Manual therapy
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Randomized Controlled Trial Multicenter Study Comparative Study
Does a combination of physical training, specific exercises and pain education improve health-related quality of life in patients with chronic neck pain? A randomised control trial with a 4-month follow up.
To investigate the effect of combining pain education, specific exercises and graded physical activity training (exercise) compared with pain education alone (control) on physical health-related quality of life (HR-QoL) in chronic neck pain patients. ⋯ This multimodal intervention may be an effective intervention for chronic neck pain patients.
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Randomized Controlled Trial Multicenter Study Comparative Study
Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness: A prospective randomized study comparing three exercise programs.
Dizziness and unsteadiness are common symptoms following a whiplash injury. ⋯ Between and within group comparisons suggest that physiotherapist led neck exercise groups including a behavioural approach had advantages in improving measures of dizziness compared with the general physical activity group, although many still complained of dizziness and balance impairment. Future studies should consider exercises specifically designed to address balance, dizziness and cervical proprioception in those with persistent whiplash.
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Multicenter Study Comparative Study
Somatization is associated with worse outcome in a chiropractic patient population with neck pain and low back pain.
To determine if psychosocial factors are associated with outcome in patients with neck pain or low back pain. ⋯ Somatization was the only variable consistently found to be associated with diminished perceived recovery, higher degree of neck or low back disability, and increased neck or low back pain.
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Multicenter Study Comparative Study
Patient characteristics in low back pain subgroups based on an existing classification system. A descriptive cohort study in chiropractic practice.
Sub-grouping of low back pain (LBP) is believed to improve prediction of prognosis and treatment effects. The objectives of this study were: (1) to examine whether chiropractic patients could be sub-grouped according to an existing pathoanatomically-based classification system, (2) to describe patient characteristics within each subgroup, and (3) to determine the proportion of patients in whom clinicians considered the classification to be unchanged after approximately 10 days. A cohort of 923 LBP patients was included during their first consultation. ⋯ In conclusion, LBP patients could be classified according to a standardised protocol, and chiropractors considered most patient classifications to be unchanged within 10 days. Differences in patient characteristics between subgroups were very small, and the clinical relevance of the classification system should be investigated by testing its value as a prognostic factor or a treatment effect modifier. It is recommended that this classification system be combined with psychological and social factors if it is to be useful.
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Randomized Controlled Trial Multicenter Study
Effectiveness of Diacutaneous Fibrolysis for the treatment of subacromial impingement syndrome: a randomised controlled trial.
Our objective was to assess the effectiveness of Diacutaneous Fibrolysis on pain intensity, range of motion and functional status in patients suffering from Subacromial Impingement Syndrome. A randomised controlled trial was conducted in two Spanish National Health Service Primary Health Care Centres. Participants (n = 120) were randomly assigned to one of three groups (intervention, placebo or control groups). ⋯ At the 3 month follow-up assessment, between-groups differences were not statistically significant and clinical relevance was achieved only for external rotation movement between intervention and control groups. At the post-treatment assessment 89% of the participants in the intervention group, 76% of the participants in the placebo group and 67% of the participants in the control group reported subjective improvement (p < 0.01). In conclusion, adding Diacutaneous Fibrolysis to the conservative treatment of Subacromial Impingement Syndrome improves function and external rotation movements and also gives significantly higher patient satisfaction.