Pub Date : 2025-07-01Epub Date: 2025-11-13DOI: 10.1016/j.jmpt.2025.10.051
Vanessa Maria da Silva Alves Gomes PhD, Thaynara do Nascimento Paes Barreto MSc, Gisele da Silva Vitorino Barbosa MSc, Ana Clara Catanho Pereira BSc, Laylla Marjorye Rebouças Bezerra MSc, Geisa Guimarães de Alencar PhD, Marianna de Melo Salemi MSc, Thania Maion de Souza Melo MSc, Eduardo José Nepomuceno Montenegro PhD, Patrícia Clara Pereira dos Santos PhD, Daniella Araújo de Oliveira PhD, Gisela Rocha de Siqueira PhD
Objective
To evaluate the effects of diacutaneous fibrolysis (DF) on pain intensity and cervical range of motion in individuals with chronic nonspecific neck pain (CNPP), compared to a sham intervention.
Methods
This randomized clinical trial included 30 adults with CNPP, randomly assigned in equal numbers to the DF group (DFG) or the sham group (ShG). Both groups received a single 30-minute session. Outcomes included the Visual Analog Scale (VAS) for pain, cervical range of motion (ROM), pressure pain threshold (PPT), and the area of myofascial trigger points (MTP) in the upper trapezius muscle. Analysis of covariance (ANCOVA) was used, with baseline values as covariates. Mean differences (MD) and 95% CIs were calculated, with significance set at P < .05.
Results
DFG exhibited reduction in VAS (MD = −3.38; 95% CI: −4.22 to −2.48) and improvements in cervical ROM, including extension (MD = 11.44; 95% CI: 5.45 to 17.44), right rotation (MD = 10.68; 95% CI: 4.49 to 16.44), and left rotation (MD = 7.91; 95% CI: 4.03 to 11.78), and right lateral flexion (MD = 6.90; 95% CI: 0.29 to 10.84) and left lateral flexion (MD = 3.51; 95% CI: 0.29 to 6.73), compared to the ShG. The DFG also showed greater increases in PPT (MD = 0.73; 95% CI: 0.46 to 0.99) and reductions in the area of MTP (MD = −0.57; 95% CI: −0.89 to −0.25), in the upper trapezius.
Conclusions
A single session of DF was effective in reducing neck pain, improving cervical ROM, increasing PPT, and decreasing MTP area in the upper trapezius of adults with CNPP.
{"title":"Effects of Diacutaneous Fibrolysis on Pain and Mobility in Chronic Neck Pain: A Randomized Sham-Controlled Trial","authors":"Vanessa Maria da Silva Alves Gomes PhD, Thaynara do Nascimento Paes Barreto MSc, Gisele da Silva Vitorino Barbosa MSc, Ana Clara Catanho Pereira BSc, Laylla Marjorye Rebouças Bezerra MSc, Geisa Guimarães de Alencar PhD, Marianna de Melo Salemi MSc, Thania Maion de Souza Melo MSc, Eduardo José Nepomuceno Montenegro PhD, Patrícia Clara Pereira dos Santos PhD, Daniella Araújo de Oliveira PhD, Gisela Rocha de Siqueira PhD","doi":"10.1016/j.jmpt.2025.10.051","DOIUrl":"10.1016/j.jmpt.2025.10.051","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effects of diacutaneous fibrolysis (DF) on pain intensity and cervical range of motion in individuals with chronic nonspecific neck pain (CNPP), compared to a sham intervention.</div></div><div><h3>Methods</h3><div>This randomized clinical trial included 30 adults with CNPP, randomly assigned in equal numbers to the DF group (DFG) or the sham group (ShG). Both groups received a single 30-minute session. Outcomes included the Visual Analog Scale (VAS) for pain, cervical range of motion (ROM), pressure pain threshold (PPT), and the area of myofascial trigger points (MTP) in the upper trapezius muscle. Analysis of covariance (ANCOVA) was used, with baseline values as covariates. Mean differences (MD) and 95% CIs were calculated, with significance set at <em>P</em> < .05.</div></div><div><h3>Results</h3><div>DFG exhibited reduction in VAS (MD = −3.38; 95% CI: −4.22 to −2.48) and improvements in cervical ROM, including extension (MD = 11.44; 95% CI: 5.45 to 17.44), right rotation (MD = 10.68; 95% CI: 4.49 to 16.44), and left rotation (MD = 7.91; 95% CI: 4.03 to 11.78), and right lateral flexion (MD = 6.90; 95% CI: 0.29 to 10.84) and left lateral flexion (MD = 3.51; 95% CI: 0.29 to 6.73), compared to the ShG. The DFG also showed greater increases in PPT (MD = 0.73; 95% CI: 0.46 to 0.99) and reductions in the area of MTP (MD = −0.57; 95% CI: −0.89 to −0.25), in the upper trapezius.</div></div><div><h3>Conclusions</h3><div>A single session of DF was effective in reducing neck pain, improving cervical ROM, increasing PPT, and decreasing MTP area in the upper trapezius of adults with CNPP.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 778-788"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this study was to explore the immediate effects of myofascial release (MFR) of the quadriceps or hamstrings on active range of motion (ROM) of cervical flexion and extension.
