Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Jan 2002
Randomized Controlled Trial Clinical TrialThe reliability of multitest regimens with sacroiliac pain provocation tests.
Studies concerning the reliability of individual sacroiliac tests have inconsistent results. It has been suggested that the use of a test regimen is a more reliable form of diagnosis than individually performed tests. ⋯ A multitest regimen of 5 sacroiliac joint pain provocation tests is a reliable method to evaluate sacroiliac joint dysfunction, although further study is needed to assess the validity of this test method.
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J Manipulative Physiol Ther · Jan 2002
Clinical Trial Controlled Clinical TrialFirst Prize: Central motor excitability changes after spinal manipulation: a transcranial magnetic stimulation study.
The physiologic mechanism by which spinal manipulation may reduce pain and muscular spasm is not fully understood. One such mechanistic theory proposed is that spinal manipulation may intervene in the cycle of pain and spasm by affecting the resting excitability of the motoneuron pool in the spinal cord. Previous data from our laboratory indicate that spinal manipulation leads to attenuation of the excitability of the motor neuron pool when assessed by means of peripheral nerve Ia-afferent stimulation (Hoffmann reflex). ⋯ When motor neuron pool excitability is measured directly by central corticospinal activation with transcranial magnetic stimulation techniques, a transient but significant facilitation occurs as a consequence of spinal manipulation. Thus, a basic neurophysiologic response to spinal manipulation is central motor facilitation.
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J Manipulative Physiol Ther · Nov 2001
Comparative StudyA descriptive study of medical and chiropractic patients with chronic low back pain and sciatica: management by physicians (practice activities) and patients (self-management).
A practice-based study of ambulatory patients with low back pain noted a long-term outcome advantage for self-referred chiropractic (DC) patients over medical (MD) patients within a subgroup of patients with chronic low back pain and radiating pain below the knee. The frequency of self-care education by physicians in both provider cohorts coupled with current thinking on management of chronic low back pain led to an exploration and description of physicians' noncore practice activities and patients' self-management attitudes and behaviors. ⋯ The chiropractic encounter may have enhanced patients' self-efficacy motivation, leading to better coping abilities and better pain and disability outcomes. Understanding, respecting, and capitalizing on the role and influence of psychosocial factors can help all physicians become more effective healers and counselors for their patients with back pain.
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J Manipulative Physiol Ther · Nov 2001
Case ReportsThe centralization phenomenon in chiropractic spinal manipulation of discogenic low back pain and sciatica.
To describe 3 cases of discogenic low back pain and leg pain in which the centralization phenomenon was used in determining chiropractic treatment and prognosis. ⋯ Assessment of the centralization phenomenon provided valuable diagnostic and prognostic information regarding chiropractic side-posture manipulation in this case series.
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J Manipulative Physiol Ther · Nov 2001
Case ReportsChiropractic treatment of postsurgical neck syndrome with mechanical force, manually assisted short-lever spinal adjustments.
To describe a case of postsurgical neck pain, after multiple spinal surgeries, that was successfully treated by chiropractic intervention with instrumental adjustment of the cervical spine. ⋯ Chiropractic treatment of postsurgical neck syndrome may be effectively treated, in certain cases, by mechanical force, manually assisted adjusting procedures with an AAI. The use of instrumental adjustment methodology may provide chiropractic physicians with an effective alternative to manual manipulation in those cases in which the patient's surgical history or presenting symptoms make forceful manipulation of the spine, particularly performed at end range, inappropriate. This approach may be contemplated by physicians faced with managing this type of condition. Further study should be made in this regard, in an academic research setting, to determine the safest and most effective approaches to managing postsurgical patients in a chiropractic setting.