Manual therapy
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Segmental neurological modulation, neural hysteresis and biomechanical effects have been proposed as mechanisms underpinning the effects of manual therapy. An increasing number of studies hypothesise activation of the central nervous system resulting in a non-segmental hypoalgesic effect with concurrent activation of other neural pathways as a potential mechanism of action. Whether this model is consistent with the current literature is unknown. ⋯ Pooling of data suggested that joint mobilisation improved outcomes by approximately 20% relative to controls. This specific pattern suggests that descending pathways might play a key role in manual therapy induced hypoalgesia. Our review supports the existence of an alternative neurophysiological model, in which passive joint mobilisation stimulates areas within the central nervous system.
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Comparative Study
Physiotherapy for low back pain: differences between public and private healthcare sectors in Ireland--a retrospective survey.
European clinical guidelines for low back pain (LBP) recommend early referral of appropriate patients to health services such as physiotherapy. The current study aimed to investigate any differences between the physiotherapy management of LBP, and the physiotherapist and patient profiles in public and private health settings in Ireland. ⋯ Findings showed longer waiting times, and a higher number and duration of physiotherapy treatments for acute and chronic LBP in the public setting suggesting the need to develop publicly funded primary healthcare in Ireland.
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The research diagnostic criteria for temporomandibular disorders (RDC/TMD) are used for the classification of patients with temporomandibular disorders (TMD). Surface electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 103 TMD patients subdivided according to the RDC/TMD into 3 non-overlapping groups: (a) 25 myogenous; (b) 61 arthrogenous; and (c) 17 psycogenous patients. Thirty-two control subjects matched for sex and age were also measured. ⋯ No differences were found for masseter muscle symmetry and torque coefficient (p>0.05). Surface electromyography of the masticatory muscles allowed an objective discrimination among different RDC/TMD subgroups. This evaluation could assist conventional clinical assessments.