Methods
Sixty healthy individuals were randomly divided into 3 groups: Group intervention 1 (GI 1) (n = 20), group intervention 2 (GI 2) (n = 20), and group control (GC) (n = 20). In the first assessment (M0), the cervical flexion and extension ROM were measured with a goniometer. MFR with a foam roller was applied on the hamstrings (GI 1) or quadriceps (GI 2) of the dominant lower limb for 3 series of 1 minute with 30 seconds rest. The GC had no intervention. Immediately after the intervention, all groups were assessed again (M1).
Results
The results showed a significant increase in the active ROM for cervical flexion in GI 1 (P = .002, rank biserial correlation = –0.821) and GI 2 (P = .001, rank biserial correlation = –1.000), as well as for cervical extension in GI 1 (P = .001, rank biserial correlation = –0.905) and GI 2 (P = .001, rank biserial correlation = –0.858). However, there were no differences in the GC active ROM of cervical flexion (P = .150) and extension (P = .376). Significant intergroup differences were observed for cervical flexion and extension when comparing GI 1 and GI 2 to GC (P = .002; P = .001, ϵ² = 0.304-0.326).
Conclusion
This study showed that applying MFR using a foam roller to the quadriceps or hamstrings increased the ROM of cervical flexion and extension in healthy individuals in the short term.
{"title":"Immediate Effects of Quadriceps or Hamstrings Myofascial Release on Cervical Active Range of Motion in Healthy Individuals: A Randomized Controlled Trial","authors":"Ricardo Cardoso PhD , Adérito Seixas MSc , Isabel Moreira-Silva PhD , Joana Azevedo MSc , Doryne Lopes BS","doi":"10.1016/j.jmpt.2025.10.038","DOIUrl":"10.1016/j.jmpt.2025.10.038","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to explore the immediate effects of myofascial release (MFR) of the quadriceps or hamstrings on active range of motion (ROM) of cervical flexion and extension.</div></div><div><h3>Methods</h3><div>Sixty healthy individuals were randomly divided into 3 groups: Group intervention 1 (GI 1) (<em>n</em> = 20), group intervention 2 (GI 2) (<em>n</em> = 20), and group control (GC) (<em>n</em> = 20). In the first assessment (M0), the cervical flexion and extension ROM were measured with a goniometer. MFR with a foam roller was applied on the hamstrings (GI 1) or quadriceps (GI 2) of the dominant lower limb for 3 series of 1 minute with 30 seconds rest. The GC had no intervention. Immediately after the intervention, all groups were assessed again (M1).</div></div><div><h3>Results</h3><div>The results showed a significant increase in the active ROM for cervical flexion in GI 1 (<em>P</em> = .002, rank biserial correlation = –0.821) and GI 2 (<em>P</em> = .001, rank biserial correlation = –1.000), as well as for cervical extension in GI 1 (<em>P</em> = .001, rank biserial correlation = –0.905) and GI 2 (<em>P</em> = .001, rank biserial correlation = –0.858). However, there were no differences in the GC active ROM of cervical flexion (<em>P</em> = .150) and extension (<em>P</em> = .376). Significant intergroup differences were observed for cervical flexion and extension when comparing GI 1 and GI 2 to GC (<em>P</em> = .002; <em>P</em> = .001, <em>ϵ</em>² = 0.304-0.326).</div></div><div><h3>Conclusion</h3><div>This study showed that applying MFR using a foam roller to the quadriceps or hamstrings increased the ROM of cervical flexion and extension in healthy individuals in the short term.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 927-934"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-11-18DOI: 10.1016/j.jmpt.2025.10.028
Samantha Pritty MS, DC , Kyle Schwartz DC , Christopher Farrell MS, DC , Jesse Anderson DC , Sheryl Walters MLS , Lindsay Rae DC
Objective
The purpose of this scoping review was to assess the literature on patient education and delivery methods utilized by chiropractors.
