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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  [2801 journals]
  • An Electronic Patient-Reported Outcome Measures System in UK Chiropractic
           Practices: A Feasibility Study of Routine Collection of Outcomes and Costs
           
    • Abstract: Publication date: Available online 1 February 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Dave Newell, Emily Diment, Jenni E Bolton
      Objective The purpose of this study was to test the feasibility of collecting valid and widely used health outcomes, including information concerning cost of care, using a Web-based patient-driven patient-reported outcome measure (PROM) collection process within a cohort of UK chiropractic practices. Methods A Web-based PROM system (Care Response) was used. Patients with low back and neck pain were recruited from a group of chiropractic practices located in the United Kingdom. Information collected included demographic data, generic and condition-specific PROMs at the initial consultation and 90 days later, patient-reported experience measures, and additional health seeking to estimate costs of care. Results A group of 33 clinics provided information from a total of 1895 patients who completed baseline questionnaires with 844 (45%) completing the measures at 90-day follow-up. Subsequent outcomes suggest that more than 70% of patients improved over the course of treatment regardless of the outcome used. Using the baseline as a virtual counterfactual with respect to follow-up, we calculated quality-adjusted life years and the cost thereof resulting in a mean quality-adjusted life years gained of 0.8 with an average cost of £895 per quality-adjusted life year. Conclusion Routine collection of PROMs, including information about cost, is feasible and can be achieved using an online system within a clinical practice environment. We describe a Web-based collection system and discuss the choice of measures leading to a comprehensive understanding of outcomes and costs in routine practice.


      PubDate: 2016-02-01T19:56:53Z
       
  • Influence of Subclinical Neck Pain on the Ability to Perform a Mental
           Rotation Task: A 4-Week Longitudinal Study With a Healthy Control Group
           Comparison
    • Abstract: Publication date: Available online 1 February 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Julianne K. Baarbé, Michael W.R. Holmes, Heather E. Murphy, Heidi Haavik, Bernadette A. Murphy
      Objective Mental rotation of objects and the frame of reference of those objects are critical for executing correct and skillful movements and are important for object recognition, spatial navigation, and movement planning. The purpose of this longitudinal study was to compare the mental rotation ability of those with subclinical neck pain (SCNP) to healthy controls at baseline and after 4 weeks. Methods Twenty-six volunteers (13 SCNP and 12 healthy controls) were recruited from a university student population. Subclinical neck pain participants had scores of mild to moderate on the Chronic Pain Grade Scale, and controls had minimal or no pain. For the mental rotation task, participants were presented with an object (letter “R”) on a computer screen presented randomly in either normal or backwards parity at various orientations (0°, 45°, 90°, 135°, 180°, 225°, 270°, and 315°). Participants indicated the object's parity by pressing “N” for normal or “B” for backwards. Each orientation for normal and backward parities was presented 5 times, and the average response time for all letter presentations was calculated for each participant, at baseline and 4 weeks later. Results Both groups had overall improved response times from baseline to 4 weeks. Healthy participants had significantly improved response times compared to SCNP, both at baseline (P < .05) and 4 weeks (P < .05). Conclusions Healthy participants performed better than the SCNP group at both time points. Subclinical neck pain may impair the ability to perform a complex mental rotation task involving cerebellar connections, possibly due to altered body schema.


      PubDate: 2016-02-01T19:56:53Z
       
  • Clinical Outcomes in a Large Cohort of Musculoskeletal Patients Undergoing
           Chiropractic Care in the United Kingdom: A Comparison of Self- and
           National Health Service–Referred Routes
    • Abstract: Publication date: Available online 1 February 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jonathan R Field, Dave Newell
      Objective An innovative commissioning pathway has recently been introduced in the United Kingdom allowing chiropractic organizations to provide state-funded chiropractic care to patients through referral from National Health Service (NHS) primary care physicians. The purpose of this study was to examine the outcomes of NHS and private patient groups presenting with musculoskeletal conditions to chiropractors under the Any Qualified Provider scheme and compare the clinical outcomes of these patients with those presenting privately. Methods A prospective cohort design monitoring patient outcomes comparing self-referring and NHS-referred patients undergoing chiropractic care was used. The primary outcome was the change in Bournemouth Questionnaire scores. Within- and between-group analyses were performed to explore differences between outcomes with additional analysis of subgroups as categorized by the STarT back tool. Results A total of 8222 patients filled in baseline questionnaires. Of these, NHS patients (41%) had more adverse health measures at baseline and went on to receive more treatment. Using percent change in Bournemouth Questionnaire scores categorized at minimal clinical change cutoffs and adjusting for baseline differences, patients with low back and neck pain presenting privately are more likely to report improvement within 2 weeks and to have slightly better outcomes at 90 days. However, these patients were more likely to be attending consultations beyond 30 days. Conclusions This study supports the contention that chiropractic services as provided in United Kingdom are appropriate for both private and NHS-referred patient groups and should be considered when general medical physicians make decisions concerning referral routes and pain pathways for patients with musculoskeletal conditions.


      PubDate: 2016-02-01T19:56:53Z
       
  • Attenuation Effect of Spinal Manipulation on Neuropathic and Postoperative
           Pain Through Activating Endogenous Anti-Inflammatory Cytokine Interleukin
           10 in Rat Spinal Cord
    • Abstract: Publication date: Available online 1 February 2016
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Xue-Jun Song, Zhi-Jiang Huang, William B. Song, Xue-Song Song, Arlan F. Fuhr, Anthony L. Rosner, Harrison Ndtan, Ronald L. Rupert
      Objectives The purpose of this study was to investigate roles of the anti-inflammatory cytokine interleukin (IL) 10 and the proinflammatory cytokines IL-1β and tumor necrosis factor α (TNF-α) in spinal manipulation–induced analgesic effects of neuropathic and postoperative pain. Methods Neuropathic and postoperative pain were mimicked by chronic compression of dorsal root ganglion (DRG) (CCD) and decompression (de-CCD) in adult, male, Sprague-Dawley rats. Behavioral pain after CCD and de-CCD was determined by the increased thermal and mechanical hypersensitivity of the affected hindpaw. Hematoxylin and eosin staining, whole-cell patch clamp electrophysiological recordings, immunohistochemistry, and enzyme-linked immunosorbent assay were used to examine the neural inflammation, neural excitability, and expression of c-Fos and PKC as well as levels of IL-1β, TNF-α, and IL-10 in blood plasma, DRG, or the spinal cord. We used the activator adjusting instrument, a chiropractic spinal manipulative therapy tool, to deliver force to the spinous processes of L5 and L6. Results After CCD and de-CCD treatments, the animals exhibited behavioral and neurochemical signs of neuropathic pain manifested as mechanical allodynia and thermal hyperalgesia, DRG inflammation, DRG neuron hyperexcitability, induction of c-Fos, and the increased expression of PKCγ in the spinal cord as well as increased level of IL-1β and TNF-α in DRG and the spinal cord. Repetitive Activator-assisted spinal manipulative therapy significantly reduced simulated neuropathic and postoperative pain, inhibited or reversed the neurochemical alterations, and increased the anti-inflammatory IL-10 in the spinal cord. Conclusion These findings show that spinal manipulation may activate the endogenous anti-inflammatory cytokine IL-10 in the spinal cord and thus has the potential to alleviate neuropathic and postoperative pain.


      PubDate: 2016-02-01T19:56:53Z
       
  • A Literature Review of Pediatric Spinal Manipulation and Chiropractic
           Manipulative Therapy: Evaluation of Consistent Use of Safety Terminology
    • Abstract: Publication date: November–December 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 9
      Author(s): Aurélie M. Marchand
      Objective The purpose of this study was to perform a literature search to identify relevant studies on pediatric spinal manipulation and chiropractic manipulative therapy and to assess if safety terminology was consistent with the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). Methods A literature search was performed in PubMed using the following terms: spinal manipulation pediatric, chiropractic safety pediatric, and manual therapy safety pediatric. PubMed was searched from inception to April 2012 with no language limitations. The international standards included the terminology of the World Health Organization on side effects, adverse reactions, adverse events and the ICH guideline templates that were adapted for manual therapy for this study. Results Of the 9 relevant articles identified in this study, 3 reported methodology for classifying safety incidents, and all 9 used safety terminology (adverse effects or adverse events). However, terminology was not used consistently. Conclusion Most of the articles identified in this literature review did not use terminology consistent with the standards established by the ICH when reporting on safety incidents following pediatric spinal manipulation or chiropractic manipulative therapy. More efforts should be taken to include consistent terminology for studies of spinal manipulation and chiropractic manipulative therapy for children.


