Journal of Manipulative and Physiological Therapeutics最新文献

Objective: This study aimed to establish if chiropractic care can improve oculomotor and cognitive symptoms in individuals with persistent postconcussion syndrome (PPCS).

Methods: A single-blind, randomized controlled intervention study recorded baseline computerized eye-tracker assessment (CEA) outcomes in 40 young adults with PPCS following mild traumatic brain injury. Participants were randomly allocated to either a chiropractic or age-matched active control intervention, and the change in CEA outcomes following intervention was compared between the chiropractic and control groups. A battery of CEAs including egocentric localization, fixation stability, pursuit, saccades, Stroop, and the vestibulo-ocular reflex, were used to assess oculomotor function, visual attention/processing, and selective attention.

Results: Relative to the control group, participants receiving the chiropractic intervention scored better in the Stroop test (P < .001), had improved gaze stability during both vestibulo-ocular reflex (P < .001) and fixation stability (P = .009), and a lower vertical error in egocentric localization (P < .001). However, performance was poorer in pursuits, where they had an increased tracking error (P < .001).

Conclusion: Chiropractic care in participants with PPCS significantly improved static and dynamic gaze stability, and performance in the Stroop test, compared with a control intervention. These results suggest that chiropractic care can offer a novel avenue for alleviating certain visual and cognitive symptoms in patients with PPCS. It also adds to the growing evidence that suggests that some longstanding PPCS visual symptoms may have a spinal or proprioceptive basis.

Objective: The purpose of this study was to analyze the influence of pain and no pain expectation on pupil diameter and the cognitive assessment of pain using pupillometry and the visual analog scale (VAS).

Methods: This was an experimental cross-sectional study in which painful stimulation of the muscle masseter was produced by palpation with an algometer in a sample of 30 healthy participants. Before the painful stimulation, pain expectation and no pain expectation situations were induced by employing instructional videos. Cognitive and physiological pain responses were measured by the VAS and by pupillometry. Visual analog scale score was assessed at the end of each experimental condition, and pupillometry measurements were recorded at different moments of the experimental process (events).

Results: The pain score and larger pupil diameter for all events (except, as expected, for the initial baseline), were statistically significant for the pain expectation condition compared with the no pain expectation.

Conclusion: Within the conditions of this study, pain expectation modulated both cognitive assessment of pain (VAS) and pupil diameter. These findings suggest that pupil diameter may be a useful and complementary tool with the VAS for pain assessment. Furthermore, the findings support models postulating that emotion and cognition are important aspects involved in pain perception, which is in line with the recent International Association for the Study of Pain definition of pain.

Objective: This study aimed to investigate the locomotor behavior of older adults with and without a history of falls as they avoided obstacles with different physical characteristics.

Methods: Twenty-one older adults participated in this study. The group was divided into higher risk of falling (n = 10) and lower risk of falling (n = 11). The following conditions were carried out: (1) walking and avoiding a solid obstacle and (2) walking and avoiding a fragile obstacle.

Results: Older adults at higher risk of falling had worse performance during the obstacle approach phase. Both groups performed worse when avoiding the fragile obstacle than when avoiding the solid obstacle. Older adults at higher risk of falling had their feet closer when avoiding the obstacle, and both groups raised their limbs higher to avoid a fragile obstacle. Older adults at higher risk of falling were closer to obstacles after avoiding them.

Conclusion: For the participants in this study, the physical characteristics of the obstacle did not interfere with the locomotor performance of older adults during obstacle avoidance. This study found that older adults at higher risk of falls modulated their locomotor pattern before avoiding the obstacles, presenting lower velocity, shorter step length, and greater step width compared with older adults at lower risk of falling.

Objective: The purpose of this study was to evaluate the accuracy of heel rise test (HRT) for assessing the functional capacity (FC) of individuals with peripheral arterial disease (PAD) and determine the best sensitivity cutoff point to stratify individuals with worse FC.

Methods: This retrospective methodological study included adults of both sexes diagnosed with PAD and intermittent claudication. Individuals performed the HRT (number of plantar flexions, execution time, and execution rate were recorded) and the incremental shuttle walking test (distance walked was recorded). The accuracy analysis and the determination of the sensitivity of the HRT in assessing FC were performed by the receiver operating characteristic curve based on the following incremental shuttle walking test cutoff point: 380 meters. Alpha was set at 5%.