Methods
For this scoping review, we searched peer-reviewed and gray literature including all study designs except for commentaries and protocols, which pertained to patient education within the chiropractic setting. Studies that included pediatrics were excluded. A literature search was performed through PubMed, Index to Chiropractic Literature, CINAHL, and Cochrane Database of Systematic Reviews from journal inception to March 4, 2025. After extraction, findings were qualitatively analyzed using thematic analysis.
Results
Of 2338 articles identified, 68 studies were eligible for thematic analysis. There was heterogeneity in the content and delivery methods of patient education. More lifestyle education reported than pain education. Predominately, education was delivered by direct instruction in a multimodal treatment approach.
Conclusion
Our literature findings suggest that chiropractors are utilizing pain education in addition to other patient education topics, such as lifestyle education, ergonomics/biomechanics, diagnosis/prognosis, and self-management strategies. Patient education is performed as part of a multimodal treatment approach within the chiropractic setting, primarily through direct instruction.
目的：本综述的目的是评估关于脊医患者教育和提供方法的文献。方法：在此范围综述中，我们检索了同行评议和灰色文献，包括除评论和协议外的所有研究设计，这些研究设计与脊椎指压治疗背景下的患者教育有关。包括儿科在内的研究被排除在外。从期刊创刊到2025年3月4日，通过PubMed、Index to Chiropractic literature、CINAHL和Cochrane系统评价数据库进行文献检索。提取后，使用专题分析对结果进行定性分析。结果：在鉴定的2338篇文章中，有68篇研究符合专题分析的条件。患者教育的内容和方式存在异质性。生活方式教育多于疼痛教育。在多模式治疗方法中，教育主要是通过直接指导进行的。结论：我们的文献发现表明，脊医除了对患者进行生活方式教育、人体工程学/生物力学、诊断/预后和自我管理策略等其他教育主题外，还利用疼痛教育。患者教育是脊椎指压治疗中多模式治疗方法的一部分，主要是通过直接指导。
{"title":"Prevalence and Delivery of Pain Education Interventions in the Chiropractic Setting: a Scoping Review","authors":"Samantha Pritty MS, DC , Kyle Schwartz DC , Christopher Farrell MS, DC , Jesse Anderson DC , Sheryl Walters MLS , Lindsay Rae DC","doi":"10.1016/j.jmpt.2025.10.028","DOIUrl":"10.1016/j.jmpt.2025.10.028","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this scoping review was to assess the literature on patient education and delivery methods utilized by chiropractors.</div></div><div><h3>Methods</h3><div>For this scoping review, we searched peer-reviewed and gray literature including all study designs except for commentaries and protocols, which pertained to patient education within the chiropractic setting. Studies that included pediatrics were excluded. A literature search was performed through PubMed, Index to Chiropractic Literature, CINAHL, and Cochrane Database of Systematic Reviews from journal inception to March 4, 2025. After extraction, findings were qualitatively analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>Of 2338 articles identified, 68 studies were eligible for thematic analysis. There was heterogeneity in the content and delivery methods of patient education. More lifestyle education reported than pain education. Predominately, education was delivered by direct instruction in a multimodal treatment approach.</div></div><div><h3>Conclusion</h3><div>Our literature findings suggest that chiropractors are utilizing pain education in addition to other patient education topics, such as lifestyle education, ergonomics/biomechanics, diagnosis/prognosis, and self-management strategies. Patient education is performed as part of a multimodal treatment approach within the chiropractic setting, primarily through direct instruction.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 895-903"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-11-09DOI: 10.1016/j.jmpt.2025.09.010
Nada G. Saad Mohamed BSC , Abeer A. Yamany PhD , Amr A. Azzam MD , Mariam O. Grase PhD
Objective
The purpose of this study was to investigate the effects of instrument-assisted soft tissue mobilization (IASTM) and lidocaine phonophoresis combined or separated on trigger points in patients with tension-type headache (TTH).
