Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Nov 2008
Randomized Controlled TrialImmediate hypoalgesic and motor effects after a single cervical spine manipulation in subjects with lateral epicondylalgia.
The purpose of this study is to investigate the immediate effects of a single cervical spine manipulation and a manual contact intervention (MCI) on pressure pain thresholds (PPTs) and thermal pain thresholds over the elbow region and pain-free grip (PFG) force in patients with lateral epicondylalgia (LE). ⋯ The application of a manipulation at the cervical spine produced an immediate bilateral increase in PPT in patients with LE. No significant changes for HPT and CPT were found. Finally, cervical manipulation increased PFG on the affected side, but not the maximum grip force on the unaffected arm. Future studies with larger sample sizes are required to examine the effects of thrust manipulation on PPT, HPT, CPT, or PFG.
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J Manipulative Physiol Ther · Nov 2008
Literature syntheses for the Council on Chiropractic Guidelines and Practice Parameters: methodology.
The purpose of this project was to initiate an iterative process for systematic review of the literature involving a broad spectrum of individuals with experience across multiple domains (clinicians, educators, clinical scientists, and politically active) within the chiropractic profession. ⋯ Although all literature in health care is challenged by complex methodological issues that limit how the information may be generalized, the preponderance of evidence in any of the domains can be informative to the clinician as well as give guidance to new scientific efforts to improve the quality of care.
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J Manipulative Physiol Ther · Oct 2008
The development of contemporary chiropractic education in Denmark: an exploratory study.
The purpose of this study was to capture the experience of key stakeholders regarding the development, structure, and influence of the local education program on the Danish chiropractic profession. ⋯ The Danish chiropractic profession's incentive to raise its legitimacy lay in the access it stood to gain, through a local education, to state-subsidized copayments. "Stakeholder behavior," "boundary work," and "countervailing powers" underscore this example of professionalization; and evidence for secondary legitimization appears evident in the third-party influences, peer association legitimacy, and disciplinary endorsement observed. Our study suggests that secondary legitimacy may serve the interests of an emergent profession in its bid to claim a position of dominance, in this instance, chiropractic.
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J Manipulative Physiol Ther · Oct 2008
Interexaminer reliability of T2-weighted magnetic resonance imaging for lumbar bright facet sign.
The aims of this study were to characterize the bright facet response within the lumbar spine, to identify a constellation of findings associated with the response, and to quantify the interexaminer agreement on the previous objectives. ⋯ The bright facet response was a common phenomenon on T2-weighted magnetic resonance imaging of the lumbar spine in these cases. There was sufficient agreement with respect to the presence and extent of the bright facet response to conclude that the examiners' determinations were not made by random chance. There exist sufficient repeatability and reliability that a single descriptive term can be applied to unify the bright facet response, the bright facet sign.
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J Manipulative Physiol Ther · Sep 2008
ReviewClinical assessment of the deep cervical flexor muscles: the craniocervical flexion test.
The craniocervical flexion test (CCFT) is a clinical test of the anatomical action of the deep cervical flexor muscles, the longus capitis, and colli. It has evolved over 15 years as both a clinical and research tool and was devised in response to research indicating the importance of the deep cervical flexors in support of the cervical lordosis and motion segments and clinical observations of their impairment with neck pain. ⋯ Research has established that patients with neck pain disorders, compared to controls, have an altered neuromotor control strategy during craniocervical flexion characterized by reduced activity in the deep cervical flexors and increased activity in the superficial flexors usually accompanied by altered movement strategies. Furthermore, they display reduced isometric endurance of the deep cervical flexor muscles. The muscle impairment identified with the CCFT appears to be generic to neck pain disorders of various etiologies. These observations prompted the use of the craniocervical flexion action for retraining the deep cervical flexor muscles within a motor relearning program for neck pain patients, which has shown positive therapeutic benefits when tested in clinical trials.