjess Nabavi; Mohammad A. Mohseni Bandpei; Zahra Mosallanezhad; Mahdi Rahgozar; Shapour Jaberzadeh
      Pages: 102 - 110
      Abstract: Publication date: February 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 2
      Author(s): Narjess Nabavi, Mohammad A. Mohseni Bandpei, Zahra Mosallanezhad, Mahdi Rahgozar, Shapour Jaberzadeh
      Objectives The purpose of this study was to compare the effect of 2 exercise programs combined with electrotherapy on pain intensity and lumbar stabilizer muscles dimensions in patients with nonspecific chronic low back pain. Methods A randomized controlled clinical trial was performed with 41 patients with chronic LBP. Participants were randomly allocated into 2 groups: an experimental group (n = 20) received stabilization exercises plus electrotherapy, and a control group (n = 21) received routine exercises plus electrotherapy. Pain intensity, using a visual analog scale, and muscle dimensions of both right and left transverse abdominis and lumbar multifidus muscles, using rehabilitative ultrasonography, were assessed before and immediately after 4 weeks of intervention. Results Significant improvement was identified after interventions on pain intensity and muscle size measurements in both groups (P < .01 in all instances). The only exception was the right-side lumbar multifidus cross-sectional area of the control group, which was not statistically significant (P = .081). No significant differences were found between the 2 exercise groups on pain intensity and muscle dimensions (P > .05 in all instances). Conclusions The results of this study suggest that a combination of electrotherapy with either routine or stabilization exercise programs may improve pain intensity and muscle dimensions in patients with nonspecific chronic low back pain.

      PubDate: 2018-02-25T18:19:28Z
      DOI: 10.1016/j.jmpt.2017.03.011
       
  • Change in Low Back Movement Patterns After Neurosurgical Intervention for
           Lumbar Spondylosis
    • Authors: Aubrey P. Monie; Roger I. Price; Christopher R.P. Lind; Kevin P. Singer
      Pages: 111 - 122
      Abstract: Publication date: February 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 2
      Author(s): Aubrey P. Monie, Roger I. Price, Christopher R.P. Lind, Kevin P. Singer
      Objectives The purpose of this study was to assess the use of computer-aided combined movement examination (CME) to measure change in low back movement after neurosurgical intervention for lumbar spondylosis and to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from lumbar disk disease, disk protrusion, and nerve root compression cases. Methods A test-retest, cohort observational study was conducted. Computer-aided CME was used to record lumbar range of motion in 18 patients, along with pain, stiffness, disability, and health self-report questionnaires. A minimal clinically important difference of 30% was used to interpret meaningful change in self-reports. z Scores were used to compare CME. Post hoc observation included subgrouping cases into 3 discrete pathologic conditions—disk disease, disk protrusion, and nerve root compression—to report intergroup differences in CME. Results Self-report data indicated that 11, 7, and 10 patients improved by ≥30% in pain, stiffness, and function, respectively. Three patients experienced clinically significant improvement in health survey. A CME pattern reduced in all directions suggested disk disease. Unilaterally restricted movement in side-flexed or extended directions suggested posterolateral disk protrusion with or without ipsilateral nerve root compression. Bilateral restrictions in extension suggested posterior disk protrusion with or without nerve root compression. In 11 of the 18 cases, CME converged toward the NRR after surgery. Conclusion We described the use of CME to identify atypical lumbar movement relative to an NRR. Data from this short-term postoperative study provide preliminary evidence for CME movement patterns suggestive of disk disease, disk protrusion, and nerve root compression.

      PubDate: 2018-02-25T18:19:28Z
      DOI: 10.1016/j.jmpt.2017.08.008
       
  • Uniaxial Tensile Properties of Atherosclerotic Carotid Artery After
           Mobilization of Pushing on Qiao-Gong: A Safety Study Using an Animal Model
           of Carotid Atherosclerosis
    • Authors: Ji Qi; Shaoqun Zhang; Lei Zhang; Ruiyue Ping; Kaike Ping; Da Ye; Honggui Shen; Yili Chen; Yikai Li
      Pages: 164 - 173
      Abstract: Publication date: February 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 2
      Author(s): Ji Qi, Shaoqun Zhang, Lei Zhang, Ruiyue Ping, Kaike Ping, Da Ye, Honggui Shen, Yili Chen, Yikai Li
      Objectives This study aimed to preliminarily explore the effects of the soft tissue mobilization of pushing on Qiao-Gong (MPQ) on biomechanical properties of the carotid artery using an animal model of carotid atherosclerosis (CAS). Methods Fifty rabbits were randomly divided into 4 groups: animals with CAS treated with MPQ (CAS-MPQ [n = 15]); animals with CAS treated without MPQ (CAS [n = 15]); normal animals treated with MPQ (normal-MPQ [n = 10]); and a blank control group (n = 10). The MPQ procedure consisted of soft tissue mobilization of the Qiao-Gong acupoint on the front edge of the sternocleidomastoid muscle applied from top to bottom, by flat pushing with the thumb repeatedly for 20 times. Disease in the CAS models was induced by carotid artery balloon injury combined with a high-fat diet for 12 weeks. At the end of modeling, carotid color Doppler ultrasonography examination was performed to confirm which animal models were successfully induced with CAS, excluding model rabbits without typical CAS at the same time. Then, MPQ was applied on rabbits in the CAS-MPQ and the normal-MPQ groups for 3 weeks. By contrast, rabbits in the other 2 groups were fed normally without MPQ. Uniaxial failure tests were later performed on carotid arteries in all 4 groups, and at the end of the study, a 2-way factorial analysis of variance of the results was conducted. Results (1) At the end of modeling, 10 rabbits in the CAS-MPQ group and 9 in the CAS group were included with typical carotid atherosclerotic characteristics. (2) Young’s elastic modulus of the rabbit carotid artery increased more significantly in the CAS-MPQ group than the CAS group. (3) Compared with normal rabbit carotid arteries, atherosclerotic carotid arteries had lower levels of ultimate stress and ultimate strain but higher levels of ultimate load. Conclusions The uniaxial tensile mechanical properties of the rabbit atherosclerotic carotid artery were impaired after MPQ.