Methods
A double-blind randomized trial. A total of 60 participants with TTH were randomized into 4 equal groups. All groups received conventional treatment at the National Institute of Neuromotor System. Group A received conventional treatment only; group B received IASTM; group C received lidocaine phonophoresis; and group D received IASTM and phonophoresis. Visual analog scale (VAS), Arabic neck disability index (ANDI), headache frequency, and pressure pain threshold (PPT) were among the outcome measurements. All variables were measured before treatment and 4 weeks post-treatment.
Results
Within the group's analysis, multiple pairwise comparison tests revealed improvements at all measurement variables (P < .01) in all groups. Post-treatment, results showed a significant difference in groups D versus group A, groups B, and C with mean difference (MD) and 95% CI in VAS [3.18 (2.379-3.981), 1.133 (0.332-1.935), and 1.907 (1.105-2.708) respectively], ANDI [10.267 (8.382-12.151), 4.2 (2.316-6.084) 7 (5.116-8.884) respectively], headache frequency [1.9 (1.246-2.554), 0.8 (0.146-1.454), and 1.4 (0.764-2.054) respectively], and PPT. Additionally, there was a significant difference in all variables between group A and group B with MD in VAS, ANID, and headache frequency (2.047, 6.067, and 1.1 respectively) in favor of group B. Moreover, there was a statistically significant difference between group A and group C in VAS, ANDI, and PPT of left the suboccipital muscles on the side of group C. In group B versus group C, there was a statistically significant difference in ANDI and PPT of the left upper fibers of the trapezius muscles as P < .05 in favor of group B.
Conclusion
Both conventional treatments, IASTM, lidocaine phonophoresis, and the combination of IASTM and phonophoresis had statistically significant effects in relieving pain, increasing neck functional ability, decreasing headache frequency, and improving PPT in participants with TTP. Adding IASTM and lidocaine phonophoresis to conventional treatment was more effective than the other treatments.
{"title":"Effect of Instrument-Assisted Soft Tissue Mobilization Combined With Lidocaine Phonophoresis on Tension-Type Headache: A Randomized Clinical Trial","authors":"Nada G. Saad Mohamed BSC , Abeer A. Yamany PhD , Amr A. Azzam MD , Mariam O. Grase PhD","doi":"10.1016/j.jmpt.2025.09.010","DOIUrl":"10.1016/j.jmpt.2025.09.010","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to investigate the effects of instrument-assisted soft tissue mobilization (IASTM) and lidocaine phonophoresis combined or separated on trigger points in patients with tension-type headache (TTH).</div></div><div><h3>Methods</h3><div>A double-blind randomized trial. A total of 60 participants with TTH were randomized into 4 equal groups. All groups received conventional treatment at the National Institute of Neuromotor System. Group A received conventional treatment only; group B received IASTM; group C received lidocaine phonophoresis; and group D received IASTM and phonophoresis. Visual analog scale (VAS), Arabic neck disability index (ANDI), headache frequency, and pressure pain threshold (PPT) were among the outcome measurements. All variables were measured before treatment and 4 weeks post-treatment.</div></div><div><h3>Results</h3><div>Within the group's analysis, multiple pairwise comparison tests revealed improvements at all measurement variables (<em>P</em> < .01) in all groups. Post-treatment, results showed a significant difference in groups D versus group A, groups B, and C with mean difference (MD) and 95% CI in VAS [3.18 (2.379-3.981), 1.133 (0.332-1.935), and 1.907 (1.105-2.708) respectively], ANDI [10.267 (8.382-12.151), 4.2 (2.316-6.084) 7 (5.116-8.884) respectively], headache frequency [1.9 (1.246-2.554), 0.8 (0.146-1.454), and 1.4 (0.764-2.054) respectively], and PPT. Additionally, there was a significant difference in all variables between group A and group B with MD in VAS, ANID, and headache frequency (2.047, 6.067, and 1.1 respectively) in favor of group B. Moreover, there was a statistically significant difference between group A and group C in VAS, ANDI, and PPT of left the suboccipital muscles on the side of group C. In group B versus group C, there was a statistically significant difference in ANDI and PPT of the left upper fibers of the trapezius muscles as <em>P</em> < .05 in favor of group B.</div></div><div><h3>Conclusion</h3><div>Both conventional treatments, IASTM, lidocaine phonophoresis, and the combination of IASTM and phonophoresis had statistically significant effects in relieving pain, increasing neck functional ability, decreasing headache frequency, and improving PPT in participants with TTP. Adding IASTM and lidocaine phonophoresis to conventional treatment was more effective than the other treatments.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 643-655"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-11-11DOI: 10.1016/j.jmpt.2025.10.001
Braden G. Keil BAppSc (Chiropractic), MChiroSc (Paediatrics), FICC, FACCP, Christian J. Fludder BChiroSc, MChiropractic, DACCP
Objective
The purpose of this study was to record preload force, peak force, and time from preload to peak force used with 4 manipulation techniques in a simulated 3- to 4-month-old infant.
