Manual therapy
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Comparative Study
Hypoaesthesia occurs with sensory hypersensitivity in chronic whiplash--further evidence of a neuropathic condition.
Hypersensitivity to a variety of stimuli has been shown in whiplash associated disorders and may be indicative of peripheral nerve involvement. This cross-sectional study utilised Quantitative sensory testing (QST) including vibration, thermal, electrical detection thresholds as an indirect measure of primary afferents that mediate innocuous and painful sensation. Pain thresholds and psychological distress (SCL-90-R) were also measured. ⋯ A combination of pain threshold and detection measures best predicted the whiplash group. Sensory hypoaesthesia and hypersensitivity co-exist in the chronic whiplash condition. These findings may indicate peripheral afferent nerve fibre involvement but could be a further manifestation of disordered central pain processing.
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We assessed the reliability, validity and responsiveness of the French short version of the scale Disability of the Arm, Shoulder and Hand-Disability/Symptom (F-QuickDASH-D/S) in patients with shoulder disorders. We extracted QuickDASH item responses from the responses to the full-length DASH questionnaire completed by 153 patients. In addition to collecting demographic and clinical data, subjective assessment of activities of daily living (ADL), active range of motion (ROM), and measurement of abduction strength (strength) were recorded by use of the Constant scale. ⋯ The responsiveness of F-QuickDASH-D/S was excellent, with standardized response mean and effect size values of 1.09 and 1.23, respectively. The F-QuickDASH-D/S has good reliability, construct validity and responsiveness. The strong correlation of its score with the full-length DASH-D/S scale score suggests that the QuickDASH-D/S could be the preferred scale because it is easier to use.
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The sacroiliac joint (SIJ) has been implicated as a potential source of low back and buttock pain. Several types of motion palpation and provocation tests are used to examine the SIJ. It has been suggested that use of a cluster of motion palpation or provocation tests is a more acceptable method than single test to assess SIJ. ⋯ PABAK for intra- and inter-examiner reliability for clusters of motion palpation or provocation tests ranged from 0.44 to 0.92 (95% CI: -0.36 to 1.2) which is considered moderate to excellent reliability. PABAK for intra- and inter-examiner reliability of composites of motion palpation and provocation tests ranged from 0.44 to 1.00 (95% CI: -0.22 to 1.12) and 0.52 to 0.92 (95% CI: -0.02 to 1.32) which is considered substantial to excellent. It seems that composites of motion palpation and provocation tests together have reliability sufficiently high for use in clinical assessment of the SIJ.