      PubDate: 2018-02-25T18:19:28Z
      DOI: 10.1016/j.jmpt.2017.12.002
       
  • Repeatability of Cervical Joint Flexion and Extension Within and Between
           Days
    • Authors: Xu Wang; René Lindstroem; Maciej Plocharski; Lasse Riis Østergaard; Thomas Graven-Nielsen
      Pages: 10 - 18
      Abstract: Publication date: January 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 1
      Author(s): Xu Wang, René Lindstroem, Maciej Plocharski, Lasse Riis Østergaard, Thomas Graven-Nielsen
      Objective The purpose of this study was to investigate within- and between-day repeatability of free and unrestricted healthy cervical flexion and extension motion when assessing dynamic cervical spine motion. Methods Fluoroscopy videos of 2 repeated cervical flexion and 2 repeated extension motions were examined for within-day repeatability (20-second interval) for 18 participants (6 females) and between-day repeatability (1-week interval) for 15 participants (6 females). The dynamic cervical motions were free and unrestricted from neutral to end range. The flexion videos and extension videos were evenly divided into 10% epochs of the C0-to-C7 range of motion. Within-day and between-day repeatability of joint motion angles (all 7 joints and epochs, respectively) was tested in a repeated-measures analysis of variance. Joint motion angle differences between repetitions were calculated for each epoch and joint (7 joints), and these joint motion angle differences between within-day and between-day repetitions were tested in mixed-model analysis of variance. Results For all joints and epochs, respectively, no significant differences were found in joint motion angle between within-day or between-day repetitions. There were no significant effects of joint motion angle differences between within-day and between-day repetitions. The average within-day joint motion angle differences across all joints and epochs were 0.00° ± 2.98° and 0.00° ± 3.05° for flexion and extension, respectively. The average between-day joint motion angle differences were 0.02° ± 2.56° and 0.05° ± 2.40° for flexion and extension, respectively. Conclusions This is the first study to report the within-day and between-day joint motion angle differences of repeated cervical flexion and extension. This study supports the idea that cervical joints repeat their motion accurately.

      PubDate: 2018-02-14T17:58:29Z
      DOI: 10.1016/j.jmpt.2017.08.005
       
  • Glucocorticoid-Induced Changes in Rat Skeletal Muscle Biomechanical and
           Viscoelastic Properties: Aspects of Aging
    • Authors: Karin Alev; Arved Vain; Maire Aru; Ando Pehme; Priit Purge; Priit Kaasik; Teet Seene
      Pages: 19 - 24
      Abstract: Publication date: January 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 1
      Author(s): Karin Alev, Arved Vain, Maire Aru, Ando Pehme, Priit Purge, Priit Kaasik, Teet Seene
      Objectives The purpose of this study was to estimate the state of tension (tone) and the biomechanical and viscoelastic properties of skeletal muscle in aging rats during the administration of different doses of dexamethasone and to find the relationships among the state of muscle atrophy, muscle strength, and the abovementioned muscle properties. Methods Muscle state of tension, biomechanical (elasticity, dynamic stiffness) and viscoelastic (mechanical stress relaxation time, Deborah number) properties (using MyotonPRO, Myoton Ltd, Tallinn, Estonia), lean body mass (BM), and hind limb grip strength were measured before and after the administration of a 10-day treatment with dexamethasone 100 μg/100 g BM (young and old group) and 50 μg/100 g BM (old group). Results Muscle elasticity (logarithmic decrement) was lower in old animals (1.86 ± 0.03) in comparison with young adult rats (1.38 ± 0.04) (P < .01). After the 10-day treatment with dexamethasone 100 μg/100 g BM, young adult rats had 10% lower muscle elasticity (P < .01). The same dose of dexamethasone in old rats increased tone (frequency of natural oscillation) from 29.13 ± 0.51 Hz to 38.50 ± 0.95 Hz (P < .001). There were dose-dependent differences in dynamic stiffness and tone of muscle; changes in elasticity were independent of the dose in old animals. In old rats, the muscle’s viscoelastic properties decreased after dexamethasone administration. Significant correlation was found between changes in muscle logarithmic decrement and stiffness (rs = 0.90; P < .05) in old animals. Conclusions Biomechanical and viscoelastic properties of skeletal muscle indicate changes in the main function of muscle during glucocorticoid-induced muscle atrophy and are in agreement with changes in hind limb strength. The myometric measurements indicate the direction and magnitude of change in muscle tissue after different doses of dexamethasone administration easily and quickly.

      PubDate: 2018-02-14T17:58:29Z
      DOI: 10.1016/j.jmpt.2017.06.009
       
  • Correlation Between Skin Temperature Over Myofascial Trigger Points in the
           Upper Trapezius Muscle and Range of Motion, Electromyographic Activity,
           and Pain in Chronic Neck Pain Patients
    • Authors: Carlos Eduardo Girasol; Almir Vieira Dibai-Filho; Alessandra Kelly de Oliveira; Rinaldo Roberto de Jesus Guirro
      Abstract: Publication date: Available online 7 April 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Carlos Eduardo Girasol, Almir Vieira Dibai-Filho, Alessandra Kelly de Oliveira, Rinaldo Roberto de Jesus Guirro
      Objective The purpose of this study was to assess the correlation between skin temperature over a myofascial trigger point in the upper trapezius muscle and range of motion of the cervical spine, electromyographic activity, and pain in patients with chronic neck pain. Methods This is a single-blind cross-sectional study. Forty participants of both sexes, aged 18 to 45 years, with chronic neck pain and myofascial trigger points in the upper trapezius muscle were included in the study. The participants were assessed using the Numeric Rating Scale, the Neck Disability Index, infrared thermography, algometry, fleximetry, and electromyographic activity. Results A positive association was observed between skin temperature to the right with the range of motion of cervical flexion (r = 0.322, P = .043), the median frequency of isometrics to the right (r = 0.341, P = .032), and the median frequency of rest to the left (r s = 0.427, P = .006); as were a negative association between skin temperature to the right and the root mean square of rest to the right (r s = -0.447, P = .004), and a positive association of skin temperature to the left with the median frequency of isometrics to the right (r = 0.365, P = .020), and the median frequency of rest to the left (r s = 0.573, P < .001). Conclusion Patients with chronic neck pain who had reduction of skin temperature over myofascial trigger points in the upper trapezius muscle had reduced cervical range of motion for flexion, reduced median frequency at rest and during isometric contraction, and increased root mean square at rest.

      PubDate: 2018-04-15T21:14:28Z
      DOI: 10.1016/j.jmpt.2017.10.009
       
  • Spinal Manipulative Therapy and Other Conservative Treatments for Low Back
           Pain: A Guideline From the Canadian Chiropractic Guideline Initiative
    • Authors: André E. Bussières; Gregory Stewart; Fadi Al-Zoubi; Philip Decina; Martin Descarreaux; Danielle Haskett; Cesar Hincapié; Isabelle Pagé; Steven Passmore; John Srbely; Maja Stupar; Joel Weisberg; Joseph Ornelas
      Abstract: Publication date: Available online 30 March 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): André E. Bussières, Gregory Stewart, Fadi Al-Zoubi, Philip Decina, Martin Descarreaux, Danielle Haskett, Cesar Hincapié, Isabelle Pagé, Steven Passmore, John Srbely, Maja Stupar, Joel Weisberg, Joseph Ornelas
      Objective The objective of this study was to develop a clinical practice guideline on the management of acute and chronic low back pain (LBP) in adults. The aim was to develop a guideline to provide best practice recommendations on the initial assessment and monitoring of people with low back pain and address the use of spinal manipulation therapy (SMT) compared with other commonly used conservative treatments. Methods The topic areas were chosen based on an Agency for Healthcare Research and Quality comparative effectiveness review, specific to spinal manipulation as a nonpharmacological intervention. The panel updated the search strategies in Medline. We assessed admissible systematic reviews and randomized controlled trials for each question using A Measurement Tool to Assess Systematic Reviews and Cochrane Back Review Group criteria. Evidence profiles were used to summarize judgments of the evidence quality and link recommendations to the supporting evidence. Using the Evidence to Decision Framework, the guideline panel determined the certainty of evidence and strength of the recommendations. Consensus was achieved using a modified Delphi technique. The guideline was peer reviewed by an 8-member multidisciplinary external committee. Results For patients with acute (0-3 months) back pain, we suggest offering advice (posture, staying active), reassurance, education and self-management strategies in addition to SMT, usual medical care when deemed beneficial, or a combination of SMT and usual medical care to improve pain and disability. For patients with chronic (>3 months) back pain, we suggest offering advice and education, SMT or SMT as part of a multimodal therapy (exercise, myofascial therapy or usual medical care when deemed beneficial). For patients with chronic back-related leg pain, we suggest offering advice and education along with SMT and home exercise (positioning and stabilization exercises). Conclusions A multimodal approach including SMT, other commonly used active interventions, self-management advice, and exercise is an effective treatment strategy for acute and chronic back pain, with or without leg pain.