Methods
The project recorded 4 scenarios involving spinal manipulation applied to a mannequin comparable with a 3- to 4-month-old infant by 2 postgraduate trained and experienced practitioners and educators in pediatric spinal manipulation and mobilization. Results for preload force, peak force, time to peak, and rate of force application were determined.
Results
Preload force was less than 10 N in the majority of scenarios. Average peak force in 3 cervical spine scenarios ranged from 35.2 to 79.9 N. Sacral data recorded an average peak force of 34.9 to 41.2 N with a standard distribution of 3.6 to 7.1 N. The time to peak force recorded for the 4 scenarios were under 110 ms. The rate of force production for all but 1 scenario was in excess of 300 N/s. Intrapractitioner data analysis demonstrated peak forces were not significantly different across 3 scenarios, with interpractitioner data not significantly different across 2 scenarios.
Conclusion
Average peak forces recorded were similar to those previously reported. Time to peak recordings were typically under 100 ms and rate of force application above 300 N/s; within the optimal range for muscle spindle receptor and Golgi tendon organ activation. Further research into forces used across the pediatric age ranges is needed.
{"title":"Forces Recorded in Manual Therapy Techniques Applied to a Mannequin Simulating A 3- to 4-Month-Old Infant","authors":"Braden G. Keil BAppSc (Chiropractic), MChiroSc (Paediatrics), FICC, FACCP, Christian J. Fludder BChiroSc, MChiropractic, DACCP","doi":"10.1016/j.jmpt.2025.10.001","DOIUrl":"10.1016/j.jmpt.2025.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to record preload force, peak force, and time from preload to peak force used with 4 manipulation techniques in a simulated 3- to 4-month-old infant.</div></div><div><h3>Methods</h3><div>The project recorded 4 scenarios involving spinal manipulation applied to a mannequin comparable with a 3- to 4-month-old infant by 2 postgraduate trained and experienced practitioners and educators in pediatric spinal manipulation and mobilization. Results for preload force, peak force, time to peak, and rate of force application were determined.</div></div><div><h3>Results</h3><div>Preload force was less than 10 N in the majority of scenarios. Average peak force in 3 cervical spine scenarios ranged from 35.2 to 79.9 N. Sacral data recorded an average peak force of 34.9 to 41.2 N with a standard distribution of 3.6 to 7.1 N. The time to peak force recorded for the 4 scenarios were under 110 ms. The rate of force production for all but 1 scenario was in excess of 300 N/s. Intrapractitioner data analysis demonstrated peak forces were not significantly different across 3 scenarios, with interpractitioner data not significantly different across 2 scenarios.</div></div><div><h3>Conclusion</h3><div>Average peak forces recorded were similar to those previously reported. Time to peak recordings were typically under 100 ms and rate of force application above 300 N/s; within the optimal range for muscle spindle receptor and Golgi tendon organ activation. Further research into forces used across the pediatric age ranges is needed.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 689-697"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-11-11DOI: 10.1016/j.jmpt.2025.10.027
Deeksha Devadiga BPT , Rajasekar Sannasi PhD , Prajna D. Rao MPT , Hareesh H. Keshavmurthy BPT , Jan Dommerholt DPT , Shine Thomas MPT
Objective
The purpose of this study was to determine the association between trigger points (TrPs) in the sternocleidomastoid (SCM) and upper trapezius (UT) muscles and primary headaches.
Methods
A total of 60 participants (25 males and 35 females) were included in this cross-sectional study and divided into 2 groups based on the presence or absence of a primary headache, as determined by the Headache Impact Test. Both the bilateral SCM and UT muscles were palpated to assess the presence of TrPs.
Results
The results showed a significant association between TrPs in the SCM and headaches (right SCM: χ2 value = 6.696, P < .010, phi [φ] = 0.334; left SCM: χ2 value = 8.076, P < .004, phi [φ] = 0.367). The UT TrPs did not show a strong association with headaches (right UT: χ2 value = 2.857, P < .091, phi [φ] = 0.218; left UT: χ2 value = 3.455, P < .063, phi [φ] = 0.240).