      PubDate: 2015-12-12T23:00:36Z
       
  • Serious Adverse Events and Spinal Manipulative Therapy of the Low Back
           Region: A Systematic Review of Cases
    • Abstract: Publication date: November–December 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 9
      Author(s): Jeffrey J. Hebert, Norman J. Stomski, Simon D. French, Sidney M. Rubinstein
      Objective The purpose of this study was to systematically search the literature for studies reporting serious adverse events following lumbopelvic spinal manipulative therapy (SMT) and to describe the case details. Methods A systematic search was conducted in PubMed including MEDLINE, EMBASE, CINAHL, and The Cochrane Library up to January 12, 2012, by an experienced reference librarian. Study selection was performed by 2 independent reviewers using predefined criteria. We included cases involving individuals 18 years or older who experienced a serious adverse event following SMT applied to the lumbar spine or pelvis by any type of provider (eg, chiropractic, medical, physical therapy, osteopathic, layperson). A serious adverse event was defined as an untoward occurrence that results in death or is life threatening, requires hospital admission, or results in significant or permanent disability. We included studies published in English, German, Dutch, and Swedish. Results A total of 2046 studies were screened, and 41 studies reporting on 77 cases were included. Important case details were frequently unreported, such as descriptions of SMT technique, the pre-SMT presentation of the patient, the specific details of the adverse event, time from SMT to the adverse event, factors contributing to the adverse event, and clinical outcome. Adverse events consisted of cauda equina syndrome (29 cases, 38% of total); lumbar disk herniation (23 cases, 30%); fracture (7 cases, 9%); hematoma or hemorrhagic cyst (6 cases, 8%); or other serious adverse events (12 cases, 16%) such as neurologic or vascular compromise, soft tissue trauma, muscle abscess formation, disrupted fracture healing, and esophageal rupture. Conclusions This systematic review describes case details from published articles that describe serious adverse events that have been reported to occur following SMT of the lumbopelvic region. The anecdotal nature of these cases does not allow for causal inferences between SMT and the events identified in this review. Recommendations regarding future case reporting and research aimed at furthering the understanding of the safety profile of SMT are discussed.


      PubDate: 2015-12-12T23:00:36Z
       
  • The Association Between Cervical Spine Manipulation and Carotid Artery
           Dissection: A Systematic Review of the Literature
    • Abstract: Publication date: November–December 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 9
      Author(s): Chadwick L.R. Chung, Pierre Côté, Paula Stern, Georges L'Espérance
      Objective Controversy surrounds the safety of cervical spine manipulation. Ischemic stroke secondary to cervical spine manipulation is a hypothesized adverse event. In Canada, the seriousness of these events and their perceived association to cervical spine manipulation has led some members of the public to call for a ban of the procedure. The primary objective of this study was to determine the incidence of internal carotid artery (ICA) dissection after cervical spine manipulation in patients who experience neck pain and its associated disorders. The secondary objective was to determine whether cervical spine manipulation is associated with an increased risk of ICA dissection in patients with neck pain, upper back pain, or headaches. Methods We systematically searched MEDLINE, CINAHL, Alternative Health, AMED, Index to Chiropractic Literature, and EMBASE from 1970 to November 2012. Two independent reviewers used standardized criteria to screen the eligibility of articles. We considered cohort studies, case-control studies, and randomized clinical trials that addressed our objectives. We planned to critically appraise eligible articles using the Scottish Intercollegiate Guideline Network methodology. Results We did not find any epidemiologic studies that measured the incidence of cervical spine manipulation and ICA dissection. Similarly, we did not find any studies that determined whether cervical spine manipulation is associated with ICA dissection. Conclusions The incidence of ICA dissection after cervical spine manipulation is unknown. The relative risk of ICA dissection after cervical spine manipulation compared with other health care interventions for neck pain, back pain, or headache is also unknown. Although several case reports and case series raise the hypothesis of an association, we found no epidemiologic studies that validate this hypothesis.


      PubDate: 2015-12-12T23:00:36Z
       
  • A Proposed Model With Possible Implications for Safety and Technique
           Adaptations for Chiropractic Spinal Manipulative Therapy for Infants and
           Children
    • Abstract: Publication date: November–December 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 9
      Author(s): Aurélie M. Marchand
      Objective A literature review of tensile strength of adults and pediatric human spine specimens was performed to gather information about biomechanical forces and spinal differences of adults and children and to synthesize these findings into a scaling model to guide safety and clinical decisions for spinal manipulative therapy (SMT) for children and infants. Methods The literature search was performed using PubMed from inception to November 2012 with no filters or language restrictions. The search included terms related to pediatric spine biomechanics and tensile strength. Studies included those in which human tensile strengths necessary to create anatomical damage in the cervical, thoracic, or lumbar spine of pediatric human subjects were recorded. The pediatric population was defined as human subjects from birth to 18 years old. Biomechanical findings were used to propose a scaling model based on specimen age and differences in tensile strengths. A model of care was proposed using the scaling model and the existing literature on pediatric technique adaptations. Results Nine experimental studies were selected, 5 in the pediatric population (46 specimens) and 4 in the adult population (47 specimens). Mean tensile strengths were estimated, and ratios were used to describe differences between 4 age groups. The preliminary model of care proposed includes maximum loading forces by age group. From these studies, a model showed a nonlinear increase in the cervical spine tensile strengths based on specimen age. Conclusions The literature showed that tensile strength differences have been observed between pediatric and adult specimens. A preliminary model of care including pediatric SMT technique adaptation based on patient age is proposed, which may possibly contribute to further knowledge of safety and clinical implications for SMT for children and infants.


      PubDate: 2015-12-12T23:00:36Z
       
  • Adverse Events Due to Chiropractic and Other Manual Therapies for Infants
           and Children: A Review of the Literature
    • Abstract: Publication date: November–December 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 9
      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: 2015-12-12T23:00:36Z
       
  • Editorial Board
    • Abstract: Publication date: November–December 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 9




      PubDate: 2015-12-12T23:00:36Z
       
  • Table of Contents
    • Abstract: Publication date: November–December 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 9




      PubDate: 2015-12-12T23:00:36Z
       
  • Information for Readers
    • Abstract: Publication date: November–December 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 9




      PubDate: 2015-12-12T23:00:36Z
       
  • Internal Carotid Artery Strains During High-Speed, Low-Amplitude Spinal
           Manipulations of the Neck
    • Abstract: Publication date: November–December 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 9
      Author(s): Walter Herzog, Conrad Tang, Tim Leonard
      Objective The primary objective of this study was to quantify the strains applied to the internal carotid artery (ICA) during neck spinal manipulative treatments and range of motion (ROM)/diagnostic testing of the head and neck. Methods Strains of the ICA (n = 12) were measured in 6 fresh, unembalmed cadaveric specimens using sonomicrometry. Peak and average strains of the ICA obtained during cervical spinal manipulations given by experienced doctors of chiropractic were compared with the corresponding strains obtained during ROM and diagnostic testing of the head and neck. Results Peak and average strains of the ICA for cervical spinal manipulative treatments were significantly smaller (P < .001) than the corresponding strains obtained for the ROM and diagnostic testing. All strains during ROM and treatment testing were dramatically smaller than the initial failure strains of the ICA. Conclusions This study showed that maximal ICA strains imparted by cervical spinal manipulative treatments were well within the normal ROM. Chiropractic manipulation of the neck did not cause strains to the ICA in excess of those experienced during normal everyday movements. Therefore, cervical spinal manipulative therapy as performed by the trained clinicians in this study, did not appear to place undue strain on the ICA and thus does not seem to be a factor in ICA injuries.


      PubDate: 2015-12-12T23:00:36Z
       
  • Thank You to JMPT Peer Reviewers for 2014
    • Abstract: Publication date: Available online 11 November 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Claire Johnson
      This article recognizes editorial board members and peer reviewers who completed manuscript reviews for the Journal of Manipulative and Physiological Therapeutics in the year 2014 and provides a summary of international representation of peer reviewers.