      PubDate: 2018-04-15T21:14:28Z
      DOI: 10.1016/j.jmpt.2017.12.004
       
  • Information for Readers
    • Abstract: Publication date: March–April 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 3


      PubDate: 2018-04-15T21:14:28Z
       
  • Validity of an Alternate Hand Behind Back Shoulder Range of Motion
           Measurement in Patients With Shoulder Pain and Movement Dysfunction
    • Authors: Kiran H. Satpute; Toby Hall; Aditi Adanani
      Abstract: Publication date: Available online 23 February 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Kiran H. Satpute, Toby Hall, Aditi Adanani
      Objectives The purpose of this study was to determine the criterion-related validity of a novel method of measuring hand behind back (HBB) shoulder range of motion (ROM) for evaluating pain and disability in people with shoulder pain and movement impairment. Methods This cross-sectional study design evaluated shoulder ROM, pain, fear-avoidance beliefs, and disability in 60 people (aged 35-70 years, 31 male) with chronic unilateral shoulder dysfunction (mean duration 15.73 weeks). Shoulder HBB ROM was measured with a bubble inclinometer in a manner that did not require the patient to disrobe. Correlations were sought between HBB ROM and other shoulder movements, as well as scores recorded on the Shoulder Pain and Disability Index (SPADI), visual analogue scale for pain, Fear Avoidance Beliefs Questionnaire (FABQ), and duration of symptoms. Results Restriction of HBB movement was significantly correlated with SPADI total disability score (r = 0.39, P < .01), flexion ROM (r = 0.30, P < .05), abduction ROM (r = 0.39, P < .01), and external rotation ROM (r = 0.60, P < .01). Other variables were not significantly correlated with HBB ROM. Multiple linear regression analysis indicated that the variance in HBB ROM was explained by the SPADI disability subscore (P = .01) but not by visual analogue scale score (P = .05), FABQ score (P = .65), or duration of symptoms (P = .73). The FABQ score was not explained by limitation in HBB ROM and shoulder movements. Conclusion These findings suggest that this novel method of measuring HBB ROM could be used as a functional outcome measure in the evaluation of patients with shoulder disorders. This method could be considered as an additional or alternative where there are challenges in measuring HBB because of restrictions in undressing a patient, such as for cultural reasons.

      PubDate: 2018-02-25T18:19:28Z
      DOI: 10.1016/j.jmpt.2017.09.010
       
  • Immedicate Effects of Core Stabilization Exercise on β-Endorphin and
           Cortisol Levels Among Patients With Chronic Nonspecific Low Back Pain: A
           Randomized Crossover Design
    • Authors: Aatit Paungmali; Leonard Henry Joseph; Khanittha Punturee; Patraporn Sitilertpisan; Ubon Pirunsan; Sureeporn Uthaikhup
      Abstract: Publication date: Available online 17 February 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Aatit Paungmali, Leonard Henry Joseph, Khanittha Punturee, Patraporn Sitilertpisan, Ubon Pirunsan, Sureeporn Uthaikhup
      Objective The main objective of the study was to measure the levels of plasma β-endorphin (PB) and plasma cortisol (PC) under lumbar core stabilization exercise (LCSE), placebo and control conditions in patients with chronic nonspecific low back pain. Methods Twenty-four participants with chronic nonspecific low back pain participated in a randomized, placebo-controlled, crossover design study. There were 3 experimental exercise conditions: control condition (positioning in crook lying and rest), placebo condition (passive cycling in crook lying using automatic cycler), and LCSE on a Pilates device tested with a 48-hour interval between sessions by concealed randomization. A blood sample was collected before and after the exercise conditions. Plasma β-endorphin and PC were measured through enzyme-linked immunosorbent assay and electrochemiluminescence in a Cobas E411 auto analyzer. Results A significant difference in PB level was identified before and after the LCSE condition (P < .05), whereas no significant differences were noted in control and placebo exercise conditions. Also, the trend of elevation of PB under the LCSE was significantly different compared with the placebo and control conditions (P < .01). In contrast, the PC level remained unchanged in all 3 conditions. Conclusion The findings of this study indicate that LCSE could possibly influence PB but not PC level among patients with chronic nonspecific low back pain. The mechanism of action of the pain-relieving effect of LCSE might be related to an endogenous opioid mechanism as part of its effects and might not be involved with a stress-induced analgesia mechanism.

      PubDate: 2018-02-25T18:19:28Z
      DOI: 10.1016/j.jmpt.2018.01.002
       
  • Effect of Adding Interferential Current in an Exercise and Manual Therapy
           Program for Patients With Unilateral Shoulder Impingement Syndrome: A
           Randomized Clinical Trial
    • Authors: Cid André Fidelis de Paula Gomes; Almir Vieira Dibai-Filho; William Arruda Moreira; Shirley Quispe Rivas; Emanuela dos Santos Silva; Ana Claudia Bogik Garrido
      Abstract: Publication date: Available online 16 February 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Cid André Fidelis de Paula Gomes, Almir Vieira Dibai-Filho, William Arruda Moreira, Shirley Quispe Rivas, Emanuela dos Santos Silva, Ana Claudia Bogik Garrido
      Objective The purpose of this study was to measure the additional effect of adding interferential current (IFC) to an exercise and manual therapy program for patients with unilateral shoulder impingement syndrome. Methods Forty-five participants were randomly assigned to group 1 (exercise and manual therapy), group 2 (exercise and manual therapy + IFC), or group 3 (exercise and manual therapy + placebo ultrasound). Individuals participated in 16 treatment sessions, twice a week for 8 weeks. The primary outcome of the study was total score of the Shoulder Pain and Disability Index (SPADI). The secondary outcomes were the pain and disability subscales of SPADI, Numeric Rating Scale, and Pain-Related Self-Statement Scale. Adjusted between-group mean differences (MDs) and 95% confidence intervals (CIs) were calculated using linear mixed models. Results After 16 treatment sessions, statistically significant but not clinically important differences were identified in favor of the exercise and manual therapy program alone in the SPADI-total (group 1 vs group 2, MD 11.12 points, 95% CI 5.90-16.35; group 1 vs group 3, MD 13.43 points, 95% CI 8.21-18.65). Similar results were identified for secondary outcomes. Conclusion The addition of IFC does not generate greater clinical effects in an exercise and manual therapy program for individuals with unilateral shoulder impingement syndrome.

