Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Jul 2001
Review Randomized Controlled Trial Clinical TrialChiropractic technique procedures for specific low back conditions: characterizing the literature.
Many original clinical trials and several review papers have come to the conclusion that manipulation is safe and effective for the treatment of low back pain. However, it is necessary to determine which specific types of manipulation and nonmanipulative types of chiropractic adjustive care are most effective for particular types of low back pain across both tissue-specific and functional classifications. ⋯ The 3 most studied adjustive procedures are side-posture high-velocity, low-amplitude; distraction (mostly flexion distraction); and mobilization, respectively. The clinical condition most commonly addressed by the included studies is low back pain. The procedure with the widest base of evidence support is side posture manipulation for low back pain.
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J Manipulative Physiol Ther · Jul 2001
Randomized Controlled Trial Comparative Study Clinical TrialEffectiveness of spinal manipulative therapy in the treatment of mechanical thoracic spine pain: a pilot randomized clinical trial.
To date, no substantiated studies have been performed to investigate the efficacy of spinal manipulative therapy on thoracic spinal syndromes. ⋯ This pilot study suggests that spinal manipulative therapy has greater benefits than placebo treatment. The sample size was small, therefore the findings of this trial study should not be considered conclusive but rather should be used as a foundation for planning future studies. In further studies a larger sample size will be necessary to identify subtle changes in measurement parameters and to add to the validity of the results.
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J Manipulative Physiol Ther · Jul 2001
Randomized Controlled Trial Clinical TrialChronic pediatric asthma and chiropractic spinal manipulation: a prospective clinical series and randomized clinical pilot study.
The first objective was to determine if chiropractic spinal manipulative therapy (SMT) in addition to optimal medical management resulted in clinically important changes in asthma-related outcomes in children. The second objective was to assess the feasibility of conducting a full-scale, randomized clinical trial in terms of recruitment, evaluation, treatment, and ability to deliver a sham SMT procedure. ⋯ After 3 months of combining chiropractic SMT with optimal medical management for pediatric asthma, the children rated their quality of life substantially higher and their asthma severity substantially lower. These improvements were maintained at the 1-year follow-up assessment. There were no important changes in lung function or hyperresponsiveness at any time. The observed improvements are unlikely as a result of the specific effects of chiropractic SMT alone, but other aspects of the clinical encounter that should not be dismissed readily. Further research is needed to assess which components of the chiropractic encounter are responsible for important improvements in patient-oriented outcomes so that they may be incorporated into the care of all patients with asthma.
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J Manipulative Physiol Ther · Jul 2001
Effects of a mechanical pain stimulus on erector spinae activity before and after a spinal manipulation in patients with back pain: a preliminary investigation.
Several recent studies in animal models of spinal pain have shown changes in sensory processing and in reflex muscular responses. One group of researchers reported consistent electromyographic responses in the paraspinal muscles of healthy men after spinal manipulation, and they speculated that such responses may underlie some of the observed clinical effects of spinal manipulation (namely, reduction in pain and muscular hypertonicity). ⋯ This study suggests that motion segments identified as a problem in subjects with chronic low back pain have an exaggerated local muscular response to a painful stimulus compared with that observed in problem segments. In addition, spinal manipulation appears to attenuate the electromyographic response to a painful stimulus.