      PubDate: 2015-11-11T21:07:11Z
       
  • A Test-Retest Reliability Study of the Whiplash Disability Questionnaire
           in Patients With Acute Whiplash-Associated Disorders
    • Abstract: Publication date: Available online 11 November 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Maja Stupar, Pierre Côté, Dorcas E. Beaton, Eleanor Boyle, J David Cassidy
      Objective The purpose of this study was to determine the test-retest reliability and the Minimal Detectable Change (MDC) of the Whiplash Disability Questionnaire (WDQ) in individuals with acute whiplash-associated disorders (WADs). Methods We performed a test-retest reliability study. We included insurance claimants from Ontario who were at least 18years of age, within 21days of their motor vehicle collision and diagnosed as having acute WAD grades I to III. The WDQ, a 13-item questionnaire scored from 0 (no disability) to 130 (complete disability), was administered to all participants at baseline and by telephone 3days later. We computed the intraclass correlation coefficient (model 2,1) and the MDC with 95% confidence intervals (CIs; MDC95). Results The mean (SD) age of the 66 participants was 41.6 (12.7) years and 71.2% were female. Twenty-nine percent had WAD I and 71.2% had WAD II. Time since injury ranged from 0 to 19 days. The mean (SD) baseline WDQ score was 49.3 (28.8) and 46.5 (29.8) 3days later. The intraclass correlation coefficient for the WDQ total score was 0.89 (95% CI, 0.85-0.92) in the entire sample and 0.83 (95% CI, 0.69-0.93) for the 15 participants reporting no change in neck pain. The MDC95 of the WDQ was 21.4 (SD = 14.9) for participants reporting no change. Conclusion The WDQ was reliable in individuals with acute WAD. There is 95% confidence that a change of approximately one-sixth of the total score is beyond the daily variation of a stable condition. This level of measurement error must be taken into consideration when interpreting change in WDQ scores.


      PubDate: 2015-11-11T21:07:11Z
       
  • A Randomized Pragmatic Clinical Trial of Chiropractic Care for Headaches
           With and Without a Self-Acupressure Pillow
    • Abstract: Publication date: Available online 6 November 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Howard Vernon, Cam Borody, Glen Harris, Brad Muir, Jarrod Goldin, Maricelle Dinulos
      Objective The purpose of this study was to determine if the addition of a self-acupressure pillow (SAP) to typical chiropractic treatment results in significantly greater improvement in tension-type and cervicogenic headache sufferers. Methods A pragmatic randomized clinical trial was conducted in a chiropractic college teaching clinic. Thirty-four subjects, including tension-type and cervicogenic headache sufferers, 21 to 60 years of age, male or female, completed the study. Group A (n = 15) received typical chiropractic care only (manual therapy and exercises), and group B (n = 19) received typical chiropractic care with daily home use of the SAP. The intervention period was 4 weeks. The main outcome measure was headache frequency. Satisfaction and relief scores were obtained from subjects in the SAP group. Analysis of variance was used to analyze the intergroup comparisons. Results Owing to failure of randomization to produce group equivalence on weekly headache frequency, analysis of covariance was performed showing a trend (P = .07) favoring the chiropractic-only group; however, this was not statistically significant. Group A obtained a 46% reduction of weekly headache frequency (t = 3.1, P = .002; d = 1.22). The number of subjects in group A achieving a reduction in headaches greater than 40% was 71%, while for group B, this was 28%. The mean benefit score (0-3) in group B of the use of the SAP was 1.2 (.86). The mean satisfaction rating of users of the SAP was 10.4 (2.7) out of 15 (63%). Conclusion This study suggests that chiropractic care may reduce frequency of headaches in patients with chronic tension-type and cervicogenic headache. The use of a self-acupressure pillow (Dr Zaxx device) may help those with headache and headache pain relief as well as producing moderately high satisfaction with use.


      PubDate: 2015-11-07T20:53:56Z
       
  • Comparing Propensity Score Methods for Creating Comparable Cohorts of
           Chiropractic Users and Nonusers in Older, Multiply Comorbid Medicare
           Patients With Chronic Low Back Pain
    • Abstract: Publication date: Available online 5 November 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): William B. Weeks, Tor D. Tosteson, James M. Whedon, Brent Leininger, Jon D. Lurie, Rand Swenson, Christine M. Goertz, Alistair J. O'Malley
      Objective Patients who use complementary and integrative health services like chiropractic manipulative treatment (CMT) often have different characteristics than do patients who do not, and these differences can confound attempts to compare outcomes across treatment groups, particularly in observational studies when selection bias may occur. The purposes of this study were to provide an overview on how propensity scoring methods can be used to address selection bias by balancing treatment groups on key variables and to use Medicare data to compare different methods for doing so. Methods We described 2 propensity score methods (matching and weighting). Then we used Medicare data from 2006 to 2012 on older, multiply comorbid patients who had a chronic low back pain episode to demonstrate the impact of applying methods on the balance of demographics of patients between 2 treatment groups (those who received only CMT and those who received no CMT during their episodes). Results Before application of propensity score methods, patients who used only CMT had different characteristics from those who did not. Propensity score matching diminished observed differences across the treatment groups at the expense of reduced sample size. However, propensity score weighting achieved balance in patient characteristics between the groups and allowed us to keep the entire sample. Conclusions Although propensity score matching and weighting have similar effects in terms of balancing covariates, weighting has the advantage of maintaining sample size, preserving external validity, and generalizing more naturally to comparisons of 3 or more treatment groups. Researchers should carefully consider which propensity score method to use, as using different methods can generate different results.


      PubDate: 2015-11-07T20:53:56Z
       
  • Fiber Typing of the Erector Spinae and Multifidus Muscles in Healthy
           Controls and Back Pain Patients: A Systematic Literature Review
    • Abstract: Publication date: Available online 5 November 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Barbara Cagnie, Famke Dhooge, Charline Schumacher, Kayleigh De Meulemeester, Mirko Petrovic, Jessica van Oosterwijck, Lieven Danneels
      Objective Understanding the changes in muscle fiber typing is relevant in the context of muscle disorders because it provides information on the metabolic profile and functional capacity. The aim of this study was to systematically review the literature comparing muscle fiber typing in the back muscles of healthy subjects with low back pain (LBP) patients. Methods Predefined keywords regarding muscle fiber typing and back muscles were combined in PubMed and Web of Science electronic search engines from inception to August 2014. Full-text articles were independently screened by 2 independent, blinded researchers. Full texts fulfilling the predefined inclusion criteria were assessed on risk of bias by 2 independent researchers, and relative data were extracted. Data were not pooled because of heterogeneity in biopsy locations and population. Results From the 214 articles that were identified, 18 met the inclusion criteria. These articles evaluated the muscle fiber type distribution or proportional fiber type area between muscles, muscle layers, men, and women or healthy subjects and LBP patients. Regarding muscle fiber type distribution, findings in healthy subjects and LBP patients show no or inconclusive evidence for intermuscular and interindividual differentiation. Studies evaluating the proportional fiber type area also suggest little intermuscular differentiation but provide plausible evidence that the proportional area occupied by type I fibers is higher in women compared to men. The evidence for differentiation based on the presence of low back pain is conflicting. Conclusion This study found that the evidence regarding muscle fiber typing in back muscles is either inconclusive or shows little differences. The most plausible evidence exists for differentiation in proportional fiber type area depending on sex.


      PubDate: 2015-11-07T20:53:56Z
       
  • Editorial Board
    • Abstract: Publication date: October 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 8




      PubDate: 2015-10-31T20:33:31Z
       
  • Table of Contents
    • Abstract: Publication date: October 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 8




      PubDate: 2015-10-31T20:33:31Z
       
  • Information for Readers
    • Abstract: Publication date: October 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 8




      PubDate: 2015-10-31T20:33:31Z
       
  • Comparison of Hypoalgesic Effects of Neural Stretching vs Neural Gliding:
           A Randomized Controlled Trial
    • Abstract: Publication date: Available online 21 October 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Hector Beltran-Alacreu, Laura Jiménez-Sanz, Josue Fernández Carnero, Roy La Touche
      Objective The purpose of this study was to evaluate the immediate mechanical hypoalgesic effect of neural mobilization in asymptomatic subjects. We also compared neural gliding vs neural stretching to see which produced greater hypoalgesic effects in asymptomatic subjects. Methods Forty-five asymptomatic subjects (20 men and 25 women; mean ± SD age, 20.8 ± 2.83 years) were randomly allocated into 3 groups: the neural glide group, the neural stretch group, and the placebo group. Each subject received 1 treatment session. Outcome measures included bilateral pressure pain threshold measured at the trigeminal, cervical, and tibialis anterior points, assessed pre-treatment and immediately post-treatment by a blinded assessor. Three-way repeated-measures analysis of variance was used to evaluate changes in pressure pain threshold, with group (experimental or control) as the between-subjects variable and time (pre-, post-treatment) or side (dominant, nondominant) as the within-subjects variable. Results Group differences were identified between neural mobilization groups and the placebo group. Changes occurred in all of the pressure pain threshold measures for neural gliding, and in all but the trigeminal point for neural stretch. No changes in the pressure pain threshold measures occurred in the placebo group. Conclusions This research provides new experimental evidence that neural mobilization produces an immediate widespread hypoalgesic effect vs placebo but neural gliding produces hypoalgesic effects in more body sites than neural stretching.


