Journal of manipulative and physiological therapeutics
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J Manipulative Physiol Ther · Feb 2001
Comparative StudyPatient characteristics and physicians' practice activities for patients with chronic low back pain: a practice-based study of primary care and chiropractic physicians.
Chronic low back pain sufferers are among those who account for the greatest usage of health care resources. Primary care medical (MD) physicians and chiropractic (DC) physicians treat most of these patients. ⋯ Differences in sociodemographics, present pain intensity, and functional disability may distinguish patients with chronic low back pain seeking care from primary care medical physicians from those seeking care from DC physicians. Although the primary treatment modality differs, the practice activities of MD physicians and DC physicians have much in common. Long-term evaluation suggests that chronic back pain is persistent and difficult to treat for both provider types.
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J Manipulative Physiol Ther · Nov 2000
Clinical Trial Controlled Clinical TrialMechanical force spinal manipulation increases trunk muscle strength assessed by electromyography: a comparative clinical trial.
The objective of this study was to determine whether mechanical force, manually-assisted (MFMA) spinal manipulative therapy (SMT) affects paraspinal muscle strength as assessed through use of surface electromyography (sEMG). ⋯ The results of this preliminary clinical trial demonstrated that MFMA SMT results in a significant increase in sEMG erector spinae isometric MVC muscle output. These findings indicate that altered muscle function may be a potential short-term therapeutic effect of MFMA SMT, and they form a basis for a randomized, controlled clinical trial to further investigate acute and long-term changes in low back function.
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J Manipulative Physiol Ther · Nov 2000
The effects of metronome breathing on the variability of autonomic activity measurements.
Many chiropractors hypothesize that spinal manipulation affects the autonomic nervous system (ANS). However, the ANS responses to chiropractic manipulative therapy are not well documented, and more research is needed to support this hypothesis. This study represents a step toward the development of a reliable method by which to document that chiropractic manipulative therapy does affect the ANS by exploring the use of paced breathing as a way to reduce the inherent variability in ANS measurements. ⋯ Metronome breathing increased parasympathetic activity, as evidenced by augmented HF power in the ECG and SBP data. The variability (CV%) of ECG-determined ANS measurements was significantly reduced with paced breathing at 12 breaths/min, but no significant reductions were observed for the SBP-determined ANS measurements. These findings indicate that ECG data are more sensitive than SBP data for future clinical trials.
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J Manipulative Physiol Ther · Oct 2000
Randomized Controlled Trial Clinical TrialNonoperative treatments for sciatica: a pilot study for a randomized clinical trial.
To assess the feasibility of patient recruitment, the ability of patients and clinicians to comply with study protocols, and the use of data collection instruments to collect cost-effectiveness data, and to obtain variability estimates for sample-size calculations for a full-scale trial. ⋯ Pilot studies such as these are important for the determination of the feasibility of conducting costly, larger scale trials. Recruitment for a full-scale study of sciatica of 2 to 12 weeks duration is not feasible, given the methods used in this pilot study. Our results do indicate, however, that there are substantial numbers of patients with sciatica more chronic in nature who would be interested in participating in a similar study. In addition, collaboration with a local health maintenance organization would likely facilitate clinician referrals and optimize the recruitment process. Patient and provider compliance was high in the pilot study, which indicates that most study protocols are feasible. Additionally, we were able to collect complete outcomes data, including those regarding health care use. A suggested modification by investigators and outside consultants has resulted in the replacement of the medication group with a minimal intervention control group (ie, self-care advice). As a result, a second pilot study of patients with sciatica of more than 4 weeks duration has been planned before a full-scale trial is attempted.
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J Manipulative Physiol Ther · Sep 2000
ReviewMRI of the spine and spinal cord: imaging techniques, normal anatomy, artifacts, and pitfalls.
Magnetic resonance imaging (MRI) is widely used to evaluate the spine and spinal cord. ⋯ MRI enables the imaging specialist to evaluate a large anatomic region in multiple planes and can better examine the spinal cord.