Pub Date : 2025-07-01DOI: 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}
Pub Date : 2025-07-01DOI: 10.1016/j.jmpt.2025.10.055
Irene Torres-Sánchez PhD , Andrea Ramírez-Zafra MSc , Elisabet Rueda-García MSc , Irene Cabrera-Martos PhD , Esther Díaz-Mohedo PhD
Objective
The aim of this study was to analyze the effects of manual therapy techniques on adults with functional constipation (FC).
Methods
Four databases (CINAHL, PubMed, Scopus and Web of Science) were searched up to May 2025. Inclusion criteria were defined following PICOS recommendations. Methodological quality was assessed with the Downs and Black scale, and the risk of bias was evaluated with the Cochrane risk of bias assessment tool. The meta-analysis was performed using RevMan 5.4 software.
Results
Fifteen randomized clinical trials with a total of 859 patients were included in the systematic review and eleven were included in the meta-analysis. Manual therapy compared to no manual therapy significantly improved constipation severity, constipation status, quality of life (QOL), defecation frequency, and defecation duration. In addition, abdominal massage compared to no manual therapy significantly improved constipation severity. Manual therapy, compared to a control intervention, significantly improved constipation severity. Manual therapy applied alone or combined with another treatment showed significant differences compared to no manual therapy.
Conclusion
Manual therapy, compared to no manual therapy, significantly improved constipation severity and status, QOL and defecation frequency and duration in adults with FC without any other pathology. In addition, abdominal massage compared to no manual therapy and manual therapy compared to a control group also significantly improved constipation severity. Similar significant differences were also found in favor of manual therapy when it was applied alone or combined with another treatment. High heterogeneity between studies affected the consistency of results, therefore these findings should be considered with caution.
目的：本研究的目的是分析手工治疗技术对成人功能性便秘（FC）的影响。方法：检索截至2025年5月的4个数据库（CINAHL、PubMed、Scopus和Web of Science）。纳入标准根据PICOS推荐定义。采用Downs和Black量表评估方法学质量，采用Cochrane偏倚风险评估工具评估偏倚风险。meta分析采用RevMan 5.4软件进行。结果：系统评价纳入15项随机临床试验，共纳入859例患者，meta分析纳入11项试验。与无手工治疗相比，手工治疗可显著改善便秘严重程度、便秘状态、生活质量（QOL）、排便频率和排便时间。此外，腹部按摩与没有手工治疗相比，明显改善便秘的严重程度。与对照组干预相比，手工疗法显著改善了便秘的严重程度。手工疗法单独应用或与另一种治疗相结合，与无手工疗法相比有显著差异。结论：与不进行手工治疗相比，手工治疗可显著改善无其他病理的成年FC患者的便秘严重程度和状态、生活质量、排便次数和持续时间。此外，腹部按摩组相比无推拿治疗组和有推拿治疗组相比便秘严重程度也有明显改善。当手工疗法单独应用或与另一种疗法联合使用时，也发现了类似的显著差异。研究之间的高度异质性影响了结果的一致性，因此这些发现应谨慎考虑。
{"title":"Effects of Manual Therapy on Patients with Functional Constipation: Systematic Review and Meta-analysis of Randomized Clinical Trials","authors":"Irene Torres-Sánchez PhD , Andrea Ramírez-Zafra MSc , Elisabet Rueda-García MSc , Irene Cabrera-Martos PhD , Esther Díaz-Mohedo PhD","doi":"10.1016/j.jmpt.2025.10.055","DOIUrl":"10.1016/j.jmpt.2025.10.055","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to analyze the effects of manual therapy techniques on adults with functional constipation (FC).</div></div><div><h3>Methods</h3><div>Four databases (CINAHL, PubMed, Scopus and Web of Science) were searched up to May 2025. Inclusion criteria were defined following PICOS recommendations. Methodological quality was assessed with the Downs and Black scale, and the risk of bias was evaluated with the Cochrane risk of bias assessment tool. The meta-analysis was performed using RevMan 5.4 software.</div></div><div><h3>Results</h3><div>Fifteen randomized clinical trials with a total of 859 patients were included in the systematic review and eleven were included in the meta-analysis. Manual therapy compared to no manual therapy significantly improved constipation severity, constipation status, quality of life (QOL), defecation frequency, and defecation duration. In addition, abdominal massage compared to no manual therapy significantly improved constipation severity. Manual therapy, compared to a control intervention, significantly improved constipation severity. Manual therapy applied alone or combined with another treatment showed significant differences compared to no manual therapy.</div></div><div><h3>Conclusion</h3><div>Manual therapy, compared to no manual therapy, significantly improved constipation severity and status, QOL and defecation frequency and duration in adults with FC without any other pathology. In addition, abdominal massage compared to no manual therapy and manual therapy compared to a control group also significantly improved constipation severity. Similar significant differences were also found in favor of manual therapy when it was applied alone or combined with another treatment. High heterogeneity between studies affected the consistency of results, therefore these findings should be considered with caution.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 712-723"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495762","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 : 2025-07-01DOI: 10.1016/j.jmpt.2025.10.015
