Manual therapy
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To determine if real-time feedback enables students to apply mobilisation forces to the cervical spine that are similar to an expert physiotherapist. ⋯ Practice with real-time objective feedback enables students to apply forces similar to an expert, supporting its use in manual therapy training.
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Randomized Controlled Trial Comparative Study
Effect of physical exercise interventions on musculoskeletal pain in all body regions among office workers: a one-year randomized controlled trial.
This study investigated effects of physical exercise on musculoskeletal pain symptoms in all regions of the body, as well as on other musculoskeletal pain in association with neck pain. A single blind randomized controlled trial testing a one-year exercise intervention was performed among 549 office workers; specific neck/shoulder resistance training, all-round physical exercise, or a reference intervention. Pain symptoms were determined by questionnaire screening of twelve selected body regions. ⋯ The additional number of pain regions in neck cases decreased in the two exercise groups only (P<0.01-0.05). In individuals with no or minor pain at baseline, development of pain was minor in all three groups. In conclusion, both specific resistance training and all-round physical exercise for office workers caused better effects than a reference intervention in relieving musculoskeletal pain symptoms in exposed regions of the upper body.
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The clinical criteria by which clinicians determine mechanisms-based classifications of pain are not known. The aim of this study was to generate expert consensus-derived lists of clinical criteria suggestive of a clinical dominance of 'nociceptive', 'peripheral neuropathic' and 'central' mechanisms of musculoskeletal pain. A web-based 3 round Delphi survey method was employed as an expert consensus building technique. ⋯ Twelve 'nociceptive', 14 'peripheral neuropathic' and 17 'central' clinical indicators reached consensus. These expert consensus-derived lists of clinical indicators of 'nociceptive', 'peripheral neuropathic' and 'central' mechanisms of musculoskeletal pain provide some indication of the criteria upon which clinicians may base such mechanistic classifications. Further empirical testing is required in order to evaluate the discriminative validity of these clinical criteria in particular and of mechanisms-based approaches in general.
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This study investigated the reliability, validity and diagnostic accuracy of manual palpation of the sciatic, tibial and common peroneal nerves in the examination of 45 subjects with low-back related leg pain. The nerves were palpated manually and with an algometer, to determine pressure pain thresholds (PPTs). A second examiner performed the straight leg raise (SLR) and slump tests to determine nerve trunk mechanosensitivity. ⋯ PPTs were significantly lower on the symptomatic side, for each of the three nerves, in subjects who were positive on manual palpation. In subjects who were negative on manual palpation, PPTs were not significantly different between sides, demonstrating criterion-based validity, using PPT as the criterion. Highest scores of diagnostic accuracy were obtained when two or more of the three nerves were positive on palpation (sensitivity = 0.83; specificity = 0.73).