      PubDate: 2015-10-31T20:33:31Z
       
  • Short-Term Effects of Kinesiotaping on Pain and Joint Alignment in
           Conservative Treatment of Hallux Valgus
    • Abstract: Publication date: Available online 3 October 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Gul Oznur Karabicak, Nilgun Bek, Ugur Tiftikci
      Objective The main aim of this study was to measure short-term effects of kinesiotaping on pain and joint alignment in the conservative treatment of hallux valgus. Method Twenty-one female patients diagnosed with a total of 34 feet with hallux valgus (13 bilateral, 6 right, and 2 left) participated in this study. Kinesiotaping was implemented after the first assessment and renewed in days 3, 7, and 10. The main outcome measures were pain, as assessed using visual analog scale, and hallux adduction angle, as measured by goniometry. Secondary outcome measure was patients' functional status, as measured by Foot Function Index and the hallux valgus scale of the American Orthopaedic Foot and Ankle Society (AOFAS). The radiographic results were also measured before and after 1 month of treatment. The Wilcoxon test was used to compare the differences between initial and final scores of AOFAS, as well as FFI scales and hallux valgus angle assessment scores. Results There was a significant reduction in goniometric measurement of hallux valgus angle (P = .001). There was a significant reduction in pain intensity (P = .001) and AOFAS and Foot Function Index scores at the end of the treatment (P = .001 and P = .001, respectively). There was a significant difference between radiographic results in 1-month control (P = .009). Conclusions For this group of female patients, pain and joint alignment were improved after a 10-day kinesiotape implementation in patients with hallux valgus. The findings showed short-term decreased pain and disability in hallux valgus deformity.


      PubDate: 2015-10-06T10:35:11Z
       
  • Editorial Board
    • Abstract: Publication date: September 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 7




      PubDate: 2015-10-06T10:35:11Z
       
  • Table of Contents
    • Abstract: Publication date: September 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 7




      PubDate: 2015-10-06T10:35:11Z
       
  • Information for Readers
    • Abstract: Publication date: September 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 7




      PubDate: 2015-10-06T10:35:11Z
       
  • Effect of Interactive Neurostimulation Therapy on Inflammatory Response in
           Patients With Chronic and Recurrent Mechanical Neck Pain
    • Abstract: Publication date: Available online 4 October 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Julita A. Teodorczyk-Injeyan, John J. Triano, Marion McGregor, Linda Woodhouse, H. Stephen Injeyan
      Objective The purpose of this study is to evaluate the effect of treatment with a novel noninvasive interactive neurostimulation device (InterX5000) on the production of inflammatory biomarkers in chronic and recurrent mechanical neck pain (NP) syndrome. Methods This study represents pilot biological data from a randomized controlled clinical trial. Twenty-five NP patients and 14 asymptomatic subjects included for baseline comparison only completed the study. The patients received 6 InterX5000 or placebo treatments within 2 weeks, and pretreatment and post-treatment blood samples were collected for in vitro determination of biomarker production. Whole blood cell cultures were activated by lipopolysaccharide or by the combination of lipopolysaccharide and phytohemagglutinin for 24 to 48 hours. The levels of tumor necrosis factor α (TNFα) and its soluble type II receptor (sTNFR II), interleukin (IL) 1, IL-1 receptor antagonist (IL-1RA), IL-6, IL-10, and monocyte chemotactic protein (CCL2/MCP-1) were determined by specific immunoassays. Results Compared with asymptomatic subjects, baseline production levels of all proinflammatory mediators (TNFα, IL-1β, IL-6, and CCL2/MCP-1) were significantly augmented or trended higher (P = .000-.008) in patients with NP. Of the anti-inflammatory markers, only IL-1RA was significantly elevated (P = .004). The increase in IL-10 and tumor necrosis factor receptor II levels did not reach statistical significance. Neither InterX5000 nor placebo therapy had any significant effect on the production of the inflammatory mediators over the study period. Conclusion This investigation determined that inflammatory cytokine pathways are activated in NP patients but found no evidence that a short course of InterX5000 treatment normalized the production of inflammatory biomarkers.


      PubDate: 2015-10-06T10:35:11Z
       
  • Rater Reliability and Concurrent Validity of Single and Dual Bubble
           Inclinometry to Assess Cervical Lateral Flexion
    • Abstract: Publication date: Available online 26 September 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): David S. Lachtman, Dennis A. Bartha, Mario M. Beltran, Danielle N. Dominguez, Angela R. Messerli, Susan E. Miller, Alice M. Davis, Erika Nelson-Wong
      Objective The purpose of this study was to assess interrater and intrarater reliability and validity for single inclinometry (SI) and dual inclinometry (DI) assessment of cervical lateral flexion (CLF) range of motion and compare reliability in a practicing physical therapist (PT) and student PTs (SPTs). Methods Twenty-four subjects performed right and left CLF while SI, DI, and 3-dimensional kinematics were concurrently recorded. Subjects were reassessed by 2 SPTs and 1 PT using both SI and DI. Each subject was measured twice per rater in round-robin fashion. Results There were significant positive relationships between DI and motion capture for both right (r = 0.841; P < .01) and left lateral flexion (r = 0.838; P < .01). Single inclinometry also had a significant correlation with motion capture for right (r = 0.927, P < .01) and left (r = 0.834, P < .01) lateral flexion. Interrater reliability was good for both SI and DI methods. For SI, intraclass correlation coefficient (ICC) (3,1) was 0.905 and 0.870 for right and left CLF, respectively. For DI, ICC(3,1) was 0.803 and 0.757 for right and left CLF, respectively. Intrarater reliability was good for both methods. Average SI values were ICC(2,1) of 0.928 and 0.897 for right and left CLF, respectively. Average DI values were ICC(2,1) of 0.882 and 0.851 for left and right, respectively. Although not significant, the PT had slightly higher reliability in all measures (range, 0.881-0.935) compared to the SPTs (range, 0.880-0.925). Conclusions Both SI and DI are acceptable for clinical use and both are reliable measurement methods for CLF between raters and for repeated measures. There are minimal differences in reliability between a PT with experience and SPTs with minimal experience.


      PubDate: 2015-09-28T09:51:42Z
       
  • Neuromechanical Responses After Biofeedback Training in Participants With
           Chronic Low Back Pain: An Experimental Cohort Study
    • Abstract: Publication date: Available online 26 September 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Isabelle Pagé, Andrée-Anne Marchand, François Nougarou, Julie O'Shaughnessy, Martin Descarreaux
      Objective The objective of this study was to evaluate changes in neuromechanical responses and clinical outcomes in chronic low back pain participants after 4 sessions of biofeedback training. Methods Twenty-one participants took part in an electromyography biofeedback 4-session training program aimed at reducing lumbar paraspinal muscle activity during full trunk flexion. The sessions consisted of ~46 trunk flexion-extension divided into 5 blocks. The effects of training blocks and sessions on lumbar flexion-relaxation ratio and lumbopelvic ranges of motion were assessed. Changes in disability (Oswestry Disability Index), pain intensity (numerical rating scale), and fear of movement (Tampa Scale for Kinesiophobia) were also evaluated. Results Analyses of variance revealed a significant block effect for which an increase in the flexion-relaxation ratio and the lumbar range of motion between block 1 and the other blocks for sessions 1 and 2 (P < .0001) was observed. However, no significant session or interaction effect was observed. Among clinical outcomes, only fear of movement significantly decreased between the baseline (mean [SD], 33.05 [7.18]) and the fourth session (29.80 [9.88]) (P = .02). There was no significant correlation between clinical outcomes and neuromechanical variables. Conclusion Biofeedback training led to decreases in lumbar paraspinal muscle activity in full trunk flexion and increases in lumbopelvic range of motion in participants with chronic nonspecific low back pain. Although the neuromechanical changes were mostly observed at the early stage of the program, the presence of a decrease in the fear of movement suggests that the participants' initially limited ROMs may have been modulated by fear avoidance behaviors.