Júlia Lacet Silva Ferreira MSc , Silvana Cristina de Araújo Pereira Venceslau MSc , Ronny Marcos de Morais PT , Rayanne Kethleen do Nascimento Silva MSc , Heleodório Honorato dos Santos PhD , José Jamacy de Almeida Ferreira PhD , Palloma Rodrigues de Andrade PhD
Objective
This study aimed to compare short-term effects of low-level laser therapy and far-infrared radiation on pain intensity, pressure-induced pain, and skin temperature of the trapezius muscle of individuals with subacute and chronic neck pain.
Methods
A randomized, sham-controlled, superiority clinical trial with 3 parallel arms and blind evaluator was performed. Ninety-one individuals were treated with phototherapy for subacute and chronic neck pain. Pain intensity was assessed using visual analog scale. Pressure-induced pain was assessed using a pressure dynamometer. Skin temperature of the trapezius region was evaluated with infrared thermography. Individuals were evaluated before (T0), immediately after (T1), 10 minutes (T2), 20 minutes (T3), and 48 hours (T4) after 1 session of phototherapy. Individuals were randomly allocated into 3 groups: (1) laser therapy (GLAS), punctual laser application (808 nm, 0.5 J/cm², power of 10 mW); (2) infrared (GINF), application at 30 cm and incidence angle of 90° for 30 minutes; (3) sham (GSHAM), simulated punctual laser. Mixed linear models were performed using group, time, and group-versus-time interaction, considering a first-order automatic covariance matrix.
Results
Pain intensity reduced in intragroup analysis among all evaluation times (P < .05), but not intergroup. Pressure-induced pain was not altered. There was increased skin temperature with infrared at T1 and T2 compared with laser therapy and sham (P < .05).
Conclusions
A single application of low-level or infrared laser therapy was not effective in the short term for subacute and chronic neck pain and did not change skin temperature in trapezius region.
{"title":"Single Application of Low-Level or Infrared Laser Therapy Not Effective in the Short Term for Neck Pain: A Randomized Controlled Clinical Trial","authors":"Júlia Lacet Silva Ferreira MSc , Silvana Cristina de Araújo Pereira Venceslau MSc , Ronny Marcos de Morais PT , Rayanne Kethleen do Nascimento Silva MSc , Heleodório Honorato dos Santos PhD , José Jamacy de Almeida Ferreira PhD , Palloma Rodrigues de Andrade PhD","doi":"10.1016/j.jmpt.2025.10.015","DOIUrl":"10.1016/j.jmpt.2025.10.015","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to compare short-term effects of low-level laser therapy and far-infrared radiation on pain intensity, pressure-induced pain, and skin temperature of the trapezius muscle of individuals with subacute and chronic neck pain.</div></div><div><h3>Methods</h3><div>A randomized, sham-controlled, superiority clinical trial with 3 parallel arms and blind evaluator was performed. Ninety-one individuals were treated with phototherapy for subacute and chronic neck pain. Pain intensity was assessed using visual analog scale. Pressure-induced pain was assessed using a pressure dynamometer. Skin temperature of the trapezius region was evaluated with infrared thermography. Individuals were evaluated before (T0), immediately after (T1), 10 minutes (T2), 20 minutes (T3), and 48 hours (T4) after 1 session of phototherapy. Individuals were randomly allocated into 3 groups: (1) laser therapy (GLAS), punctual laser application (808 nm, 0.5 J/cm², power of 10 mW); (2) infrared (GINF), application at 30 cm and incidence angle of 90° for 30 minutes; (3) sham (GSHAM), simulated punctual laser. Mixed linear models were performed using group, time, and group-versus-time interaction, considering a first-order automatic covariance matrix.</div></div><div><h3>Results</h3><div>Pain intensity reduced in intragroup analysis among all evaluation times (<em>P</em> < .05), but not intergroup. Pressure-induced pain was not altered. There was increased skin temperature with infrared at T1 and T2 compared with laser therapy and sham (<em>P</em> < .05).</div></div><div><h3>Conclusions</h3><div>A single application of low-level or infrared laser therapy was not effective in the short term for subacute and chronic neck pain and did not change skin temperature in trapezius region.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 742-749"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495796","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 investigate the intra and inter-rater reliability, standard error of measurement (SEM) and the smallest detectable change (SDC) of the tests recommended by Osteoarthritis Research Society International (OARSI) for patients with symptomatic knee osteoarthritis (KOA).
