Manual therapy
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Randomized Controlled Trial
Clinical response and relapse in patients with chronic low back pain following osteopathic manual treatment: results from the OSTEOPATHIC Trial.
Clinical response and relapse following a regimen of osteopathic manual treatment (OMT) were assessed in patients with chronic low back pain (LBP) within the OSTEOPATHIC Trial, a randomized, double-blind, sham-controlled study. Initial clinical response and subsequent stability of response, including final response and relapse status at week 12, were determined in 186 patients with high baseline pain severity (≥50 mm on a 100-mm visual analogue scale). Substantial improvement in LBP, defined as 50% or greater pain reduction relative to baseline, was used to assess clinical response at weeks 1, 2, 4, 6, 8, and 12. ⋯ Among patients with an initial clinical response prior to week 12, 13 (24%) patients in the OMT group vs. 18 (51%) patients in the sham OMT group relapsed (RR, 0.47; 95% CI, 0.26-0.83). Overall, 49 (52%) patients in the OMT group attained or maintained a clinical response at week 12 vs. 23 (25%) patients in the sham OMT group (RR, 2.04; 95% CI, 1.36-3.05). The large effect size for short-term efficacy of OMT was driven by stable responders who did not relapse.
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This systematic review investigated the measurement properties of disease-specific patient-reported outcome measures used in Patellofemoral Pain Syndrome. Two independent reviewers conducted a systematic search of key databases (MEDLINE, EMBASE, AMED, CINHAL+ and the Cochrane Library from inception to August 2013) to identify relevant studies. A third reviewer mediated in the event of disagreement. ⋯ Other measurement properties were evaluated with poor methodological quality, and many properties were not evaluated in any of the included papers. Current disease-specific outcome measures for Patellofemoral Pain Syndrome require further investigation. Future studies should evaluate all important measurement properties, utilising an appropriate framework such as COSMIN to guide study design, to facilitate optimal methodological quality.
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Comparative Study
Reliability and concurrent validity of knee angle measurement: smart phone app versus universal goniometer used by experienced and novice clinicians.
The use of goniometers to measure joint angles is a key part of musculoskeletal practice. Recently smartphone goniometry applications have become available to clinicians. This study examined the intra- and inter-measurer reliability of novice and experienced clinicians and the concurrent validity of assessing knee range of motion using a smartphone application (the Knee Goniometer App (Ockendon(©))) (KGA) and a standard universal goniometer (UG). ⋯ The Standard Error of Measurement ranged between 1.56° (0.52-2.66) for the UG and 0.62° (0.29-1.27) for the KGA. The universal goniometer and the smartphone goniometric application were reliable in repeated measures of knee flexion angles. Smaller error of measurement values for the smartphone goniometric application might indicate superiority for assessment where clinical situations demand greater precision of knee range of motion.
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Many epidemiological surveys on playing-related musculoskeletal disorders (PRMDs) have been conducted on professional musicians, but none have evaluated or confirmed the psychometric properties of the self-report instruments that were used. The aim of the present study was to develop and validate a self-report instrument for professional orchestra musicians to measure musculoskeletal (MSK) pain and pain interference in terms of function and psychosocial constructs. 183 professional orchestra musicians in Scotland were eligible to participate in the study, of which 101 (55% response rate) took part. Development of the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM) involved the selection and modification of the most appropriate instruments measuring MSK pain, followed by psychometric evaluation of the new instrument. ⋯ High internal consistency was achieved for each subscale (Cronbach's alpha = 0.91). Substantial test-retest reliability for the pain intensity items (range 0.78-0.82), and moderate to substantial test-retest reliability for the pain interference items (range 0.56-0.76) were obtained. The MPIIQM is a valid and reliable self-report instrument for the measurement and evaluation of MSK pain and pain interference in a population of professional orchestra musicians.