      PubDate: 2015-09-28T09:51:42Z
       
  • Reliability and Validity of Transversus Abdominis Measurement at the
           Posterior Muscle-Fascia Junction with Ultrasonography in Asymptomatic
           Participants
    • Abstract: Publication date: Available online 26 September 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Yen-Hua Chen, Huei-Ming Chai, Jing-Lan Yang, Ya-Jung Lin, Shwu-Fen Wang
      Objective The purposes of this study were (1) to establish the intrarater sliding and change in thickness of the transversus abdominis (TrA) measurement at the posterior muscle-fascia junction and (2) to examine the relationship between the muscle thickness and sliding of the TrA at the anterior and posterior sites. Methods Asymptomatic participants (n = 20) were placed into the hook-lying position to perform the abdominal drawing-in maneuver viewed in B-mode with a 5- to 12-MHz linear ultrasound transducer. The outcome variables included the resting thickness, the thickness during contraction, the change of thickness, and the change of sliding length. Both intraclass correlation coefficient and Pearson correlation were used for analysis. Results Measuring the thickness and sliding of the TrA at the posterior muscle-fascia junction showed good reliability (intraclass correlation coefficient (3,3), 0.89-0.98). The correlations between the sliding measurements of the TrA at the anterior and posterior sites were moderate to good (r = 0.41-0.74). Conclusion This study found that measuring the musculofascial corset from the posterior site using ultrasonography is reliable, allowing for ultrasound measurements at both the anterior and posterior sites of the TrA to provide a comprehensive evaluation of the TrA fascia.


      PubDate: 2015-09-28T09:51:42Z
       
  • Effectiveness of Training Clinicians' Communication Skills on Patients'
           Clinical Outcomes: A Systematic Review
    • Abstract: Publication date: Available online 26 September 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Vinicius C. Oliveira, Manuela L. Ferreira, Rafael Z. Pinto, Ruben F. Filho, Kathryn Refshauge, Paulo H. Ferreira
      Objective The aim of this systematic review was to investigate the literature on the effectiveness of communication skills training for clinicians on patients' clinical outcomes in primary care and rehabilitation settings. Methods We systematically reviewed the literature for randomized controlled trials investigating the effectiveness of communication skills training for clinicians on patients' satisfaction with care and on pain and disability in primary care and rehabilitation settings. The search strategy was conducted using AMED, PsycINFO, MEDLINE, CINAHL, EMBASE, PEDro, and Cochrane Central Register of Controlled Trials through June 2015. Methodological quality of included trials was assessed by 2 independent investigators using the PEDro scale, and consensus was used to resolve disagreements. Data were extracted, and meta-analyses were performed. Results Nineteen randomized controlled trials were included. Of these, 16 investigated communication training for clinicians that emphasized patient participation (eg, shared decision-making approaches). Communication training had small effects on patients' satisfaction with care when compared to control (4.1 points on a 100-point scale, 95% confidence interval [CI], 1.1-7.0). Communication training also had small effects on pain and disability with pooled results showing weighted mean differences of −3.8 points (95% CI, −6.5 to −1.1) and −3.6 (95% CI, −5.4 to −1.7), respectively. Conclusions Studies show that communication training for clinicians produces small effects in improving patients' satisfaction with care or reducing pain and disability in primary care and rehabilitation settings.


      PubDate: 2015-09-28T09:51:42Z
       
  • Prevalence, Incidence, Localization, and Pathophysiology of Myofascial
           Trigger Points in Patients With Spinal Pain: A Systematic Literature
           Review
    • Abstract: Publication date: Available online 19 September 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Enrique Lluch, Jo Nijs, Margot De Kooning, Dries Van Dyck, Rob Vanderstraeten, Filip Struyf, Nathalie Anne Roussel
      Objective A systematic review was performed to evaluate the existing evidence related to the prevalence, incidence, localization, and pathophysiology of myofascial trigger points (MTrPs) in patients with spinal (back and neck) pain. Methods A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed in 2 electronic databases (PubMed and Web of Science) using predefined keywords regarding MTrPs and spinal pain. A “PICOS” questionnaire was used to set up the search strategies and inclusion criteria. Full-text reports concerning MTrPs in patients with back or neck pain, which described their prevalence, incidence, location, or underlying physiopathology were included and screened for methodological quality by 3 independent researchers. Each study was assessed for risk of bias using a checklist derived from the Web site of the Dutch Cochrane Centre. Results Fourteen articles were retrieved for quality assessment and data extraction. Studies reporting the incidence of MTrPs in patients with spinal pain were lacking. Within spinal pain, patients with neck pain were found to have the highest prevalence rates of MTrPs. The trapezius descendens, levator scapulae, and suboccipitales muscles were the most prevalent locations for active MTrPs in patients with neck pain. Latent MTrPs were present in asymptomatic people, but no significant differences were found in the prevalence rate of latent MTrPs between patients with spinal (neck) pain and healthy controls. The only study investigating prevalence of MTrPs in different localizations of the same muscle reported no significant differences in prevalence between active and latent MTrPs within the trapezius descendens muscle. Studies examining pathophysiological mechanisms underlying MTrPs demonstrated an acidic environment, high concentration of algogenic/inflammatory substances, stiffer muscle tissue, retrograde diastolic blood flows, spontaneous muscle activity at rest, and loss of muscle contractibility in muscles with MTrPs. Altered central processing was also found to play a role in the development of MTrPs. Conclusions Myofascial trigger points are a prevalent clinical entity, especially in patients with neck pain. Evidence was not found to support or deny the role of MTrPs in other spinal pain. Compelling evidence supports local mechanisms underlying MTrPs. Future research should unravel the relevance of central mechanisms and investigate the incidence of MTrPs in patients with spinal pain.


      PubDate: 2015-09-24T09:33:37Z
       
  • Immediate and Short-Term Effects of Upper Thoracic Manipulation on
           Myoelectric Activity of Sternocleidomastoid Muscles in Young Women With
           Chronic Neck Pain: A Randomized Blind Clinical Trial
    • Abstract: Publication date: Available online 19 September 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Paulo Fernandes Pires, Amanda Carine Packer, Almir Vieira Dibai-Filho, Delaine Rodrigues-Bigaton
      Objective The aim of this study was to assess the immediate and short-term effects of upper thoracic spine manipulation on pain intensity and myoelectric activity of the sternocleidomastoid muscles in young women with chronic neck pain. Methods A randomized clinical trial was carried out involving 32 women with chronic neck pain (mean age, 24.8 ± 5.4 years) allocated to an experimental group and a placebo group. Three evaluations were carried out: baseline, immediate postintervention, and short-term postintervention (48-72 hours after intervention). Myoelectric activity of the right and left sternocleidomastoid muscles was assessed at rest and during isometric contractions for cervical flexion and elevation of the shoulder girdle. Neck pain intensity was assessed at rest using a visual analog scale. Comparisons of the data were performed using 2-way repeated-measures analysis of variance with the Bonferroni correction. The level of significance was set at P < .05. Results A moderate treatment effect on myoelectric activity of the right and left sternocleidomastoid muscles during isometric elevation of the shoulder girdle was found in the experimental group only on the short-term postintervention evaluation (d > 0.40). No statistically significant differences were found for any of the variables analyzed in the intergroup comparisons at the different evaluation times (P > .05). Conclusion No statistically significant differences were found in the intragroup or intergroup analyses of the experimental and placebo groups regarding myoelectric activity of the cervical muscles or the intensity of neck pain at rest in the immediate or short-term postintervention evaluations.


      PubDate: 2015-09-24T09:33:37Z
       
  • The Effect of 3 Different Exercise Approaches on Neck Muscle Endurance,
           Kinesiophobia, Exercise Compliance, and Patient Satisfaction in Chronic
           Whiplash
    • Abstract: Publication date: Available online 18 September 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Gunnel E. Peterson, Maria H. Landén Ludvigsson, Shaun P. O'Leary, Åsa M. Dedering, Thorne Wallman, Margaretha I.N. Jönsson, Anneli L.C. Peolsson
      Objective The purpose of this study was to compare the effects of 3 different exercise approaches on neck muscle endurance (NME), kinesiophobia, exercise compliance, and patient satisfaction in patients with chronic whiplash. Methods This prospective randomized clinical trial included 216 individuals with chronic whiplash. Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise (NSE), NSE combined with a behavioral approach (NSEB), or prescribed physical activity (PPA). Measures of ventral and dorsal NME (endurance time in seconds), perceived pain after NME testing, kinesiophobia, exercise compliance, and patient satisfaction were recorded at baseline and at the 3- and 6-month follow-ups. Results Compared with individuals in the prescribed physical activity group, participants in the NSE and NSEB groups exhibited greater gains in dorsal NME (P = .003), greater reductions in pain after NME testing (P = .03), and more satisfaction with treatment (P < .001). Kinesiophobia and exercise compliance did not significantly differ between groups (P > .07). Conclusion Among patients with chronic whiplash, a neck-specific exercise intervention (with or without a behavioral approach) appears to improve NME. Participants were more satisfied with intervention including neck-specific exercises than with the prescription of general exercise.


