Journal of manipulative and physiological therapeutics
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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.
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J Manipulative Physiol Ther · Jun 2001
Case ReportsRapid progression of acute sciatica to cauda equina syndrome.
To demonstrate the importance of clinical examination and continued vigilance for neurologic deterioration in patients with sciatica. Cauda equina syndrome, a rare sequela of sciatica, is considered a medical emergency requiring surgical decompression. ⋯ Most cases of sciatica, regardless of cause, will self-resolve; as a result, there might be a tendency to maintain a low index of suspicion for serious, progressive disorders such as cauda equina syndrome. Patients need to be educated as to signs of this emergency condition and informed as to the possible consequences of delaying treatment. By maintaining a high index of suspicion for any case that fails to respond as expected to a course of conservative therapy or that demonstrates signs of cauda equina syndrome, chiropractors can assume a pivotal role by investigating and referring appropriately and by aiding in active rehabilitation postoperatively.
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J Manipulative Physiol Ther · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialA pilot randomized clinical trial on the relative effect of instrumental (MFMA) versus manual (HVLA) manipulation in the treatment of cervical spine dysfunction.
To determine the relative effect of instrument-delivered thrust cervical manipulations in comparison with traditional manual-delivered thrust cervical manipulations in the treatment of cervical spine dysfunction. ⋯ The results of this clinical trial indicate that both instrumental (MFMA) manipulation and manual (HVLA) manipulation have beneficial effects associated with reducing pain and disability and improving cervical range of motion in this patient population. A randomized, controlled clinical trial in a similar patient base with a larger sample size is necessary to verify the clinical relevance of these findings.
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J Manipulative Physiol Ther · May 2001
Which patients with chronic reflex sympathetic dystrophy are most likely to benefit from physical therapy?
Chronic reflex sympathetic dystrophy (RSD) is a painful and disabling disorder for which no treatment with proven effects exists. Physical therapy (PT) has been demonstrated to be effective for recently diagnosed RSD, but its value in chronic RSD has not yet been studied. ⋯ In overall terms, PT did not influence functional parameters or give satisfaction to patients with chronic RSD in this study. A randomized trial is required to prove or exclude the actual value of PT for these patients.
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J Manipulative Physiol Ther · Mar 2001
Clinical TrialIntraexaminer and interexaminer reliability for palpation of the cranial rhythmic impulse at the head and sacrum.
A range of health care practitioners use cranial techniques. Palpation of a cranial rhythmic impulse (CRI) is a fundamental clinical skill used in diagnosis and treatment with these techniques. There has been little research establishing the reliability of CRI rate palpation. ⋯ The results fail to support the construct validity of the "core-link" hypothesis as it is traditionally held by proponents of craniosacral therapy and osteopathy in the cranial field.