Methods
Thirty participants with KOA were evaluated by 3 raters in 2 sessions with 1 week interval. Intra-rater and inter-rater reliability were calculated using the intraclass correlation coefficient (ICC) for the following tests: 30s Chair Stand Test (30sCST),40m Fast Paced Walk Test (40mFPWT), and 11-Step Climb Test (11-step SCT). The SEM and SDC were calculated for all the tests.
Results
The inter-rater reliability was excellent (ICC > 0.90) for the 40mFPWT, 11-step SCT and moderate reliability (ICC > 0.70) for the 30s CST. The intra-rater reliability was excellent (ICC>0.90) for the 40m FPWT, 11-step SCT and moderate (ICC > 0.70) for the 30s CST. The inter-rater SEM and SDC, respectively, were 1.2 and 3.3 for the 30s CST, 2.5 and 7.0 for the 40m FPWT, 4.5 and 12.6 for the 11-step SCT. The intra-rater SEM and SDC were calculated for all the tests.
Conclusion
The core set minimum of functional tests recommended by OARSI is reliable and demonstrates acceptable measurement error indicating they are appropriate to detect real change over assessments in individuals with knee osteoarthritis.
{"title":"Reliability, Standard Error of Measurement, and Smallest Detectable Change of the Recommended Tests by the Osteoarthritis Research Society International in People With Knee Osteoarthritis","authors":"Rebecca Bianca Ramalho MSc, Vinicius Bianquini Viterbo Montilha PT, Natalia Aparecida Casonato MSc, Stela Marcia Mattiello PhD, Luiz Fernando Approbato Selistre PhD","doi":"10.1016/j.jmpt.2025.10.024","DOIUrl":"10.1016/j.jmpt.2025.10.024","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to investigate the intra and inter-rater reliability, standard error of measurement (SEM) and the smallest detectable change (SDC) of the tests recommended by Osteoarthritis Research Society International (OARSI) for patients with symptomatic knee osteoarthritis (KOA).</div></div><div><h3>Methods</h3><div>Thirty participants with KOA were evaluated by 3 raters in 2 sessions with 1 week interval. Intra-rater and inter-rater reliability were calculated using the intraclass correlation coefficient (ICC) for the following tests: 30s Chair Stand Test (30sCST),40m Fast Paced Walk Test (40mFPWT), and 11-Step Climb Test (11-step SCT). The SEM and SDC were calculated for all the tests.</div></div><div><h3>Results</h3><div>The inter-rater reliability was excellent (ICC > 0.90) for the 40mFPWT, 11-step SCT and moderate reliability (ICC > 0.70) for the 30s CST. The intra-rater reliability was excellent (ICC>0.90) for the 40m FPWT, 11-step SCT and moderate (ICC > 0.70) for the 30s CST. The inter-rater SEM and SDC, respectively, were 1.2 and 3.3 for the 30s CST, 2.5 and 7.0 for the 40m FPWT, 4.5 and 12.6 for the 11-step SCT. The intra-rater SEM and SDC were calculated for all the tests.</div></div><div><h3>Conclusion</h3><div>The core set minimum of functional tests recommended by OARSI is reliable and demonstrates acceptable measurement error indicating they are appropriate to detect real change over assessments in individuals with knee osteoarthritis.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 706-711"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495781","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 : 2025-07-01DOI: 10.1016/j.jmpt.2025.10.060
Maryam Hajian MD , Shahram Mohaghegh MD
Objective
The purpose of this study was to compare the dynamic balance at different knee flexion angles (maximal knee flexion angles of 30° and 45°) on a 20% negative slope.
