Spine
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Questionnaire Survey. ⋯ Physicians and chiropractors generally hold beliefs that are consistent with the current evidence regarding the most helpful approaches to acute whiplash, although chiropractors were more likely to be supportive of passive therapy methods.
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A systematic review. ⋯ The quality of the research on interreliability and intrareliability of spinal palpatory diagnostic procedures needs to be improved. Pain provocation tests are most reliable. Soft tissue paraspinal palpatory diagnostic tests are not reliable.
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A systematic review of randomized and quasi-randomized controlled trials. ⋯ There is conflicting evidence regarding the efficacy of prolotherapy injections in reducing pain and disability in patients with chronic low back pain. Conclusions are confounded by clinical heterogeneity among studies and by the presence of co-interventions. There was no evidence that prolotherapy injections alone were more effective than control injections alone. However, in the presence of co-interventions, prolotherapy injections were more effective than control injections, more so when both injections and co-interventions were controlled concurrently.
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Comparative Study
Relevance of aerobic capacity measurements in the treatment of chronic work-related spinal disorders.
Prospective cohort study of rehab program completers, comparing aerobic capacity data of chronic lumbar spinal disorder patients (CLSD) to that of chronic cervical spinal disorder (CCSD), collected from a tertiary care facility. ⋯ Although mean aerobic fitness levels for all patients improved during rehabilitation, the improvement is almost entirely accounted for by initially invalid tests becoming valid. Aerobic capacity testing measured with submaximal bicycle ergometry may frequently be invalid when fear-avoidance limits effort, particularly in CLSD. Psychosocial fear-avoidance, as it applies to bicycle ergometry, can be overcome in virtually all patients motivated to complete a tertiary rehabilitation program. As such, prerehabilitation aerobic capacity testing is a poor differentiator of postrehabilitation outcomes.
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Comparative Study
Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test.
Cross-sectional study. ⋯ These data confirm that reduced performance of the craniocervical flexion test is associated with dysfunction of the deep cervical flexor muscles and support the validity of this test for patients with neck pain.