      PubDate: 2018-02-25T18:19:28Z
      DOI: 10.1016/j.jmpt.2017.09.009
       
  • Validation of the French-Canadian Pelvic Girdle Questionnaire
    • Authors: Marie-Pier Girard; Julie O’Shaughnessy; Chantal Doucet; Emeline Lardon; Britt Stuge; Stephanie-May Ruchat; Martin Descarreaux
      Abstract: Publication date: Available online 15 February 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Marie-Pier Girard, Julie O’Shaughnessy, Chantal Doucet, Emeline Lardon, Britt Stuge, Stephanie-May Ruchat, Martin Descarreaux
      Objective Pain in the pelvic girdle area is commonly reported during pregnancy and the postpartum period, and its impact on quality of life is considerable. The Pelvic Girdle Questionnaire (PGQ), developed in 2011 in Norway, is the only condition-specific tool assessing pelvic girdle pain–related symptoms and disability. The questionnaire was recently translated and adapted for the French-Canadian population. The objective of this study was to assess the measurement properties of the previously translated French-Canadian PGQ. Methods Eighty-two women with pelvic girdle pain were included in this validation study. The French-Canadian PGQ, pain intensity Numeric Rating Scale, and Oswestry Disability Index were completed by participants at baseline, 48 hours later, and 3 to 6 months later to assess test-retest reliability, construct validity, responsiveness, floor and ceiling effects, and internal consistency. Results Reliability analyses indicated an intraclass correlation coefficient of 0.841 (95% confidence interval [CI] 0.750-0.901) for the global score. Construct validity analyses indicated a Spearman rank correlation coefficient of 0.696 with the Oswestry Disability Index. Responsiveness analyses identified an effect size of 0.908 (95% CI 0.434-1.644) and an area under the receiver operating characteristics curve of 0.823 (95% CI 0.692-0.953). There was no floor or ceiling effect, and internal consistency analyses indicated a Cronbach α of .933 for the activity subscale and .673 for the symptom subscale. Conclusion Overall, the French-Canadian version of the PGQ is reliable, valid, and responsive, suggesting that it can be implemented in both research and clinical settings to assess functional limitations in pregnant and postpartum women.

      PubDate: 2018-02-25T18:19:28Z
      DOI: 10.1016/j.jmpt.2018.01.001
       
  • Association Among Opioid Use, Treatment Preferences, and Perceptions of
           Physician Treatment Recommendations in Patients With Neck and Back Pain
    • Authors: William B. Weeks; Christine M. Goertz; Cynthia R. Long; William C. Meeker; Dennis M. Marchiori
      Abstract: Publication date: Available online 15 February 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): William B. Weeks, Christine M. Goertz, Cynthia R. Long, William C. Meeker, Dennis M. Marchiori
      Objective The purpose of this study was to explore the relationship between self-reported use of opioids by patients with neck and back pain and their demographics, pain characteristics, treatment preferences, and recollections of their physicians’ opinions regarding treatment options. Methods We analyzed 2017 Gallup Poll survey data from 1680 US adults who had substantial spine pain in the past year and used logistic regression to explore the aforementioned relationships. Results Our multiple regression analysis indicated that adults with neck or back pain severe enough to have sought health care within the last year were more likely to have used opioids in the last year if they (in descending order of marginal impact) had pain that had lasted 1 year or less (adjusted odds ratio [OR] = 34.35, 90% confidence interval [CI] 17.56-74.32); concurrently used benzodiazepines (OR = 6.02, 90% CI 2.95-12.33); had Medicaid as an insurance source (OR = 3.29, 90% CI 1.40-7.48); indicated that they preferred to use pain medications prescribed by a doctor to treat physical pain (OR = 3.24, 90% CI 1.88-5.60); or were not college educated (OR = 1.83, 90% CI 1.05-3.25). Compared with patients aged 65 years and older, those aged 18 to 34 years were less likely to have used opioids in the past year (OR = 0.09, 90% CI 0.01-0.40, 0.50 for 95% CI). Respondents’ perceptions of medical doctors’ positive or negative opinions regarding a variety of neck and back pain treatment options were not significantly associated with opioid use. Conclusions Patients with neck and back pain who use opioids differ from those who do not use opioids in that they are more likely to have pain that is of shorter duration, to use benzodiazepines, to have Medicaid as an insurance source, and to prefer to use pain medications. Those characteristics should be considered when developing opioid use prevention strategies.

      PubDate: 2018-02-25T18:19:28Z
      DOI: 10.1016/j.jmpt.2017.12.003
       
  • Comparison of Median Nerve Mechanosensitivity and Pressure Pain Threshold
           in Patients With Nonspecific Neck Pain and Asymptomatic Individuals
    • Authors: Seval Yılmaz; Serkan Taş; Öznur Tunca Yılmaz
      Abstract: Publication date: Available online 15 February 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Seval Yılmaz, Serkan Taş, Öznur Tunca Yılmaz
      Objective The purpose of this study was to investigate the presence of median nerve mechanosensitivity by comparing median nerve neurodynamic test results of patients with nonspecific neck pain (NNP) and asymptomatic individuals. Methods A total of 40 patients (30 women, 10 men) with NNP between the ages of 21 and 62 years (39.53 ± 10.18 years) and 38 asymptomatic individuals (23 women, 15 men) between the ages of 18 and 60 years (37.13 ± 9.64 years) participated in the study. Pressure pain threshold was assessed with digital pressure algometer, cervical joint range of motion was assessed with a universal goniometer, and median nerve mechanosensitivity was assessed with Upper Limb Neurodynamic Test 1 (ULNT1). The test step where the first sensory response was given, the location and character of the sensory response, and the final elbow extension angle were recorded during ULNT1. Results Patients with NNP had significantly decreased pressure pain threshold (P < .001), decreased range of motion of cervical flexion (P < .001), and decreased cervical lateral flexion (P = .001) compared with asymptomatic individuals, whereas no change was identified in range of motion of rotation (P = .100). In ULNT1, 45% of patients with NNP reported pain and 40% of them reported stretch. A total of 65% of asymptomatic individuals reported stretch, and 13% of them reported pain. It was identified in ULNT1 that final elbow extension angle was lower in the NNP group compared with asymptomatic individuals (P = .008). Conclusion Median nerve mechanosensitivity increased, pressure pain threshold decreased, and active neck motion was limited in individuals with NNP compared with asymptomatic individuals.