      PubDate: 2015-09-20T09:18:45Z
       
  • Prognostic Factors for Recurrences in Neck Pain Patients Up to 1 Year
           After Chiropractic Care
    • Abstract: Publication date: Available online 15 September 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Anke Langenfeld, B. Kim Humphreys, Jaap Swanenburg, Cynthia K. Peterson
      Objective Information about recurrence and prognostic factors is important for patients and practitioners to set realistic expectations about the chances of full recovery and to reduce patient anxiety and uncertainty. Therefore, the purpose of this study was to assess recurrence and prognostic factors for neck pain in a chiropractic patient population at 1 year from the start of the current episode. Methods Within a prospective cohort study, 642 neck pain patients were recruited by chiropractors in Switzerland. After a course of chiropractic therapy, patients were followed up for 1 year regarding recurrence of neck pain. A logistic regression analysis was used to assess prognostic factors for recurrent neck pain. The independent variables age, pain medication usage, sex, work status, duration of complaint, previous episodes of neck pain and trauma onset, numerical rating scale, and Bournemouth questionnaire for neck pain were analyzed. Prognostic factors that have been identified in previous studies to influence recovery of neck pain are psychologic distress, poor general health at baseline, and a previous history of pain elsewhere. Results Five hundred forty five patients (341 females), with a mean age of 42.1 years (SD, 13.1) completed the 1-year follow-up period. Fifty-four participants (11%) were identified as “recurrent.” Prognostic factors associated with recurrent neck pain were previous episodes of neck pain and increasing age. Conclusion The results of this study suggest that recurrence of neck pain within 1 year after chiropractic intervention in Swiss chiropractic patients presenting from varied onsets is low. This study found preliminary findings that older age and a previous episode of neck may be useful predictors of neck pain recurrence within 1 year.


      PubDate: 2015-09-16T09:04:15Z
       
  • Public Perceptions of Doctors of Chiropractic: Results of a National
           Survey and Examination of Variation According to Respondents' Likelihood
           to Use Chiropractic, Experience With Chiropractic, and Chiropractic Supply
           in Local Health Care Markets
    • Abstract: Publication date: Available online 8 September 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): William B Weeks, Christine M Goertz, William C Meeker, Dennis M Marchiori
      Objectives The purpose of this study was to determine whether general perceptions of doctors of chiropractic (DCs) varied according to likeliness to use chiropractic care, whether particular demographic characteristics were associated with chiropractic care use, and whether perception of DCs varied according to the per-capita supply of DCs in local health care markets. Methods We performed a secondary analysis of results from a 26-item nationally representative survey of 5422 members of The Gallup Panel that was conducted in the spring of 2015 (response rate, 29%) that sought to elicit the perceptions and use of DCs by US adults. We compared survey responses across: (1) respondents who had different likelihoods to use DCs for treatment of neck or back pain and (2) respondents who had different experiences using DCs. We linked respondents' zip codes to hospital referral regions for which we had the per-capita supply of DCs. Using the χ 2 test, we examined relationships between likeliness to use a DC, experience using a DC, respondent demographic variables, perceptions of DCs, and the per-capita supply of DCs in the local health care market. Results Most (61.4%) respondents believed that chiropractic care was effective at treating neck and back pain, 52.6% thought DCs were trustworthy, and 24.2% thought chiropractic care was dangerous; however, as respondents' likelihood to use a DC increased, perceptions of effectiveness and trustworthiness increased, and perceptions of danger decreased. Of all 5422 survey respondents, 744 or 13.7% indicated that they had seen a DC within the last 12 months. As one moved from distant to more recent experience using a DC, respondents were more likely to be female, married, white, and employed; those who had a distant history of using a DC were older and more likely to be retired than the other groups. A higher per-capita supply of DCs was associated with higher utilization rates and showed a more favorable regard for DCs. Conclusions US adults often use chiropractic care, generally regard DCs favorably, and largely perceive that chiropractic care is safe. Where there is a higher per-capita supply of DCs in the local health care market, utilization and positive perceptions of chiropractic are higher.


      PubDate: 2015-09-11T08:46:05Z
       
  • Editorial Board
    • Abstract: Publication date: July–August 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 6




      PubDate: 2015-08-29T07:59:20Z
       
  • Table of Contents
    • Abstract: Publication date: July–August 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 6




      PubDate: 2015-08-29T07:59:20Z
       
  • Information for Readers
    • Abstract: Publication date: July–August 2015
      Source:Journal of Manipulative and Physiological Therapeutics, Volume 38, Issue 6




      PubDate: 2015-08-29T07:59:20Z
       
  • The Effectiveness of Passive Physical Modalities for the Management of
           Soft Tissue Injuries and Neuropathies of the Wrist and Hand: A Systematic
           Review by the Ontario Protocol for Traffic Injury Management (OPTIMa)
           Collaboration
    • Abstract: Publication date: Available online 21 August 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Kevin D’Angelo, Deborah Sutton, Pierre Côté, Sarah Dion, Jessica J. Wong, Hainan Yu, Kristi Randhawa, Danielle Southerst, Sharanya Varatharajan, Jocelyn Cox (Dresser), Courtney Brown, Roger Menta, Margareta Nordin, Heather M. Shearer, Arthur Ameis, Maja Stupar, Linda J. Carroll, Anne Taylor-Vaisey
      Objective The purpose of this systematic review was to determine the effectiveness of passive physical modalities compared to other interventions, placebo/sham interventions, or no intervention in improving self-rated recovery, functional recovery, clinical outcomes and/or administrative outcomes (eg, time of disability benefits) in adults and/or children with soft tissue injuries and neuropathies of the wrist and hand. Methods We systematically searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials, accessed through Ovid Technologies, Inc, and CINAHL Plus with Full Text, accessed through EBSCO host, from 1990 to 2015. Our search strategies combined controlled vocabulary relevant to each database (eg, MeSH for MEDLINE) and text words relevant to our research question and the inclusion criteria. Randomized controlled trials, cohort studies, and case-control studies were eligible. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with low risk of bias were synthesized following best evidence synthesis principles. Results We screened 6618 articles and critically appraised 11 studies. Of those, 7 had low risk of bias: 5 addressed carpal tunnel syndrome (CTS) and 2 addressed de Quervain disease. We found evidence that various types of night splints lead to similar outcomes for the management of CTS. The evidence suggests that a night wrist splint is less effective than surgery in the short term but not in the long term. Furthermore, a night wrist splint and needle electroacupuncture lead to similar outcomes immediately postintervention. Finally, low-level laser therapy and placebo low-level laser therapy lead to similar outcomes. The evidence suggests that kinesio tape or a thumb spica cast offers short-term benefit for the management of de Quervain disease. Our search did not identify any low risk of bias studies examining the effectiveness of passive physical modalities for the management of other soft tissue injuries or neuropathies of the wrist and hand. Conclusions Different night orthoses provided similar outcomes for CTS. Night orthoses offer similar outcomes to electroacupuncture but are less effective than surgery in the short term. This review suggests that kinesio tape or a thumb spica cast may offer short-term benefit for the management of de Quervain disease.


      PubDate: 2015-08-25T07:39:24Z
       
  • First-Contact Care With a Medical vs Chiropractic Provider After
           Consultation With a Swiss Telemedicine Provider: Comparison of Outcomes,
           Patient Satisfaction, and Health Care Costs in Spinal, Hip, and Shoulder
           Pain Patients
    • Abstract: Publication date: Available online 16 August 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Taco A.W. Houweling, Andrea V. Braga, Thomas Hausheer, Marco Vogelsang, Cynthia Peterson, B. Kim Humphreys
      Objective The purpose of this study was to identify differences in outcomes, patient satisfaction, and related health care costs in spinal, hip, and shoulder pain patients who initiated care with medical doctors (MDs) vs those who initiated care with doctors of chiropractic (DCs) in Switzerland. Methods A retrospective double cohort design was used. A self-administered questionnaire was completed by first-contact care spinal, hip, and shoulder pain patients who, 4 months previously, contacted a Swiss telemedicine provider regarding advice about their complaint. Related health care costs were determined in a subsample of patients by reviewing the claims database of a Swiss insurance provider. Results The study sample included 403 patients who had seen MDs and 316 patients who had seen DCs as initial health care providers for their complaint. Differences in patient sociodemographic characteristics were found in terms of age, pain location, and mode of onset. Patients initially consulting MDs had significantly less reduction in their numerical pain rating score (difference of 0.32) and were significantly less likely to be satisfied with the care received (odds ratio = 1.79) and the outcome of care (odds ratio = 1.52). No significant differences were found for Patient's Global Impression of Change ratings. Mean costs per patient over 4 months were significantly lower in patients initially consulting DCs (difference of CHF 368; US $368). Conclusion Spinal, hip, and shoulder pain patients had clinically similar pain relief, greater satisfaction levels, and lower overall cost if they initiated care with DCs, when compared with those who initiated care with MDs.