Results: In this study, 120 individuals were included (64 ± 9.65 years). The number of plantar flexions showed better accuracy for FC assessment (area under the curve, 0.78; 95% CI, 0.65-0.90). The best sensitivity cutoff to stratify the individuals with the worst FC was 63 plantar flexions (sensitivity, 0.952; specificity, 0.562).

Conclusion: The HRT showed good accuracy, adequate sensitivity, and acceptable specificity in assessing the FC of individuals with PAD. The best sensitivity cutoff point to stratify individuals with worse FC was 63 plantar flexions.

Objective: The aim of this study was to systematically review the influence of the intrinsic foot musculature on lower limb injuries, with regard to improving foot posture and self-reported function, and to point out the biomechanical effects of strengthening the intrinsic foot musculature.

Methods: A comprehensive literature search using National Library of Medicine (Medline-PubMed), Scopus, Web of Science, Pedro, SportDiscus, and Cochrane was undertaken.

Selection criteria: A literature search was peformed using: Clinical trials of patients with injuries in the lower limbs, and with alterations in the intrinsic musculature of the foot were included and published in the period up to and including April 2023.

Data synthesis: Data analysis was measured as standardized mean difference and confidence interval was set at 95%. Random effects model was used.

Results: A total of 1,051 studies were found, but, after evaluation, only 4 were included in the present study. The effect of intrinsic foot musculature strengthening improved medial longitudinal arch height in studies included in the meta-analysis (P < .00001).

Conclusion: Based on this systematic review, it is possible to conclude that increasing the strength of intrinsic foot muscles proved to be effective in promoting positive biomechanical changes in the longitudinal arch of the foot of these patients.

Objective: The purpose of this study was to investigate how rectus abdominis, external oblique (EO), internal oblique (IO), erector spinae, multifidus (MF), and gluteus maximus (GMax) muscle activities change with different hip positions during back and side bridging exercises.

Methods: Thirty-six healthy individuals participated in this cross-sectional study and performed 6 exercises including back bridging (BB) in neutral hip position, BB with internal rotation, BB with external rotation (BB + ER), side bridging with hips in neutral (SB), side bridging with hips in flexion (SB + HF), and side bridging with hips in extension (SB + HE). Muscle activity was observed using surface electromyography, normalized using maximum voluntary isometric contraction. Repeated-measures 1-way analysis of variance compared muscle readings for each position.

Results: Back bridging with internal rotation showed significant differences in EO (P = .01) and IO (P < .001) compared with other BB positions. Multifidus and GMax differed significantly in BB + ER (P = .04). Side bridging exhibited significant differences in EO (P = .02; P < .001) and IO (P < .001) compared with the other 2 SB positions, with peak in SB + HF. Erector spinae, MF, and GMax also differed significantly (P < .001, P = .02, P < .001, respectively) with peak in SB + HE.

Conclusion: The findings revealed that EO and IO muscles were most active during BB with internal rotation, whereas the MF and GMax muscles were most active during BB + ER. In terms of SB, the EO and IO muscles were most active with either SB + HF or SB + HE, whereas the erector spinae, MF, and GMax muscles were most active with SB + HE.

Objective: This study investigates the effect of cervical mobilization on balance and cervical proprioception in patients with nonspecific neck pain.

Methods: A prospective, double-blind, randomized clinical trial was conducted involving a 3-week treatment protocol for which 66 patients were randomly assigned to 2 groups. Both groups underwent conventional physiotherapy (hot pack and transcutaneous electrical nerve stimulation) twice a week for 3 weeks along with additional cervical mobilization in the mobilization group, and sham mobilization in the sham control group. Static and dynamic balance, cervical proprioception, cervical mobility, and pain intensity were evaluated using a Kinesthetic Skill Training System 3000 device, the "Joint Position Error Test," Cervical Range-of-Motion Instrument, and the visual analog scale, respectively.

Results: After treatment, significant improvements were noted in dynamic balance, mobility, pain intensity (P < .001, P < .001, P < .001, respectively), and proprioception in the left direction of rotation in the mobilization group (P = .003) that were significantly greater than those observed in the sham mobilization group (P < .001, P < .001, P < .001, P = .003, respectively). Although a significant decrease was observed in the deficits of static balance (P = .044) and proprioception in the right direction of rotation (P = .011) after mobilization, the changes were similar in both the mobilization and sham mobilization groups (P = .192, P = .154, respectively).