      PubDate: 2018-02-25T18:19:28Z
      DOI: 10.1016/j.jmpt.2017.09.008
       
  • Information for Readers
    • Abstract: Publication date: February 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 2


      PubDate: 2018-02-25T18:19:28Z
       
  • Information for Readers
    • Abstract: Publication date: January 2018
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 41, Issue 1


      PubDate: 2018-02-14T17:58:29Z
       
  • Cervical Proprioception in a Young Population Who Spend Long Periods on
           Mobile Devices: A 2-Group Comparative Observational Study
    • Authors: Andrew Portelli; Susan A. Reid
      Abstract: Publication date: Available online 17 January 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Andrew Portelli, Susan A. Reid
      Objectives The purpose of this study was to evaluate if young people with insidious-onset neck pain who spend long periods on mobile electronic devices (known as “text neck") have impaired cervical proprioception and if this is related to time on devices. Methods A 2-group comparative observational study was conducted at an Australian university. Twenty-two participants with text neck and 22 asymptomatic controls, all of whom were 18 to 35 years old and spent ≥4 hours per day on unsupported electronic devices, were assessed using the head repositioning accuracy (HRA) test. Differences between groups were calculated using independent sample t-tests, and correlations between neck pain intensity, time on devices, and HRA test were performed using Pearson’s bivariate analysis. Results During cervical flexion, those with text neck (n = 22, mean age ± standard deviation [SD]: 21 ± 4 years, 59% female) had a 3.9° (SD: 1.4°) repositioning error, and the control group (n = 22, 20 ± 1 years, 68% female) had a 2.9° (SD: 1.2°) error. The mean difference was 1° (95% confidence interval: 0–2, P = .02). For other cervical movements, there was no difference between groups. There was a moderately significant correlation (P ≤ .05) between time spent on electronic devices and cervical pain intensity and between cervical pain intensity and HRA during flexion. Conclusion The participants with text neck had a greater proprioceptive error during cervical flexion compared with controls. This could be related to neck pain and time spent on electronic devices.

      PubDate: 2018-01-25T16:32:25Z
      DOI: 10.1016/j.jmpt.2017.10.004
       
  • Criteria to Screen for Traumatic Cervical Spine Instability: A Consensus
           of Chiropractic Radiologists
    • Authors: Sarah Dion; Maja Stupar; Pierre Côté; Julie-Marthe Grenier; John A. Taylor
      Abstract: Publication date: Available online 10 January 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Sarah Dion, Maja Stupar, Pierre Côté, Julie-Marthe Grenier, John A. Taylor
      Objective The purpose of this study was to establish consensus on a radiographic definition for cervical instability for routine use in chiropractic patients who sustain trauma to the cervical spine. Method We conducted a modified Delphi study with a panel of chiropractic radiologists. Panelists were asked to rate potential screening criteria for traumatic cervical spine instability when assessing cervical spine radiographs. Items rated as important for inclusion by at least 60% of participants in round 1 were submitted for a second round of voting in round 2. Items rated for inclusion by at least 75% of the participants in round 2 were used to create the consensus-based list of screening criteria. Participants were asked to vote and reach agreement on the final screening criteria list in round 3. Results Twenty-nine chiropractic radiologists participated in round 1. After 3 rounds of survey, 85% of participants approved the final consensus-based list of criteria for traumatic cervical spine instability screening, including 6 clinical signs and symptoms and 5 radiographic criteria. Participants agreed that the presence of 1 or more of these clinical signs and symptoms and/or 1 or more of the 5 radiographic criteria on routine static radiographic studies suggests cervical instability. Conclusion The consensus-based radiographic definition of traumatic cervical spine instability includes 6 clinical signs and symptoms and 5 radiographic criteria that doctors of chiropractic should apply to their patients who sustain trauma to the cervical spine.

      PubDate: 2018-01-14T16:01:58Z
      DOI: 10.1016/j.jmpt.2017.10.002
       
  • Relationship Between Proprioception and Endurance Functionality of the
           Cervical Flexor Muscles in Chronic Neck Pain and Asymptomatic Participants
           
    • Authors: Leila Ghamkhar; Amir H. Kahlaee; Mohammad R. Nourbakhsh; Amena Ahmadi; Amir M. Arab
      Abstract: Publication date: Available online 10 January 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Leila Ghamkhar, Amir H. Kahlaee, Mohammad R. Nourbakhsh, Amena Ahmadi, Amir M. Arab
      Objective The purpose of this study was to compare the relationship between flexion endurance capacity and joint position error in participants with or without chronic neck pain (CNP). Methods Sixty-one CNP and 60 asymptomatic volunteers participated in this cross-sectional, case-control, and correlational analysis study. The measured variables included absolute and constant joint repositioning errors in the sagittal and horizontal directions, clinical flexor endurance test score, pain intensity, and neck disability index. Results The groups did not statistically differ in flexion endurance (P > .05). The CNP group had a smaller absolute error on the right (P < .01) and left (P = .01) rotation and an overshooting error pattern in the flexion direction (P < .05). But the asymptomatic group did not exhibit any over-/undershooting pattern tendency (P > .05). Although flexion endurance was not correlated with any of the joint repositioning error components in either group, pain and disability scores were significantly correlated with left rotation absolute error (r = –0.34 and ρ = –0.37, respectively). Conclusion The clinical cervical flexor endurance test, ignoring the relative contribution of the deep and superficial groups of muscles, may not efficiently characterize CNP patients.

      PubDate: 2018-01-14T16:01:58Z
      DOI: 10.1016/j.jmpt.2017.08.006
       
  • Association Between Symptoms of Central Sensitization and Cognitive
           Behavioral Factors in People With Chronic Nonspecific Low Back Pain: A
           Cross-sectional Study
    • Authors: Eva Huysmans; Kelly Ickmans; Dries Van Dyck; Jo Nijs; Yori Gidron; Nathalie Roussel; Andrea Polli; Maarten Moens; Lisa Goudman; Margot De Kooning
      Abstract: Publication date: Available online 10 January 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Eva Huysmans, Kelly Ickmans, Dries Van Dyck, Jo Nijs, Yori Gidron, Nathalie Roussel, Andrea Polli, Maarten Moens, Lisa Goudman, Margot De Kooning
      Objective The objective of this cross-sectional study was to analyze the relationship between symptoms of central sensitization (CS) and important cognitive behavioral and psychosocial factors in a sample of patients with chronic nonspecific low back pain. Methods Participants with chronic nonspecific low back pain for at least 3 months were included in the study. They completed several questionnaires and a functional test. Pearson’s correlation was used to analyze associations between symptoms of CS and pain behavior, functioning, pain, pain catastrophizing, kinesiophobia, and illness perceptions. Additionally, a between-group analysis was performed to compare patients with and without clinically relevant symptoms of CS. Results Data from 38 participants were analyzed. Significant associations were found between symptoms of CS and all other outcomes, especially current pain (r = 0.510, P = .001), mean pain during the past 7 days (r = 0.505, P = .001), and pain catastrophizing (r = 0.518, P = .001). Patients with clinically relevant symptoms of CS scored significantly worse on all outcomes compared with persons without relevant symptoms of CS, except on functioning (P = .128). Conclusions Symptoms of CS were significantly associated with psychosocial and cognitive behavioral factors. Patients exhibiting a clinically relevant degree of symptoms of CS scored significantly worse on most outcomes, compared with the subgroup of the sample with fewer symptoms of CS.

