Manual therapy
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Randomized Controlled Trial
Reduction of experimental muscle pain by passive physiological movements.
The analgesic effects of passive movements on deep-tissue pain have not been sufficiently explored in human studies. The purpose of this study was to examine the effect of passive physiological movements (PPMs) on deep-tissue pain sensitivity. Seventeen healthy subjects were included in this randomised crossover study. ⋯ McGill Pain Questionnaire (MPQ) was used to describe the quality of the induced pain. Compared with the control session PPM demonstrated: (1) a reduction of the experimental muscle pain intensity (VAS area and peak) and duration (17-31%, P<0.03), (2) lower MPQ score and a change in quality profile of experimental muscle pain (25%, P<0.01) and (3) an increased PPT (17%, P<0.0005). The present study demonstrated that PPM produced an immediate analgesic effect on deep-tissue pain indicating a possible involvement of neural inhibitory mechanisms.
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Comparative Study
Relationship between spinal stiffness and outcome in patients with chronic low back pain.
Many manual therapists assess and treat spinal stiffness of people with low back pain. The objectives of this study were to investigate: (i) whether spinal stiffness changes after treatment; (ii) the relationship between pre-treatment spinal stiffness and change in stiffness with treatment; (iii) the relationship between spinal stiffness, pain, disability and global perceived effect of treatment; (iv) whether spinal stiffness predicts outcome of treatment or response to treatment in chronic low back pain patients. One hundred and ninety-one subjects with chronic low back pain were randomly allocated to groups that received either spinal manipulative therapy, motor control exercise, or a general exercise program. ⋯ No significant association was observed between initial stiffness score and any of the final outcome measures following treatment. Initial stiffness did not predict response to any treatment. In conclusion, spinal stiffness decreases over the course of an episode of treatment, more so in those with the stiffest spines, but the decrease is not dependent on treatment and is not generally related to outcome.