      PubDate: 2015-08-17T07:07:28Z
       
  • Changes in Shoulder Pain and Disability After Thrust Manipulation in
           Subjects Presenting With Second and Third Rib Syndrome
    • Abstract: Publication date: Available online 5 August 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): James Dunning, Firas Mourad, Giuseppe Giovannico, Filippo Maselli, Thomas Perreault, César Fernández-de-las-Peñas
      Objective The purpose of this preliminary study was to investigate changes in shoulder pain, disability, and perceived level of recovery after 2 sessions of upper thoracic and upper rib high-velocity low-amplitude (HVLA) thrust manipulation in patients with shoulder pain secondary to second and third rib syndrome. Methods This exploratory study evaluated 10 consecutive individuals with shoulder pain, with or without brachial pain, and a negative Neer impingement test, who completed the Shoulder Pain and Disability Index (SPADI), the numeric pain rating scale (NPRS), and the global rating of change. Patients received 2 sessions of HVLA thrust manipulation targeting the upper thoracic spine bilaterally and the second and third ribs on the symptomatic side. Outcome measures were completed after the first treatment session, at 48 hours, 1 month, and 3 months. Results Patients showed a significant decrease in SPADI (F = 59.997; P = .001) and significant decrease in resting shoulder NPRS (F = 63.439; P = .001). For both NPRS and SPADI, there were significant differences between the pretreatment scores and each of the postintervention scores through 3-month follow-up (P < .05). Large within-group effect sizes (Cohen's d ≥ 0.8) were found between preintervention data and all postintervention assessments in both outcomes. Mean global rating of change scores (+6.8 at 3 months) indicated “a very great deal better” outcome at long-term follow-up. Conclusion This group of patients with shoulder pain secondary to second and third rib syndrome who received upper thoracic and upper rib HVLA thrust manipulations showed significant reductions in pain and disability and improvement in perceived level of recovery.


      PubDate: 2015-08-07T21:25:41Z
       
  • Evaluation of Isokinetic Trunk Muscle Strength in Adolescents With Normal
           and Abnormal Postures
    • Abstract: Publication date: Available online 5 August 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Katarzyna Barczyk-Pawelec, Jerzy Rafał Piechura, Wioletta Dziubek, Krystyna Rożek
      Objective The aim of this study was to assess existing differences in the isokinetic trunk muscle strength in males and females aged between 10 and 11 years depending on body posture. Methods The study included 145 children (67 males and 78 females) divided into 2 age groups: 10-year-old males ( x ¯ = 9.98 ± 2.34 years) and females ( x ¯ = 9.85 ± 2.94 years) and 11-year-old males ( x ¯ = 11.14 ± 2.22 years) and females ( x ¯ = 11.15 ± 2.32 years). Posture in the sagittal plane was assessed by photogrammetry using the moiré projection technique. Based on a classification system, the participants were divided into subgroups of males and females with normal and abnormal postures. Trunk muscle strength was measured using isokinetic dynamometry. Results A high prevalence of abnormal posture in children aged between 10 and 11 years was observed, primarily represented by an excessive curvature of the spine in the sagittal plane. The males and females with poor posture recorded lower values in isokinetic trunk muscle strength. Conclusion The results of the study point to the need for the application of suitable physiotherapy treatment (corrective measures/exercises) to treat musculoskeletal disorders to compensate for the loss of trunk flexor muscle strength in children with improper posture.


      PubDate: 2015-08-07T21:25:41Z
       
  • Short-Term Effects of Mulligan Mobilization With Movement on Pain,
           Disability, and Kinematic Spinal Movements in Patients With Nonspecific
           Low Back Pain: A Randomized Placebo-Controlled Trial
    • Abstract: Publication date: Available online 26 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Benjamin Hidalgo, Laurent Pitance, Toby Hall, Christine Detrembleur, Henri Nielens
      Objective The purpose of this clinical study was to compare the immediate- and short-term effects of lumbar Mulligan sustained natural apophyseal glides (SNAGs) on patients with nonspecific low back pain with respect to 2 new kinematic algorithms (KA) for range of motion and speed as well as pain, functional disability, and kinesiophobia. Methods This was a 2-armed randomized placebo-controlled trial. Subjects, blinded to allocation, were randomized to either a real-SNAG group (n = 16) or a sham-SNAG group (n = 16). All patients were treated during a single session of real/sham SNAG (3 × 6 repetitions) to the lumbar spine from a sitting position in a flexion direction. Two new KA from a validated kinematic spine model were used and recorded with an optoelectronic device. Pain at rest and during flexion as well as functional disability and kinesiophobia was recorded by self-reported measures. These outcomes were blindly evaluated before, after treatment, and at 2-week follow-up in both groups. Results Of 6 variables, 4 demonstrated significant improvement with moderate-to-large effect sizes (ES) in favor of the real-SNAG group: KA-R (P = .014, between-groups ES Cliff δ = −.52), pain at rest and during flexion (visual analog scale, P < .001; ES = −.73/−.75), and functional-disability (Oswestry Disability Index, P = .003 and ES = −.61). Kinesiophobia was not considered to be significant (Tampa scale, P = .03) but presented moderate ES = −.46. Kinematic algorithms for speed was not significantly different between groups (P = .118) with a small ES = −.33. All 6 outcome measures were significantly different (P ≤ .008) during within-group analysis (before and after treatment) only in the real-SNAG group. No serious or moderate adverse events were reported. Conclusion This study showed evidence that lumbar spine SNAGs had a short-term favorable effect on KA-R, pain, and function in patients with nonspecific low back pain.


      PubDate: 2015-07-26T21:46:38Z
       
  • The Effect of Pillow Height on Muscle Activity of the Neck and Mid-Upper
           Back and Patient Perception of Comfort
    • Abstract: Publication date: Available online 21 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Isabel C.N. Sacco, Ivye L.R. Pereira, Roberto C. Dinato, Vivian C. Silva, Beatriz Friso, Samires F. Viterbo
      Objective The purpose of this study was to evaluate the comfort and the electromyographic (EMG) activity of the neck and mid-upper back of asymptomatic adults using foam pillows of 3 different heights. Methods Twenty-one asymptomatic adults used foam pillows of 3 different heights (1: 5 cm, 2: 10 cm, and 3: 14 cm). Comfort was assessed using a 100-mm visual analog scale. Electromyographic activity was assessed in the lateral position. We calculated the root mean square (RMS) in 500-millisecond windows of bilateral EMG activity of the sternocleidomastoid and upper and middle trapezius, normalized by maximal isometric contraction of each individual. The RMS of the EMG signals was compared among pillow heights using repeated-measures analysis of variance (P < .05). Results The middle trapezius muscle of the down-side showed the highest RMS in height 1 when compared with heights 2 (P = .0163) and 3 (P = .0313), with no statistical significance between pillow heights 2 and 3 for this muscle. There were no statistical differences between pillows 2 and 3 in any muscle activity. Height 2 was considered the most comfortable (P < .001) compared with heights 1 and 3, and height 1 the least comfortable (P < .001) compared with the other heights. Conclusion For the participants in this study, there was an association among pillow height, myoelectric activity, and comfort.


      PubDate: 2015-07-22T21:33:40Z
       
  • Test-Retest Reliability of Trunk Motor Variability Measured By Large-Array
           Surface Electromyography
    • Abstract: Publication date: Available online 21 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Jacques Abboud, François Nougarou, Michel Loranger, Martin Descarreaux
      Objective The objective of this study was to evaluate the test-retest reliability of the trunk muscle activity distribution in asymptomatic participants during muscle fatigue using large-array surface electromyography (EMG). Methods Trunk muscle activity distribution was evaluated twice, with 3 to 4 days between them, in 27 asymptomatic volunteers using large-array surface EMG. Motor variability, assessed with 2 different variables (the centroid coordinates of the root mean square map and the dispersion variable), was evaluated during a low back muscle fatigue task. Test-retest reliability of muscle activity distribution was obtained using Pearson correlation coefficients. Results A shift in the distribution of EMG amplitude toward the lateral-caudal region of the lumbar erector spinae induced by muscle fatigue was observed. Moderate to very strong correlations were found between both sessions in the last 3 phases of the fatigue task for both motor variability variables, whereas weak to moderate correlations were found in the first phases of the fatigue task only for the dispersion variable. Conclusion These findings show that, in asymptomatic participants, patterns of EMG activity are less reliable in initial stages of muscle fatigue, whereas later stages are characterized by highly reliable patterns of EMG activity.