      PubDate: 2018-01-14T16:01:58Z
      DOI: 10.1016/j.jmpt.2017.08.007
       
  • Erratum to “Changes in Lower Limb Strength and Function Following Lumbar
           Spinal Mobilization” [J Manipulative Physiol Ther. 2017;40(8):587-596]
    • Authors: Tsoi Sze Yuen; Joseph Ng; Pui Yu Lam; Mei Yan Lau; Wai Lam Siu; Ka Man Yu; Chi Ngai Lo
      Abstract: Publication date: Available online 6 January 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Tsoi Sze Yuen, Joseph Ng, Pui Yu Lam, Mei Yan Lau, Wai Lam Siu, Ka Man Yu, Chi Ngai Lo


      PubDate: 2018-01-14T16:01:58Z
      DOI: 10.1016/j.jmpt.2017.12.001
       
  • Integration of Doctors of Chiropractic Into Private Sector Health Care
           Facilities in the United States: A Descriptive Survey
    • Authors: Stacie A. Salsbury; Christine M. Goertz; Elissa J. Twist; Anthony J. Lisi
      Abstract: Publication date: Available online 5 January 2018
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Stacie A. Salsbury, Christine M. Goertz, Elissa J. Twist, Anthony J. Lisi
      Objective The purpose of this study was to describe the demographic, facility, and practice characteristics of doctors of chiropractic (DCs) working in private sector health care settings in the United States. Methods We conducted an online, cross-sectional survey using a purposive sample of DCs (n = 50) working in integrated health care facilities. The 36-item survey collected demographic, facility, chiropractic, and interdisciplinary practice characteristics, which were analyzed with descriptive statistics. Results The response rate was 76% (n = 38). Most respondents were men and mid-career professionals with a mean 21 years of experience in chiropractic. Doctors of chiropractic reported working in hospitals (40%), multispecialty offices (21%), ambulatory clinics (16%), or other (21%) health care settings. Most (68%) were employees and received salary compensation (59%). The median number of DCs per setting was 2 (range 1-8). Most DCs used the same health record as medical staff and worked in the same clinical setting. More than 60% reported co-management of patients with medical professionals. Integrated DCs most often received and made referrals to primary care, physical medicine, pain medicine, orthopedics, and physical or occupational therapy. Although in many facilities the DCs were exclusive providers of spinal manipulation (43%), in most, manipulative therapies also were delivered by physical therapists and osteopathic or medical physicians. Informal face-to-face consultations and shared health records were the most common communication methods. Conclusions Doctors of chiropractic are working in diverse medical settings within the private sector, in close proximity and collaboration with many provider types, suggesting a diverse role for chiropractors within conventional health care facilities.

      PubDate: 2018-01-14T16:01:58Z
      DOI: 10.1016/j.jmpt.2017.10.003
       
  • A Qualitative Study of Doctors of Chiropractic in a Nova Scotian
           Practice-Based Research Network: Barriers and Facilitators to the
           Screening and Management of Psychosocial Factors for Patients With Low
           Back Pain
    • Authors: Peter Stilwell; Jill A. Hayden; Piaf Des Rosiers; Katherine Harman; Simon D. French; Janet A. Curran; Warren Hefford
      Abstract: Publication date: Available online 27 December 2017
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Peter Stilwell, Jill A. Hayden, Piaf Des Rosiers, Katherine Harman, Simon D. French, Janet A. Curran, Warren Hefford
      Objectives This study aimed to assess chiropractors’ awareness of clinical practice guidelines for low back pain and to identify barriers and facilitators to the screening and management of psychosocial factors in patients with low back pain. Methods This qualitative study used semi-structured interviews informed by the Theoretical Domains Framework with 10 Nova Scotian chiropractors who were members of a practice-based research network. Results The participants correctly identified what the guidelines generally recommend and described the value of psychosocial factors; however, none of the participants could name specific clinical practice guidelines for low back pain. We identified 6 themes related to barriers and facilitators for chiropractors screening and managing psychosocial factors. The themes revolved around the participants’ desire to fulfill patients’ anatomy-focused treatment expectations and a perceived lack of training for managing psychosocial factors. Participants had concerns about going beyond the chiropractic scope of practice, and they perceived a lack of practical psychosocial screening and management resources. Social factors, such as the influence of other health care practitioners, were reported as both barriers and facilitators to screening and managing psychosocial factors. Conclusions The participants in this study reported that they mostly treated with an anatomical and biomechanical focus and that they did not always address psychosocial factors identified in their patients with low back pain. Although these findings are limited to Nova Scotian chiropractors, the barriers identified appeared to be potentially modifiable and could be considered in other groups. Low-cost interventions, such as continuing education using evidence-informed behavior change techniques, could be considered to address these barriers.

      PubDate: 2018-01-03T18:46:36Z
      DOI: 10.1016/j.jmpt.2017.07.014
       
  • Functional Magnetic Resonance Imaging of Cerebral Hemodynamic Responses to
           Pain Following Thoracic Thrust Manipulation in Individuals With Neck Pain:
           A Randomized Trial
    • Authors: Cheryl L. Sparks; Wen C. Liu; Joshua A. Cleland; Joseph P. Kelly; Sarah J. Dyer; Kathryn M. Szetela; James M. Elliott
      Pages: 625 - 634
      Abstract: Publication date: November–December 2017
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 40, Issue 9
      Author(s): Cheryl L. Sparks, Wen C. Liu, Joshua A. Cleland, Joseph P. Kelly, Sarah J. Dyer, Kathryn M. Szetela, James M. Elliott
      Objective The purpose of this study was to examine whether cerebral activation in response to noxious mechanical stimuli varies with thrust manipulation (TM) when compared with sham manipulation (SM) as measured by blood oxygenation level–dependent functional magnetic resonance imaging. Methods Twenty-four volunteers (67% female) with complaints of acute or subacute mechanical (nontraumatic) neck pain satisfied eligibility requirements and agreed to participate. Participants were randomized to receive TM to the thoracic spine or SM, and then underwent functional magnetic resonance scanning while receiving noxious stimuli before and after TM or SM. An 11-point numeric pain rating scale was administered pre- and postmanipulation for neck pain and to determine perceptions of pain intensity with respect to neck pain and mechanical stimuli. Blood oxygenation level–dependent functional magnetic resonance imaging recorded the cerebral hemodynamic response to the mechanical stimuli. Results Imaging revealed significant group differences, with those individuals in the manipulation group exhibiting increased areas of activation (postmanipulation) in the insular and somatosensory cortices and individuals in the sham group exhibiting greater areas of activation in the precentral gyrus, supplementary motor area, and cingulate cortices (P < .05). However, between-group differences on the numeric pain rating scale for mechanical stimuli and for self-reported neck pain were not statistically significant. Conclusions This study provides preliminary level 2b evidence suggesting cortical responses in patients with nontraumatic neck pain may vary between thoracic TM and a sham comparator.