Methods
In an observational cross-sectional study, 19 healthy male participants performed a modified Star Excursion Balance Test on a 20% negative slope, whereas the left standing knee was restricted by a knee brace in a maximum of 30° or 45° flexion.
Results
The balance scores were significantly better in 45° knee flexion compared with 30° flexion in the composite reach and also in the percentage of reach in any of the test directions.
Conclusion
On a 20% negative slope, 45° knee flexion resulted in better dynamic balance than 30° knee flexion.
{"title":"Comparison of Knee Flexion Angles for Maintaining Dynamic Balance on Negative Slopes: A Guide for Improving Postural Stability in Mountain Climbing and Downhill Walking","authors":"Maryam Hajian MD , Shahram Mohaghegh MD","doi":"10.1016/j.jmpt.2025.10.060","DOIUrl":"10.1016/j.jmpt.2025.10.060","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to compare the dynamic balance at different knee flexion angles (maximal knee flexion angles of 30° and 45°) on a 20% negative slope.</div></div><div><h3>Methods</h3><div>In an observational cross-sectional study, 19 healthy male participants performed a modified Star Excursion Balance Test on a 20% negative slope, whereas the left standing knee was restricted by a knee brace in a maximum of 30° or 45° flexion.</div></div><div><h3>Results</h3><div>The balance scores were significantly better in 45° knee flexion compared with 30° flexion in the composite reach and also in the percentage of reach in any of the test directions.</div></div><div><h3>Conclusion</h3><div>On a 20% negative slope, 45° knee flexion resulted in better dynamic balance than 30° knee flexion.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 656-661"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489110","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 : 2025-07-01DOI: 10.1016/j.jmpt.2025.10.022
Paula Fernanda Sávio Ribeiro MSc , Adriane A. Alves MSc , Marcos Amaral de Noronha PhD , Luiz Fernando Approbato Selistre PhD
Objective
The purpose of this systematic review was to determine the effect of manual therapy techniques on pain processing in individuals with knee osteoarthritis (KOA).
Methods
: We conducted a comprehensive search across electronic databases through June 2023, including CENTRAL, Medline, Embase, CINAHL, and PEDro. Only randomized controlled trials were considered, and methodological quality was evaluated using the Physiotherapy Evidence Database (PEDro) scale.
Results
Four studies met the inclusion criteria and underwent full reading and critical analysis. The methodological quality of these studies was rated from good to excellent. Two of 4 studies showed favorable results for manual therapy. Pain processing was assessed using pressure pain threshold, but the results of the included studies were inconclusive, failing to demonstrate a significant change in pressure pain threshold due to manual therapy techniques.
Conclusion
The limited number of studies and substantial variation in techniques used may have contributed to the lack of positive outcomes and therefore the findings are limited. No studies investigated alternative forms of pain processing beyond pressure pain threshold.