      PubDate: 2015-07-22T21:33:40Z
       
  • Consistency and Malleability of Manipulation Performance in Experienced
           Clinicians: A Pre-Post Experimental Design
    • Abstract: Publication date: Available online 18 July 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): John J. Triano, Dominic Giuliano, Ismat Kanga, David Starmer, Jennifer Brazeau, C. Elaine Screaton, Curtis Semple
      Objective The purpose of this study was to sample the stability of spinal manipulation performance in peak impulse force development over time and the ability of clinicians to adapt to arbitrary target levels with short-duration training. Methods A pre-post experimental design was used. Human analog mannequins provided standardized simulation for performance measures. A convenience sample was recruited consisting of 41 local doctors of chiropractic with 5 years of active clinical practice experience. Thoracic impulse force was measured among clinicians at baseline, after 4 months at pretraining, and again posttraining. Intraclass correlation coefficient values and within-subject variability defined consistency. Malleability was measured by reduction of error (paired t tests) in achieving arbitrary targeted levels of force development normalized to the individual's typical performance. Results No difference was observed in subgroup vs baseline group characteristics. Good consistency was observed in force-time profiles (0.55 ≤ intraclass correlation coefficient ≤ 0.75) for force parameters over the 4-month interval. With short intervals of focused training, error rates in force delivery were reduced by 23% to 45%, depending on target. Within-subject variability was 1/3 to 1/2 that of between-subject variability. Load increases were directly related to rate of loading. Conclusion The findings of this study show that recalibration of spinal manipulation performance of experienced clinicians toward arbitrary target values in the thoracic spine is feasible. This study found that experienced clinicians are internally consistent in performance of procedures under standardized conditions and that focused training may help clinicians learn to modulate procedure characteristics.


      PubDate: 2015-07-18T21:33:29Z
       
  • The Effectiveness of Exercise for the Management of Musculoskeletal
           Disorders and Injuries of the Elbow, Forearm, Wrist, and Hand: A
           Systematic Review by the Ontario Protocol for Traffic Injury Management
           (OPTIMa) Collaboration
    • Abstract: Publication date: Available online 27 June 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Roger Menta , Kristi Randhawa , Pierre Côté , Jessica J. Wong , Hainan Yu , Deborah Sutton , Sharanya Varatharajan , Danielle Southerst , Kevin D'Angelo , Jocelyn Cox , Courtney Brown , Sarah Dion , Silvano Mior , Maja Stupar , Heather M. Shearer , Gail M. Lindsay , Craig Jacobs , Anne Taylor-Vaisey
      Objective The purpose of this systematic review was to evaluate the effectiveness of exercise compared to other interventions, placebo/sham intervention, or no intervention in improving self-rated recovery, functional recovery, clinical, and/or administrative outcomes in individuals with musculoskeletal disorders and injuries of the elbow, forearm, wrist, and hand. Methods We searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials from 1990 to 2015. Paired reviewers independently screened studies for relevance and assessed the risk of bias using the Scottish Intercollegiate Guidelines Network criteria. We synthesized the evidence using the best evidence synthesis methodology. Results We identified 5 studies with a low risk of bias. Our review suggests that, for patients with persistent lateral epicondylitis, (1) adding concentric or eccentric strengthening exercises to home stretching exercises provides no additional benefits; (2) a home program of either eccentric or concentric strengthening exercises leads to similar outcomes; (3) home wrist extensor strengthening exercises lead to greater short-term improvements in pain reduction compared to “wait and see”; and (4) clinic-based, supervised exercise may be more beneficial than home exercises with minimal improvements in pain and function. For hand pain of variable duration, supervised progressive strength training added to advice to continue normal physical activity provides no additional benefits. Conclusion The relative effectiveness of stretching vs strengthening for the wrist extensors remains unknown for the management of persistent lateral epicondylitis. The current evidence shows that the addition of supervised progressive strength training does not provide further benefits over advice to continue normal physical activity for hand pain of variable duration.


      PubDate: 2015-07-02T09:10:12Z
       
  • The Effectiveness of Noninvasive Interventions for Musculoskeletal
           Thoracic Spine and Chest Wall Pain: A Systematic Review by the Ontario
           Protocol for Traffic Injury Management (OPTIMa) Collaboration
    • Abstract: Publication date: Available online 30 June 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Danielle Southerst , Andrée-Anne Marchand , Pierre Côté , Heather M. Shearer , Jessica J. Wong , Sharanya Varatharajan , Kristi Randhawa , Deborah Sutton , Hainan Yu , Douglas P. Gross , Craig Jacobs , Rachel Goldgrub , Maja Stupar , Silvano Mior , Linda J. Carroll , Anne Taylor-Vaisey
      Objective The purpose of this study was to critically appraise and synthesize evidence on the effectiveness of noninvasive interventions, excluding pharmacological treatments, for musculoskeletal thoracic pain. Methods Randomized controlled trials (RCTs), cohort studies, and case-control studies evaluating the effectiveness of noninvasive interventions were eligible. We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials accessed through Ovid Technologies, Inc, and CINAHL Plus with Full Text accessed through EBSCOhost from 1990 to 2015. Our search strategies combined controlled vocabulary relevant to each database (eg, MeSH for MEDLINE) and text words relevant to our research question and the inclusion criteria. Random pairs of independent reviewers screened studies for relevance and critically appraised relevant studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with a low risk of bias were synthesized following best evidence synthesis principles. Results We screened 6988 articles and critically appraised 2 studies. Both studies had a low risk of bias and were included in our synthesis. One RCT compared thoracic spinal manipulation, needle acupuncture, and placebo electrotherapy for recent thoracic spine pain. There were statistically significant but clinically nonimportant short-term reductions in pain favoring manipulation. There were no differences between acupuncture and placebo electrotherapy. Another RCT compared a multimodal program of care and a session of education for recent musculoskeletal chest wall pain. The multimodal care resulted in statistically significant but clinically nonimportant short-term reductions in pain over education. However, participants receiving multimodal care were more likely to report important improvements in chest pain. Conclusions Quality evidence on the management of musculoskeletal thoracic pain is sparse. The current evidence suggests that compared to placebo, spinal manipulation is associated with a small and clinically nonimportant reduction in pain intensity and that acupuncture leads to similar outcomes as placebo. Furthermore, a multimodal program of care (ie, manual therapy, soft tissue therapy, exercises, heat/ice, and advice) and a single education session lead to similar pain reduction for recent-onset musculoskeletal chest wall pain. However, patients who receive multimodal care are more likely to report pain improvements.


      PubDate: 2015-07-02T09:10:12Z
       
  • Chiropractors' Characteristics Associated With Physician Referrals:
           Results From a Survey of Canadian Doctors of Chiropractic
    • Abstract: Publication date: Available online 1 May 2015
      Source:Journal of Manipulative and Physiological Therapeutics
      Author(s): Marc-André Blanchette , Michèle Rivard , Clermont E. Dionne , J. David Cassidy
      Objective The purpose of this study was to identify characteristics of Canadian doctors of chiropractic (DCs) associated with the number of patients referred by medical doctors (MDs). Methods Secondary data analyses were performed on the 2011 cross-sectional survey of the Canadian Chiropractic Resources Databank. The Canadian Chiropractic Resources Databank survey included 81 questions about the practice of DCs. Of the 6533 mailed questionnaires, 2529 (38.7%) were returned and 489 did not meet our inclusion criteria. Our analyzed sample included 2040 respondents. Bivariate analyses were conducted between predetermined potential predictors and the annual number of patients referred by MDs, and negative binomial multivariate regression was performed. Results On average, DCs reported receiving 15.6 (standard deviation, 31.3) patient referrals from MDs per year and nearly one-third did not receive any. The type of clinic (multidisciplinary with MD), the province of practice (Atlantic provinces), the number of treatments provided per week, the number of practicing hours, rehabilitation and sports injuries as the main sector of activity, prescription of exercises, use of heat packs and ultrasound, and the percentage of patients referred to other health care providers were associated with a higher number of MD referrals to DCs. The percentage of patients with somatovisceral conditions, using a particular chiropractic technique (hole in one and Thompson), taking his/her own radiographs, being the client of a chiropractic management service, and considering maintenance/wellness care as a main sector of activity were associated with fewer MD referrals. Conclusion Canadian DCs who interacted with other health care workers and who focus their practice on musculoskeletal conditions reported more referrals from MDs.


      PubDate: 2015-07-02T09:10:12Z
       
 
 
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