      PubDate: 2017-12-11T17:44:16Z
      DOI: 10.1016/j.jmpt.2017.07.010
       
  • Relationship Between Subjective Experience of Individuals, Practitioner
           Seniority, Cavitation Occurrence, and 3-Dimensional Kinematics During
           Cervical Spine Manipulation
    • Authors: Bernard Van Geyt; Pierre-Michel A. Dugailly; Louis De Page; Veronique Feipel
      Pages: 643 - 648
      Abstract: Publication date: November–December 2017
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 40, Issue 9
      Author(s): Bernard Van Geyt, Pierre-Michel A. Dugailly, Louis De Page, Veronique Feipel
      Objective The purpose of this study was to assess individual subjective experience (ISE) of the recipients of a cervical manipulation and to analyze the influence of kinematics, cavitation occurrence, and practitioner seniority on individual experience. Methods Practitioners with different seniority (years of experience) manipulated 20 asymptomatic volunteers at C3 and C5 on both sides. Kinematics were recorded using a 3-dimensional electrogoniometer, and ISE data were gathered through a questionnaire to explore the subjects’ experiences of manipulation in terms of tactile sensations, relaxation, perception of the task, and therapist handling. Kinematics, occurrence of cavitation, practitioner’s seniority, and ISE data were analyzed concurrently. Results Motion parameters obtained during manipulation were found to be influenced by cavitation occurrence and differences between practitioners. Data analysis indicated that ISE could be grouped into 2 factors. The first revolved around grip firmness and range and speed of practitioner’s gesture. The second factor represented patient’s relaxation and the precision of handling. Also, most ISE data correlated with kinematics, although a subjective measurement did not always correlate the highest with its objective counterpart. When cavitation occurred, ISE ratings were higher, suggesting that participants may associate cavitation with the success of manipulations. Higher practitioner seniority (more years of experience) induced feelings of higher speed, amplitude, firmness, and precision. Conclusions Recipients of cervical manipulation experienced different subjective feelings that can be expressed in 2 dimensions. These feelings are influenced by cavitation occurrence and practitioner’s seniority. A better understanding of an individual’s subjective experience related to cervical manipulation could increase confidence and improve the patient-therapist relationship, and it may provide further therapeutic perspectives for the practitioners.

      PubDate: 2017-12-11T17:44:16Z
      DOI: 10.1016/j.jmpt.2017.09.002
       
  • The Effects of Forward Head Posture on Neck Extensor Muscle Thickness: An
           Ultrasonographic Study
    • Authors: Fereshte Goodarzi; Leila Rahnama; Noureddin Karimi; Raziyeh Baghi; Shapour Jaberzadeh
      Abstract: Publication date: Available online 18 December 2017
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Fereshte Goodarzi, Leila Rahnama, Noureddin Karimi, Raziyeh Baghi, Shapour Jaberzadeh
      Objective This study aimed to compare neck extensor muscle thickness, thickness changes, and strength between participants with forward head posture (FHP) and controls with normal head posture (NHP). Methods Twenty college students with FHP (mean age 21.30 ± 2.36 years) and 20 students with NHP (mean age 21.85 ± 2.78 years) participated in this case-control study. The thickness of neck extensor muscles was measured at rest and at maximal voluntary isometric contraction (MVIC). In addition, the craniovertebral angle (CVA) was calculated. To compare thickness changes between the 2 groups and among 5 muscles, a 2-way repeated measures analysis of variance was applied. In addition, Pearson’s correlation test was performed to investigate the relationship between neck extensor MVIC and CVA. Results The FHP group demonstrated lower MVIC compared with the NHP group (P = .03). Semispinalis capitis showed the smallest thickness changes during neck extensor MVIC in FHP compared with the controls (P < .001). However, no significant difference in terms of muscle thickness was observed between the 2 groups at the state of rest (P = .16-.99). A positive association was also found between the MVIC and CVA (P = .02). Conclusions Semispinalis capitis had less thickness changes during MVIC of neck extensors in individuals with FHP compared with those with NHP. This indirectly implies lower activity of this muscle in FHP condition. This study finding may help researchers develop therapeutic exercise protocols to manage FHP.

      PubDate: 2017-12-21T18:09:17Z
      DOI: 10.1016/j.jmpt.2017.07.012
       
  • The Effectiveness of Hollowing and Bracing Strategies With Lumbar
           Stabilization Exercise in Older Adult Women With Nonspecific Low Back
           Pain: A Quasi-Experimental Study on a Community-based Rehabilitation
    • Authors: Minseock Kim; Minhee Kim; Sejun Oh; BumChul Yoon
      Abstract: Publication date: Available online 16 December 2017
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Minseock Kim, Minhee Kim, Sejun Oh, BumChul Yoon
      Objective The purpose of this study was to explore the therapeutic effectiveness of hollowing lumbar stabilization exercise (HLSE) and bracing lumbar stabilization exercise (BLSE) for older adult women with nonspecific low back pain (NSLBP) in community welfare centers. Method A total of 38 older adult women with NSLBP were allocated to either the HLSE group (n = 17, 70.4 ± 1.7 years) or the BLSE group (n = 21, 66.8 ± 4.4 years). Both groups performed intervention for 12 consecutive weeks, 3 times per week. Each group performed 5 lumbar stabilization exercises, including side plank exercise, bridge exercise, 4-kneeling exercise, prone plank exercise, and prone back extension exercise with hollowing and bracing strategy, respectively. The baseline and post-test values of trunk strength, low back disability (Korean Oswestry Disability Index [K-ODI] and Korean Roland Morris Disability Questionnaire [K-RMDQ]), and static balance (1-leg standing test) were compared by using per-protocol analysis. Results In trunk strength, the trunk flexor had significant difference (F = 11.10, P = .001) between groups and within groups of BLSE (t = –5.56, P = .001) and HLSE (t = –2.50, P = .024). Trunk back extensor of HLSE (t = –6.00, P = .001) and BLSE (t = –9.19, P = .001) only had significant within-group difference. However, in trunk side flexor, HLSE and BLSE had only significant difference between groups. In low back disability, K-ODI for HLSE (t = 4.50, P = .001) and BLSE (t = 4.60, P = .001) had significant within-group difference but no significant difference between groups (F = 0.28, P = .202). In K-RMDQ, HLSE only had significant within-group difference (t = 3.97, P = .001). In trunk muscle strength, the effect size of HLSE and BLSE groups for trunk flexor was HLSE –0.53 (medium) and BLSE –1.21 (large); trunk side flexor: HLSE 0.27 (small) and BLSE –0.24 (small); and trunk back extensor: HLSE 1.1 (large) and BLSE 2.00 (large), respectively. In low back disability, the effect size of both groups for K-ODI was HLSE 0.88 (large) and BLSE 1.05 (large), and K-RMDQ, HLSE 0.19 (small) and BLSE 0.40 (small), respectively. Conclusion Our findings suggest that HLSE and BLSE could be recommended for community settings to improve trunk strength and low back disability in older adult women with NSLBP. Especially, HLSE and BLSE could be recommended for elderly women with NSLBP who have lower back disability and weak trunk muscle strength, respectively.