{"title":"Effect of Manual Therapy on Pain Processing in People With Knee Osteoarthritis:A Systematic Review","authors":"Paula Fernanda Sávio Ribeiro MSc , Adriane A. Alves MSc , Marcos Amaral de Noronha PhD , Luiz Fernando Approbato Selistre PhD","doi":"10.1016/j.jmpt.2025.10.022","DOIUrl":"10.1016/j.jmpt.2025.10.022","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this systematic review was to determine the effect of manual therapy techniques on pain processing in individuals with knee osteoarthritis (KOA).</div></div><div><h3>Methods</h3><div><strong>:</strong> We conducted a comprehensive search across electronic databases through June 2023, including CENTRAL, Medline, Embase, CINAHL, and PEDro. Only randomized controlled trials were considered, and methodological quality was evaluated using the Physiotherapy Evidence Database (PEDro) scale.</div></div><div><h3>Results</h3><div>Four studies met the inclusion criteria and underwent full reading and critical analysis. The methodological quality of these studies was rated from good to excellent. Two of 4 studies showed favorable results for manual therapy. Pain processing was assessed using pressure pain threshold, but the results of the included studies were inconclusive, failing to demonstrate a significant change in pressure pain threshold due to manual therapy techniques.</div></div><div><h3>Conclusion</h3><div>The limited number of studies and substantial variation in techniques used may have contributed to the lack of positive outcomes and therefore the findings are limited. No studies investigated alternative forms of pain processing beyond pressure pain threshold.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 724-732"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495705","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 establish the effect of core stabilization exercises applied face-to-face (FTF) and with telerehabilitation (TR) on core muscle thickness, functional capacity, back-related performance, and quality of life in asymptomatic individuals.
Method
In this randomized trial, 54 asymptomatic individuals were included in the study. FTF and TR groups performed core stabilization exercises 3 days a week for 8 weeks. Core muscle thickness was assessed by ultrasound imaging; functional capacity was assessed with repetitive side reaching, overhead lifting, and overhead working tests; back performance was assessed with the back performance scale (BPS); and quality of life was assessed with the SF-36 questionnaire.
Results
Following the core stabilization exercise program, the thickness of the right and left Transversus Abdominis muscles—measured at rest and during contraction and the thickness of the Internal Oblique muscle increased in both groups; however, the increases in Transversus Abdominis thickness at both resting and during contraction, were significantly greater in the FTF group compared with the TR group (P < .005). The improvement in the overhead working test (P = .02, effect size [ES] = 0.33) and back performance scale (BPS) score (P = .00, ES = 0.39) was greater in the FTF group compared with the TR group.
Conclusion
Core stabilization exercises provided improvements in core muscle thickness, functional capacity, back-related performance, and quality of life in asymptomatic individuals. Improvements in these parameters might inform future research investigating the prevention of low back pain with therapeutic exercise. In addition, this study demonstrated that core stabilization exercises can be implemented via TR as an alternative to FTF interventions.
{"title":"Effect of Telerehabilitation-Based and Face-to-Face Core Stabilization Exercises on Core Muscle Thickness and Functional Capacity in Asymptomatic Individuals: A Randomized Trial","authors":"Yasemin Özel Aslıyüce PT, MSc , MerveKaşıkcı MSc , Erkan Demirci MD , Egemen Turhan MD , Özlem Ülger PT, PhD","doi":"10.1016/j.jmpt.2025.10.044","DOIUrl":"10.1016/j.jmpt.2025.10.044","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to establish the effect of core stabilization exercises applied face-to-face (FTF) and with telerehabilitation (TR) on core muscle thickness, functional capacity, back-related performance, and quality of life in asymptomatic individuals.</div></div><div><h3>Method</h3><div>In this randomized trial, 54 asymptomatic individuals were included in the study. FTF and TR groups performed core stabilization exercises 3 days a week for 8 weeks. Core muscle thickness was assessed by ultrasound imaging; functional capacity was assessed with repetitive side reaching, overhead lifting, and overhead working tests; back performance was assessed with the back performance scale (BPS); and quality of life was assessed with the SF-36 questionnaire.</div></div><div><h3>Results</h3><div>Following the core stabilization exercise program, the thickness of the right and left Transversus Abdominis muscles—measured at rest and during contraction and the thickness of the Internal Oblique muscle increased in both groups; however, the increases in Transversus Abdominis thickness at both resting and during contraction, were significantly greater in the FTF group compared with the TR group (<em>P</em> < .005). The improvement in the overhead working test (<em>P</em> = .02, effect size [ES] = 0.33) and back performance scale (BPS) score (<em>P</em> = .00, ES = 0.39) was greater in the FTF group compared with the TR group.</div></div><div><h3>Conclusion</h3><div>Core stabilization exercises provided improvements in core muscle thickness, functional capacity, back-related performance, and quality of life in asymptomatic individuals. Improvements in these parameters might inform future research investigating the prevention of low back pain with therapeutic exercise. In addition, this study demonstrated that core stabilization exercises can be implemented via TR as an alternative to FTF interventions.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 820-832"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145505105","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 : 2025-07-01DOI: 10.1016/j.jmpt.2025.11.002
Carla Vanti PT, MSc , Silvano Ferrari PT , Francesco Marinelli PhD , Giulia Cappello PT , Vincenzo Corvasce PT , Francesco Girardi PT , Andrew A. Guccione MSPT, MSc, PhD , Paolo Pillastrini PT, MSc
Objective
This study aimed to examine the responsiveness of bridge maneuvers in subjects with low back pain (LBP) with respect to these outcomes.
