Journal of manipulative and physiological therapeutics
-
J Manipulative Physiol Ther · May 2013
Randomized Controlled Trial Comparative StudyMagnetic resonance imaging zygapophyseal joint space changes (gapping) in low back pain patients following spinal manipulation and side-posture positioning: a randomized controlled mechanisms trial with blinding.
The purpose of this study was to quantify lumbar zygapophyseal (Z) joint space separation (gapping) in low back pain (LBP) subjects after spinal manipulative therapy (SMT) or side-posture positioning (SPP). ⋯ Side-posture positioning showed greatest gapping at baseline. After 2 weeks, SMT resulted in greatest gapping. Side-posture positioning appeared to have additive therapeutic benefit to SMT.
-
J Manipulative Physiol Ther · May 2013
Randomized Controlled Trial Comparative StudyBilateral sensory effects of unilateral passive accessory mobilization in patients with thumb carpometacarpal osteoarthritis.
The purpose of this study was to investigate changes in pressure sensitivity and pinch grip force in the nonsymptomatic side in patients with thumb carpometacarpal (CMC) osteoarthritis (OA) after the application of a unilateral passive accessory mobilization to the symptomatic hand. ⋯ This secondary analysis found that the application of a unilateral passive accessory mobilization targeted to the symptomatic CMC joint induced an increase of PPT levels 2 weeks after treatment; however, differences were small and likely of limited clinical value. No contralateral motor effects were observed. Future studies including larger sample sizes are needed to examine the effects of joint mobilization on motor and sensory effects.
-
J Manipulative Physiol Ther · May 2013
Comparative StudySymptomatic magnetic resonance imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections.
The purpose of this study was to compare self-reported pain and "improvement" of patients with symptomatic, magnetic resonance imaging-confirmed, lumbar disk herniations treated with either high-velocity, low-amplitude spinal manipulative therapy (SMT) or nerve root injections (NRI). ⋯ Most SMT and NRI patients with radicular low back pain and magnetic resonance imaging-confirmed disk herniation matching symptomatic presentation reported significant and clinically relevant reduction in self-reported pain level and increased global perception of improvement. There were no significant differences in outcomes between NRI and SMT. When considering direct procedure costs, the average cost of SMT was slightly less expensive.
-
J Manipulative Physiol Ther · May 2013
Comparative StudyCombined thumb abduction and index finger extension strength: a comparison of older adults with and without thumb carpometacarpal osteoarthritis.
The objectives of this study were to compare thumb combined abduction/index finger extension (hand opening) strength between subjects with carpometacarpal (CMC) osteoarthritis (OA) and normal controls and to assess the reproducibility of hand opening strength and abduction range of motion (ROM) measurements in patients with thumb CMC OA to establish the cutoff values scores for minimal detectable change. ⋯ Subjects with CMC OA exhibited decreased combined thumb abduction and index finger extension strength, reduced thumb abduction ROM, and increased pain sensitivity when compared with their healthy counterparts. The minimal detectable change score in this patient population was 0.23 to 0.25 kg/cm(2) for pain pressure threshold, 0.12 to 0.13 lb for opening force, and 1.24° to 1.46° for abduction ROM measurement.