Conclusion
There was a strong association between SCM TrPs and symptomatic headaches and a weak association between UT TrPs and symptomatic headaches.
{"title":"Association Between Sternocleidomastoid and Upper Trapezius Muscle Trigger Points and Headaches: A Cross-Sectional Study","authors":"Deeksha Devadiga BPT , Rajasekar Sannasi PhD , Prajna D. Rao MPT , Hareesh H. Keshavmurthy BPT , Jan Dommerholt DPT , Shine Thomas MPT","doi":"10.1016/j.jmpt.2025.10.027","DOIUrl":"10.1016/j.jmpt.2025.10.027","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to determine the association between trigger points (TrPs) in the sternocleidomastoid (SCM) and upper trapezius (UT) muscles and primary headaches.</div></div><div><h3>Methods</h3><div>A total of 60 participants (25 males and 35 females) were included in this cross-sectional study and divided into 2 groups based on the presence or absence of a primary headache, as determined by the Headache Impact Test. Both the bilateral SCM and UT muscles were palpated to assess the presence of TrPs.</div></div><div><h3>Results</h3><div>The results showed a significant association between TrPs in the SCM and headaches (right SCM: χ<sup>2</sup> value = 6.696, <em>P</em> < .010, phi [φ] = 0.334; left SCM: χ<sup>2</sup> value = 8.076, <em>P</em> < .004, phi [φ] = 0.367). The UT TrPs did not show a strong association with headaches (right UT: χ<sup>2</sup> value = 2.857, <em>P</em> < .091, phi [φ] = 0.218; left UT: χ<sup>2</sup> value = 3.455, <em>P</em> < .063, phi [φ] = 0.240).</div></div><div><h3>Conclusion</h3><div>There was a strong association between SCM TrPs and symptomatic headaches and a weak association between UT TrPs and symptomatic headaches.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 683-688"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-12-19DOI: 10.1016/S0161-4754(25)00129-0
{"title":"Inside front cover Editorial board","authors":"","doi":"10.1016/S0161-4754(25)00129-0","DOIUrl":"10.1016/S0161-4754(25)00129-0","url":null,"abstract":"","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Page IFC"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to assess the reliability and construct validity of the Turkish version of the Atroshi–Lyrén 6-Item carpal tunnel syndrome (CTS) Symptoms Scale (A–L Scale-Tr) and to examine its associations with patient-reported outcome measures, including the Boston Carpal Tunnel Questionnaire (BCTQ) and Quick Disability of the Arm, Shoulder and Hand (QuickDASH).
Methods
A forward-backward translation procedure was performed following international guidelines. Sixty-two patients with unilateral CTS were invited to complete the A–L Scale-Tr. The test-retest reliability, convergent, and discriminant validity were evaluated.
Results
The A–L Scale-Tr revealed high values of internal consistency (Cronbach’s alpha = 0.854), and test-retest reliability (ICC = 0.96, 95% CI = 0.93-0.98). In the A–L Scale-Tr the factor structure was found optimal and explained 58.39% of the variance. The validity analysis showed strong correlation with night pain (r = 0.821), moderate correlation with BCTQ Symptoms Severity Scale (r = 0.564) and BCTQ Functional Status Scale (r = 0.453), QuickDASH (r = 0.474), pain at rest (r = 0.557), and pain at activity (r = 0.497) (P < .001).
Conclusions
It was found that the A–L Scale-Tr has good reliability and construct validity for symptom severity assessment in CTS. The A–L scale will be useful to clinicians and researchers in Turkish patients.