Methods
One hundred and thirty-nine patients with subacute and chronic LBP participated in a physical therapy program averaging 7.46 sessions of supervised exercises and home exercises to improve lumbar stability. At the beginning of the program and after the last session, participants completed the Oswestry Disability Index (ODI-I) and the Pain Numerical Rating Scale (NRS), and performed Supine Bridge test (SBT), Right Side Bridge Test (RBT), Left Side Bridge Test (LBT), and Prone Bridge Test (PBT). Global perception of effectiveness was measured with a 7-point Global Perceived Effect Questionnaire.
Results
The optimal cutoff points were approximately 38.5 seconds for the Prone Bridge Test (PBT), (44% sensitivity; 78% specificity), 29.5 seconds for the RBT (55% sensitivity; 67% specificity), and 142 seconds for the SBT (45% sensitivity; 67% specificity). The areas under curves ranged from 0.56 (SBT) to 0.61 (PBT and RBT). Low to moderate significant relationships (p < .01) among bridge maneuvers, pain and disability (−0.23 to −0.39) and high correlations among each bridge maneuver and each other (0.69-0.81) emerged.
Conclusion
Although bridge maneuvers were responsive to changes in lumbar stability and correlated significantly with pain and disability, these measures were not sufficiently sensitive or specific at baseline to predict these outcomes.
{"title":"Bridge Maneuvers in Low Back Pain: Assessment of Internal and External Responsiveness","authors":"Carla Vanti PT, MSc , Silvano Ferrari PT , Francesco Marinelli PhD , Giulia Cappello PT , Vincenzo Corvasce PT , Francesco Girardi PT , Andrew A. Guccione MSPT, MSc, PhD , Paolo Pillastrini PT, MSc","doi":"10.1016/j.jmpt.2025.11.002","DOIUrl":"10.1016/j.jmpt.2025.11.002","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to examine the responsiveness of bridge maneuvers in subjects with low back pain (LBP) with respect to these outcomes.</div></div><div><h3>Methods</h3><div>One hundred and thirty-nine patients with subacute and chronic LBP participated in a physical therapy program averaging 7.46 sessions of supervised exercises and home exercises to improve lumbar stability. At the beginning of the program and after the last session, participants completed the Oswestry Disability Index (ODI-I) and the Pain Numerical Rating Scale (NRS), and performed Supine Bridge test (SBT), Right Side Bridge Test (RBT), Left Side Bridge Test (LBT), and Prone Bridge Test (PBT). Global perception of effectiveness was measured with a 7-point Global Perceived Effect Questionnaire.</div></div><div><h3>Results</h3><div>The optimal cutoff points were approximately 38.5 seconds for the Prone Bridge Test (PBT), (44% sensitivity; 78% specificity), 29.5 seconds for the RBT (55% sensitivity; 67% specificity), and 142 seconds for the SBT (45% sensitivity; 67% specificity). The areas under curves ranged from 0.56 (SBT) to 0.61 (PBT and RBT). Low to moderate significant relationships (<em>p</em> < .01) among bridge maneuvers, pain and disability (−0.23 to −0.39) and high correlations among each bridge maneuver and each other (0.69-0.81) emerged.</div></div><div><h3>Conclusion</h3><div>Although bridge maneuvers were responsive to changes in lumbar stability and correlated significantly with pain and disability, these measures were not sufficiently sensitive or specific at baseline to predict these outcomes.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 6","pages":"Pages 956-966"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145634505","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 : 2025-01-01DOI: 10.1016/j.jmpt.2024.09.012
Poliana de Jesus Santos MSc , José Carlos Aragão-Santos MSc , Thainá Souza Santos BSc , Marcos Raphael Pereira-Monteiro MSc , Josimari Melo DeSantana PhD , Elyson Ádan Nunes Carvalho PhD , Marzo Edir Da Silva-Grigoletto PhD
Objective
The purpose of this study was to compare the effects of 16 weeks of functional versus dual-task training on aspects of pain in older women with chronic nonspecific low back pain.