Conclusion: Cervical mobilization led to significant improvements in dynamic balance, pain intensity, mobility, and partial improvements to proprioception in a comparison with a sham mobilization group, while the effect on static balance was not significant.

Objective: The purpose of this study was to assess the effect of electroacupuncture stimulation (EAS) of the vagus nerve on the inflammatory response in rat models of spinal cord injury (SCI).

Methods: The T10 SCI model in adult male Sprague Dawley rats was established using the modified Allen's method. The EAS group was treated with the therapy on the vagus nerve of rat ear nails, while the SCI group did not receive any EAS treatment. The degree of inflammatory infiltration was reflected by hematoxylin-eosin staining. The inflammatory cytokines in spinal cord tissues, cerebrospinal fluid inflammation, and peripheral blood were detected by enzyme-linked immunosorbent assay. Changes in astrocytes and microglia were assessed using an immunofluorescence assay.

Results: Electroacupuncture stimulation treatment inhibited inflammatory infiltration, as well as the concentrations of interleukin-6, interleukin-1β, tumor necrosis factor-α, astrocytes, and microglia at 1, 6, and 24 hours after 1 EAS treatment. Multiple EAS treatments had an obvious effect on SCI inflammation.

Conclusion: A single EAS treatment had a limited effect on inflammation, but multiple treatments had a significant inhibitory effect on inflammation.

Objective: The purpose of this study was to evaluate the effects of photobiomodulation therapy (PBMT) on the gastrocnemius muscle of X-linked muscular dystrophy (mdx) mice.

Methods: The study used an experimental model of Duchenne muscular dystrophy, at 3 stages of degeneration/regeneration of muscle fibers: an acute stage (14-28 days old), acute and stabilized stages (14-42 days old), and a stabilized stage (28-42 days old). Photobiomodulation therapy (also known as low-level light therapy) at 0.6 J was applied 3 times per week to the dystrophic gastrocnemius muscle of mdx mice at ages 14 to 28, 14 to 42, and 28 to 42 days. After the treatment period, the gastrocnemius muscle was collected, and cryosections were prepared for histopathologic analysis.

Results: In all 3 stages evaluated, a significant reduction was observed in immunoglobulin G uptake by muscle fibers, the inflammatory area, macrophage infiltration, the reactive dihydroethidium area, and the number of autofluorescent lipofuscin granules in the gastrocnemius muscle of mdx mice after PBMT.

Conclusion: The results demonstrated that low-level light therapy, when applied during or after the acute phase of the degeneration/regeneration muscle process, improves the pathological histomorphologic features in dystrophic muscle. Based on these results, PBMT appears to be a promising therapy for dystrophinopathies, warranting further research in humans to verify its efficacy.

Objective: The purpose of this study was to compare the short-term effects of connective tissue massage (CTM) and classic massage (CM) on pain, functional and emotional status, and menstrual complaints in women with primary dysmenorrhea (PD).

Methods: Women with PD were randomly assigned to 2 groups: CTM (n = 19) and CM (n = 19). CTM or CM was applied 5 days a week from the estimated date of ovulation to the onset of the next menstruation. The pain intensity with the Visual Analog Scale and functional and emotional status with the Functional and Emotional Dysmenorrhea Scale (FEDS) were assessed before and after the applications. Pain duration and the presence of menstrual complaints were recorded.

Results: In the postintervention period, both groups had decreased menstrual pain intensity and duration, drug use, and FEDS scores (P < .001). Pain duration and FEDS-functional scores decreased more in the CTM group than in the CM group (P < .05). Moreover, in the postintervention period, fewer women were nervous in the CM group, whereas low back pain, constipation, and sleeplessness were less frequent in the CTM group, compared with their preintervention period (P < .05). A difference was observed between groups only in terms of the changes in sleeplessness between before and after intervention (P = .016).

Conclusion: CTM and CM improved menstrual pain and functional and emotional status, and decreased drug use. Moreover, CTM was superior in improving pain duration, functional status, and sleeplessness compared with CM in PD. CTM and CM might be useful treatment methods for PD.