{"title":"Reliability and Validity of the Turkish Version of the Atroshi–Lyrén 6-Item CTS Symptoms Scale in Unilateral Carpal Tunnel Syndrome","authors":"Abdurrahman Tanhan PhD, PT , Tülay Çevik Saldıran PhD, PT , İlke Kara Öz MSc, PT , Berra Özberk Pamuk MD","doi":"10.1016/j.jmpt.2025.10.049","DOIUrl":"10.1016/j.jmpt.2025.10.049","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the reliability and construct validity of the Turkish version of the Atroshi–Lyrén 6-Item carpal tunnel syndrome (CTS) Symptoms Scale (A–L Scale-Tr) and to examine its associations with patient-reported outcome measures, including the Boston Carpal Tunnel Questionnaire (BCTQ) and Quick Disability of the Arm, Shoulder and Hand <strong>(</strong>QuickDASH).</div></div><div><h3>Methods</h3><div>A forward-backward translation procedure was performed following international guidelines. Sixty-two patients with unilateral CTS were invited to complete the A–L Scale-Tr. The test-retest reliability, convergent, and discriminant validity were evaluated.</div></div><div><h3>Results</h3><div>The A–L Scale-Tr revealed high values of internal consistency (Cronbach’s alpha = 0.854), and test-retest reliability (ICC = 0.96, 95% CI = 0.93-0.98). In the A–L Scale-Tr the factor structure was found optimal and explained 58.39% of the variance. The validity analysis showed strong correlation with night pain (r = 0.821), moderate correlation with BCTQ Symptoms Severity Scale (r = 0.564) and BCTQ Functional Status Scale (r = 0.453), QuickDASH (r = 0.474), pain at rest (r = 0.557), and pain at activity (r = 0.497) (<em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>It was found that the A–L Scale-Tr has good reliability and construct validity for symptom severity assessment in CTS. The A–L scale will be useful to clinicians and researchers in Turkish patients.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 844-852"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-11-15DOI: 10.1016/j.jmpt.2025.10.025
Salah Eid Ahmed MSc , Ayman Shfei PhD , Soheir Rezkalla PhD , Alshaymaa Shaaban Abd El-Azeim PhD
Objective
The purpose of this study was to examine the effect of adding cervical stability training (CST) to a battery of treatment modalities on somatosensory evoked potential (SSEP) in patients with forward head (FHP) and chronic mechanical neck pain (CMNP).
Methods
Sixty patients with FHP and CMNP were randomized into 2 groups: Group A (study group) was subjected to CST and a battery of treatment modalities, whereas Group B (traditional group) underwent a battery of treatment modalities alone. Treatment was applied 3 sessions per week for 8 successive weeks. The primary outcomes were SSEP and craniovertebral angle (CVA). The secondary outcomes were visual analog scale for pain intensity, Neck Disability Index Arabic version for functional disability, an endurance test for neck flexor and extensor muscles, craniocervical flexion test for deep cervical flexor muscles activation, lateral radiographs using the posterior tangent method for cervical lordotic curvatures, and a phone application clinometer for cervical range of motion.
Results
The findings demonstrated short-term statistically significant differences (P < .05) at posttreatment between the study and traditional treatment groups in favor of the study group. The mean difference and 95% CI between both groups in SSEP and CVA = 1.83 (1.63, 2.03) and 7.37 (6.49, 8.25), respectively.
Conclusion
For patients with chronic neck pain, CST exercises plus a battery of treatment modalities exhibited a greater effect on primary and secondary outcomes than the battery of treatment modalities alone.
{"title":"Effect of Including Cervical Stability Training with Treatment Modalities for Patients with Forward Head Posture and Chronic Neck Pain: a Randomized Trial","authors":"Salah Eid Ahmed MSc , Ayman Shfei PhD , Soheir Rezkalla PhD , Alshaymaa Shaaban Abd El-Azeim PhD","doi":"10.1016/j.jmpt.2025.10.025","DOIUrl":"10.1016/j.jmpt.2025.10.025","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to examine the effect of adding cervical stability training (CST) to a battery of treatment modalities on somatosensory evoked potential (SSEP) in patients with forward head (FHP) and chronic mechanical neck pain (CMNP).</div></div><div><h3>Methods</h3><div>Sixty patients with FHP and CMNP were randomized into 2 groups: Group A (study group) was subjected to CST and a battery of treatment modalities, whereas Group B (traditional group) underwent a battery of treatment modalities alone. Treatment was applied 3 sessions per week for 8 successive weeks. The primary outcomes were SSEP and craniovertebral angle (CVA). The secondary outcomes were visual analog scale for pain intensity, Neck Disability Index Arabic version for functional disability, an endurance test for neck flexor and extensor muscles, craniocervical flexion test for deep cervical flexor muscles activation, lateral radiographs using the posterior tangent method for cervical lordotic curvatures, and a phone application clinometer for cervical range of motion.</div></div><div><h3>Results</h3><div>The findings demonstrated short-term statistically significant differences (<em>P</em> < .05) at posttreatment between the study and traditional treatment groups in favor of the study group. The mean difference and 95% CI between both groups in SSEP and CVA = 1.83 (1.63, 2.03) and 7.37 (6.49, 8.25), respectively.</div></div><div><h3>Conclusion</h3><div>For patients with chronic neck pain, CST exercises plus a battery of treatment modalities exhibited a greater effect on primary and secondary outcomes than the battery of treatment modalities alone.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 882-894"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01Epub Date: 2025-11-09DOI: 10.1016/j.jmpt.2025.10.045
Yuxin He MEd , Zhikai Qin PhD , Huan Niu MEd , Fei Gao PhD , Qing Liu MEd , Jialong Bu MEd , Junsheng Wang PhD
Objective
The purpose of this study was to evaluate the effect of 9 types of exercise interventions on gait performance in stroke patients.