Methods
This randomized clinical trial included 38 participants aged 60 to 79 years divided into 2 groups: functional training (FT) and dual-task training (DT). We assessed pressure pain threshold (PPT), temporal summation of pain, conditioned pain modulation (CPM), trunk instability, isometric strength, and endurance of trunk muscles before and 16 weeks after training. Generalized mixed models were used to compare the groups over time, adopting P ≤ .05. Additionally, the effect size (Cohen's d) was calculated.
Results
Functional training and DT promoted statistically significant increases in PPT (d = 1.82 and 1.10, respectively) and CPM (d = 1.60 and 1.13, respectively). Only FT promoted a statistically significant increase in PPT (d = 1.23). Functional training was superior to DT in PPT and CPM (P < .05). Functional training and DT increased the maximum isometric strength of trunk extensors (d = 2.14 and 2.12, respectively; P < .05), without statistically significant differences between groups. Only DT showed a statistically significant improvement in the endurance of extensors and lateral flexors of the trunk (d = 0.77; d = 0.69).
Conclusion
Both FT and DT were effective in promoting increased pain pressure threshold, improvement of CPM, and trunk function in older women with chronic nonspecific low back pain, however, without effects on temporal summation of pain and trunk stability. These indicators show that the proposed training may promote pain attenuation and increased trunk function.
{"title":"Effects of 2 Training Protocols on Aspects of Pain in Older Women With Chronic Low Back Pain: A Randomized Clinical Trial","authors":"Poliana de Jesus Santos MSc , José Carlos Aragão-Santos MSc , Thainá Souza Santos BSc , Marcos Raphael Pereira-Monteiro MSc , Josimari Melo DeSantana PhD , Elyson Ádan Nunes Carvalho PhD , Marzo Edir Da Silva-Grigoletto PhD","doi":"10.1016/j.jmpt.2024.09.012","DOIUrl":"10.1016/j.jmpt.2024.09.012","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to compare the effects of 16 weeks of functional versus dual-task training on aspects of pain in older women with chronic nonspecific low back pain.</div></div><div><h3>Methods</h3><div>This randomized clinical trial included 38 participants aged 60 to 79 years divided into 2 groups: functional training (FT) and dual-task training (DT). We assessed pressure pain threshold (PPT), temporal summation of pain, conditioned pain modulation (CPM), trunk instability, isometric strength, and endurance of trunk muscles before and 16 weeks after training. Generalized mixed models were used to compare the groups over time, adopting <em>P</em> ≤ .05. Additionally, the effect size (Cohen's d) was calculated.</div></div><div><h3>Results</h3><div>Functional training and DT promoted statistically significant increases in PPT (d = 1.82 and 1.10, respectively) and CPM (d = 1.60 and 1.13, respectively). Only FT promoted a statistically significant increase in PPT (d = 1.23). Functional training was superior to DT in PPT and CPM (<em>P</em> < .05). Functional training and DT increased the maximum isometric strength of trunk extensors (d = 2.14 and 2.12, respectively; <em>P</em> < .05), without statistically significant differences between groups. Only DT showed a statistically significant improvement in the endurance of extensors and lateral flexors of the trunk (d = 0.77; d = 0.69).</div></div><div><h3>Conclusion</h3><div>Both FT and DT were effective in promoting increased pain pressure threshold, improvement of CPM, and trunk function in older women with chronic nonspecific low back pain, however, without effects on temporal summation of pain and trunk stability. These indicators show that the proposed training may promote pain attenuation and increased trunk function.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 47-56"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029886","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 : 2025-01-01DOI: 10.1016/j.jmpt.2024.09.013
Forest S. Kim PhD , David J. Kahle PhD , Neil S. Fleming PhD , Michael Gallaugher PhD , Tanner Houston MBA , Sonish Lamsal MS , Rodney X. Sturdivant PhD
Objective
The purpose of this study was to compare treatment expenditures and utilization of licensed doctors of chiropractic or doctors of physical therapy working for Airrosti (AP) compared with non-AP providers (NAP) comprising 5 different provider types.
