The Journal of manual & manipulative therapy
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Most clinicians ask their patients to rate whether their health condition has improved or deteriorated over time and then use this information to guide management decisions. Many studies also use patient-rated change as an outcome measure to determine the efficacy of a particular treatment. ⋯ The purpose of this article is to summarize this information to assist appropriate interpretation of the GRC results and to provide evidence-informed advice to guide design and administration of GRC scales. These considerations are relevant and applicable to the use of GRC scales both in the clinic and in research.
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Manual therapists question integrating manual lymphatic drainage techniques (MLDTs) into conventional treatments for athletic injuries due to the scarcity of literature concerning musculoskeletal applications and established orthopaedic clinical practice guidelines. The purpose of this systematic review is to provide manual therapy clinicians with pertinent information regarding progression of MLDTs as well as to critique the evidence for efficacy of this method in sports medicine. We surveyed English-language publications from 1998 to 2008 by searching PubMed, PEDro, CINAHL, the Cochrane Library, and SPORTDiscus databases using the terms lymphatic system, lymph drainage, lymphatic therapy, manual lymph drainage, and lymphatic pump techniques. ⋯ The best evidence suggests that efficacy of MLDT in sports medicine and rehabilitation is specific to resolution of enzyme serum levels associated with acute skeletal muscle cell damage as well as reduction of edema following acute ankle joint sprain and radial wrist fracture. Currently, there is limited high-ranking evidence available. Well-designed RCTs assessing outcome variables following implementation of MLDTs in treating athletic injuries may provide conclusive evidence for establishing applicable clinical practice guidelines in sports medicine and rehabilitation.
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This single-subject case study was conducted as a part of a randomized trial investigating the efficacy of mechanical diagnosis and therapy (MDT) and spinal thrust manipulation (STM) in patients who meet a clinical prediction rule (CPR) for spinal manipulation. Following initial examination, a patient who met the CPR was treated initially with STM and then eventually with MDT. The Oswestry Disability Questionnaire (ODI), Fear-Avoidance Beliefs Questionnaire, and the Numerical Pain Rating Scale (NPRS) were administered at the initial examination and at a two-week follow-up. ⋯ In accordance with a study protocol in which the patient was part of, this patient was changed from STM to MDT after the second physical therapy visit due to failure of overall improvement. The patient received MDT during the third session and continued with this approach until discharge. This patient responded favorably to MDT presenting with a 20 degrees improvement in SLR on the left and 10 degrees on the right, 6 points lower on the NPRS, and a 4% decrease on the OSW after a total of 6 visits.