      PubDate: 2017-12-21T18:09:17Z
      DOI: 10.1016/j.jmpt.2017.06.012
       
  • Common Manual Therapy Practices in the Netherlands for Infants With Upper
           Cervical Dysfunction: A Prospective Cohort Study
    • Authors: Eric R.I.C. Saedt; Femke Driehuis; Thomas J. Hoogeboom; Bé H. van der Woude; Rob A. de Bie; Maria W.G. Nijhuis-van der Sanden
      Abstract: Publication date: Available online 16 December 2017
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Eric R.I.C. Saedt, Femke Driehuis, Thomas J. Hoogeboom, Bé H. van der Woude, Rob A. de Bie, Maria W.G. Nijhuis-van der Sanden
      Objective The purpose of this study was to describe common clinical practices of manual therapists (MTs) in the Netherlands for infants with indications of upper cervical dysfunction (UCD). Methods A prospective observational cohort study was conducted to gain insight into characteristics, reasons for seeking care, and common clinical practice for infants (<27 weeks) with indications of UCD, referred to MTs. Pre- and posttreatment self-reported questionnaires were used to collect data from parents and MTs. Parents reported on infant characteristics and perceived effect of treatment. Manual therapists reported on diagnostics, therapeutic procedures, and outcomes. Results Between 2006 and 2007, data regarding 307 referred infants (mean age: 11.2 weeks) were collected by parents and 42 MTs. The most frequent reasons for seeking care were positional preference, restlessness, and/or abnormal head position. Manual therapists observed active, spontaneous, and provoked mobility and passive upper cervical mobility. Of the 307 infants, 295 were diagnosed with UCD based on positive outcomes on the flexion-rotation test and/or lateral flexion test. After treatment with mobilization techniques, positive outcomes on the flexion-rotation test decreased from 78.8% to 6.8%. For the lateral flexion test, the positive outcomes decreased from 91.5% to 6.2%. All parents perceived positive treatment effects. No serious adverse events were reported during this study. Conclusions This is the first study to describe common clinical practice for infants referred for manual therapy. Infants with UCD were treated mainly with upper cervical mobilization techniques, and the greatest perceived effect was observed after approximately 2 treatment sessions.

      PubDate: 2017-12-21T18:09:17Z
      DOI: 10.1016/j.jmpt.2017.08.003
       
  • Correlation Between Severity of Temporomandibular Disorder, Pain
           Intensity, and Pressure Pain Threshold
    • Authors: Carolina Marciela Herpich; Cid André Fidelis de Paula Gomes; Almir Vieira Dibai-Filho; Fabiano Politti; Cesário da Silva Souza; Daniela Aparecida Biasotto-Gonzalez
      Abstract: Publication date: Available online 15 December 2017
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Carolina Marciela Herpich, Cid André Fidelis de Paula Gomes, Almir Vieira Dibai-Filho, Fabiano Politti, Cesário da Silva Souza, Daniela Aparecida Biasotto-Gonzalez
      Objective The aim of the present study was to correlate the severity of temporomandibular disorder (TMD) with the pressure pain threshold over the temporomandibular joint and masticatory muscles. Methods A blind, cross-sectional study was conducted involving 60 women ages 18 to 40 years with a diagnosis of myogenous TMD. Evaluations were performed using the Fonseca Anamnestic Index (FAI), the visual analogue scale, and algometry over the temporomandibular joint and masticatory muscles. Spearman’s correlation coefficients (rs) were calculated to measure the association between TMD severity, pain intensity, and the pressure pain threshold. Results A moderate, significant, and negative correlation was found between TMD severity and the pressure pain threshold over the left masseter muscle (rs = –0.276; P = .034). No significant correlations were found for the other variables analyzed (P = .124-.985). Conclusions Temporomandibular disorder measured using the FAI was associated to the pressure pain threshold over the masseter muscle. The significant and negative association found between the score of the FAI and the pressure pain threshold over the masseter muscle demonstrated that patients with more severe signs and symptoms of TMD had a lower pressure pain threshold.

      PubDate: 2017-12-21T18:09:17Z
      DOI: 10.1016/j.jmpt.2017.08.001
       
  • Association of Pain Catastrophizing With Static Balance, Mobility, or
           Functional Capacity in Patients With Knee Osteoarthritis: A Blind
           Cross-sectional Study
    • Authors: Cid André Fidelis de Paula Gomes; Almir Vieira Dibai-Filho; Daniela Aparecida Biasotto-Gonzalez; Fabiano Politti; Paulo de Tarso Camillo de Carvalho
      Abstract: Publication date: Available online 15 December 2017
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Cid André Fidelis de Paula Gomes, Almir Vieira Dibai-Filho, Daniela Aparecida Biasotto-Gonzalez, Fabiano Politti, Paulo de Tarso Camillo de Carvalho
      Objective The aim of this study was to investigate whether catastrophizing is associated with static balance, mobility, and functional capacity in patients with knee osteoarthritis. Methods A blind, cross-sectional study was conducted involving 60 volunteers (males and females), ages 40 to 80 years, with a diagnosis of knee osteoarthritis. Patients were recruited from a physical therapy clinic in the city of São Paulo, Brazil. The following measures were used for the evaluations: Pain-Related Self-Statement Scale, Functional Reach Test, Timed Up and Go Test, Lower Extremity Functional Scale, and Western Ontario and McMaster University Osteoarthritis Index. In statistical analysis, histograms were created to determine distribution of data. Spearman’s correlation coefficients (rs) were then calculated to determine the strength of the associations among the variables. Results No significant correlation was found between the Pain-Related Self-Statement Scale score and the other clinical measures employed in the present study: Functional Reach Test (rs = 0.151; P = .249), Timed Up and Go Test (rs = –0.147; P =.264), Lower Extremity Functional Scale (rs = 0.023; P = .860), and Western Ontario and McMaster University Osteoarthritis (rs = –0.222; P = .088). Conclusions In this study, catastrophizing was not associated with static balance, mobility, or functional capacity in patients with knee osteoarthritis.

      PubDate: 2017-12-21T18:09:17Z
      DOI: 10.1016/j.jmpt.2017.08.002
       
  • Quantitative Postural Analysis of Children With Congenital Visual
           Impairment
    • Authors: Michelle de Pádua; Juliana F. Sauer; Silvia M.A. João
      Abstract: Publication date: Available online 8 December 2017
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Michelle de Pádua, Juliana F. Sauer, Silvia M.A. João
      Objectives The aim of this study was to compare the postural alignment of children with visual impairment with that of children without visual impairment. Methods The sample studied was 74 children of both sexes ages 5 to 12 years. Of these, 34 had visual impairment and 40 were control children. Digital photos from the standing position were used to analyze posture. Postural variables, such as tilt of the head, shoulder position, scapula position, lateral deviation of the spine, ankle position in the frontal plane and head posture, angle of thoracic kyphosis, angle of lumbar lordosis, pelvis position, and knee position in the frontal and sagittal planes, were measured with the Postural Assessment Software 0.63, version 36 (SAPO, São Paulo, Brazil), with markers placed in predetermined bony landmarks. Results The main results of this study showed that children with visual impairment have increased head tilt (P < .001), shoulder deviation in frontal plane (P = .004), lateral deviation of the spine (P < .001), changes in scapula position (P = .012), higher thoracic kyphosis (P = .004), and lower lumbar lordosis (P < .001). Conclusions Visual impairment influences postural alignment. Children with visual impairment had increased head tilt, uneven shoulders, greater lateral deviation of the spine, thoracic kyphosis, lower lumbar lordosis, and more severe valgus deformities on knees.

      PubDate: 2017-12-11T17:44:16Z
      DOI: 10.1016/j.jmpt.2017.07.016
       
  • Information for Readers
    • Abstract: Publication date: November–December 2017
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 40, Issue 9


      PubDate: 2017-12-11T17:44:16Z
       
 
 
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