Methods
This study was a retrospective, claims-based, cross-sectional study using 5 years of claims and enrollment data from the state of Texas. We compared licensed doctors of chiropractic or doctors of physical therapy working for Airrosti to NAP. Episodes of care for back and neck pain were formed using 90-day clean periods. We utilized propensity scores using inverse probability weighting to control for selection bias. We examined the association of provider type with total costs per episode and 5 different measures of utilization: numbers of visits, length of episode, hospitalization, use of advanced diagnostic imaging, and use of surgery.
Results
Included were 645 799 unique patient episodes of care. Orthopedic specialists, physiatrists, and physical therapists had higher costs and utilization than AP, except for lower visits for orthopedic specialists. Primary care providers had lower costs and utilization than AP, except for hospitalizations, in which no difference was found. AP were most similar to chiropractors in terms of costs and utilization; however, AP had higher use of advanced diagnostic imaging compared with chiropractors. Chiropractors had more visits and longer episodes than AP. Standard deviations for average episode cost, episode length, and number of visits were greater for all provider types compared with AP, except for primary care providers.
Conclusion
In the sample studied, providers using standardized treatment pathways had reduced variation and costs for patients with spinal pain. We hypothesize that adherence to treatment pathways that align with recommended clinical practice guidelines that discourage the use of diagnostic imaging and surgery as a first step for treating lower back and neck pain may have resulted in the significant cost and utilization differences found between AP and NAP.
{"title":"Comparing Costs and Utilization Between Provider Types for Back and Neck Pain: A Cross-Sectional Study","authors":"Forest S. Kim PhD , David J. Kahle PhD , Neil S. Fleming PhD , Michael Gallaugher PhD , Tanner Houston MBA , Sonish Lamsal MS , Rodney X. Sturdivant PhD","doi":"10.1016/j.jmpt.2024.09.013","DOIUrl":"10.1016/j.jmpt.2024.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to compare treatment expenditures and utilization of licensed doctors of chiropractic or doctors of physical therapy working for Airrosti (AP) compared with non-AP providers (NAP) comprising 5 different provider types.</div></div><div><h3>Methods</h3><div>This study was a retrospective, claims-based, cross-sectional study using 5 years of claims and enrollment data from the state of Texas. We compared licensed doctors of chiropractic or doctors of physical therapy working for Airrosti to NAP. Episodes of care for back and neck pain were formed using 90-day clean periods. We utilized propensity scores using inverse probability weighting to control for selection bias. We examined the association of provider type with total costs per episode and 5 different measures of utilization: numbers of visits, length of episode, hospitalization, use of advanced diagnostic imaging, and use of surgery.</div></div><div><h3>Results</h3><div>Included were 645 799 unique patient episodes of care. Orthopedic specialists, physiatrists, and physical therapists had higher costs and utilization than AP, except for lower visits for orthopedic specialists. Primary care providers had lower costs and utilization than AP, except for hospitalizations, in which no difference was found. AP were most similar to chiropractors in terms of costs and utilization; however, AP had higher use of advanced diagnostic imaging compared with chiropractors. Chiropractors had more visits and longer episodes than AP. Standard deviations for average episode cost, episode length, and number of visits were greater for all provider types compared with AP, except for primary care providers.</div></div><div><h3>Conclusion</h3><div>In the sample studied, providers using standardized treatment pathways had reduced variation and costs for patients with spinal pain. We hypothesize that adherence to treatment pathways that align with recommended clinical practice guidelines that discourage the use of diagnostic imaging and surgery as a first step for treating lower back and neck pain may have resulted in the significant cost and utilization differences found between AP and NAP.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 69-78"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040328","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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