Methods
The methodology involved conducting computerized searches of databases such as PubMed, The Cochrane Library, Embase, and Web of Science to collect relevant literature on improving gait performance in stroke patients. The search period spanned from January 2000 to March 2024. After screening and extracting data from the literature, the quality of the studies was assessed using the Cochrane Handbook. Data analysis was done using Review Manager 5.4 and STATA software.
Results
The analysis included 32 studies with 1181 participants aged 18 or older. Results from network meta-analysis indicated that Task-Oriented Training substantially improved gait performance in stroke patients (84.2%), followed by Action observational training (76.3%), Walking intervention (65.4%), Cycling training (63.2%), High-intensity interval training (52.8%), Treadmill training (50.8%), Multicomponent exercise (41.7%), Balance training (39.8%), and Virtual reality training (VRT) (15.2%).
Conclusions
The study findings suggested that Task-oriented training was the most substantial improvement in gait ability among the 9 therapies, followed by action observational training and walking intervention.
目的：评价9种运动干预对脑卒中患者步态表现的影响。方法：通过计算机检索PubMed、The Cochrane Library、Embase、Web of Science等数据库，收集改善脑卒中患者步态表现的相关文献。搜索期从2000年1月到2024年3月。从文献中筛选和提取数据后，使用Cochrane手册评估研究的质量。使用Review Manager 5.4和STATA软件进行数据分析。结果：该分析包括32项研究，1181名18岁及以上的参与者。网络荟萃分析结果显示，任务导向训练显著改善脑卒中患者的步态表现（84.2%），其次是动作观察训练（76.3%）、步行干预（65.4%）、自行车训练（63.2%）、高强度间歇训练（52.8%）、跑步机训练（50.8%）、多成分训练（41.7%）、平衡训练（39.8%）和虚拟现实训练（15.2%）。结论：研究结果表明，在9种治疗方法中，任务导向训练对步态能力的改善最为显著，其次是动作观察训练和步行干预。
{"title":"Effect of Different Exercises on the Gait Ability of Stroke Patients: A Network Meta-Analysis","authors":"Yuxin He MEd , Zhikai Qin PhD , Huan Niu MEd , Fei Gao PhD , Qing Liu MEd , Jialong Bu MEd , Junsheng Wang PhD","doi":"10.1016/j.jmpt.2025.10.045","DOIUrl":"10.1016/j.jmpt.2025.10.045","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the effect of 9 types of exercise interventions on gait performance in stroke patients.</div></div><div><h3>Methods</h3><div>The methodology involved conducting computerized searches of databases such as PubMed, The Cochrane Library, Embase, and Web of Science to collect relevant literature on improving gait performance in stroke patients. The search period spanned from January 2000 to March 2024. After screening and extracting data from the literature, the quality of the studies was assessed using the Cochrane Handbook. Data analysis was done using Review Manager 5.4 and STATA software.</div></div><div><h3>Results</h3><div>The analysis included 32 studies with 1181 participants aged 18 or older. Results from network meta-analysis indicated that Task-Oriented Training substantially improved gait performance in stroke patients (84.2%), followed by Action observational training (76.3%), Walking intervention (65.4%), Cycling training (63.2%), High-intensity interval training (52.8%), Treadmill training (50.8%), Multicomponent exercise (41.7%), Balance training (39.8%), and Virtual reality training (VRT) (15.2%).</div></div><div><h3>Conclusions</h3><div>The study findings suggested that Task-oriented training was the most substantial improvement in gait ability among the 9 therapies, followed by action observational training and walking intervention.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 631-642"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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