Journal of Manipulative and Physiological Therapeutics最新文献_第5页

Acupuncture as Adjuvant Therapy for Hypertension in the Elderly: A Network Meta-Analysis 针灸辅助治疗老年人高血压：网络荟萃分析。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-06 DOI: 10.1016/j.jmpt.2025.10.061

Huiqi Lv MD , Ming Li MD , Hong Liu MD , Yucheng Zhong MD , Hao Wen MD , Xiang Wang MD

Objective

The purpose of this study was to evaluate the effectiveness and safety of acupuncture as adjuvant therapy for hypertension in elderly patients.

Methods

We conducted a systematic review and network meta-analysis to assess the effects of acupuncture as adjuvant therapy for hypertension in the elderly. Databases searched included the Cochrane Library, PubMed, Embase, Web of Science, and the China National Knowledge Infrastructure database from their inception to March 1, 2025. The primary outcome was the mean change in blood pressure, while the secondary outcome was safety, evaluated by the incidence of adverse reactions.

Results

A total of 24 studies (3044 participants) were included. For systolic blood pressure (SBP), acupuncture combined with calcium antagonists demonstrated significantly greater efficacy compared to calcium antagonists alone, auricular acupressure plus calcium antagonists, auricular acupressure alone, acupuncture plus ACE inhibitors, auricular acupressure plus ACE inhibitors, ACE inhibitors alone, acupuncture alone, electroacupuncture, and angiotensin II (mean difference [MD]: 10.71; 17.86; 13.48; 16.47; 19.84; 25.8; 28.25; 36.34; and 27.23, respectively). For diastolic blood pressure (DBP), acupuncture combined with calcium antagonists was significantly more effective than auricular acupressure alone, calcium antagonists alone, electroacupuncture, acupuncture alone, angiotensin II, acupuncture plus ACE inhibitors (MD: 26.32; 17.48; 32.43; 29.56; 22.66; 29.18; 31.75; 24.27; and 25.61, respectively). Based on ranking probabilities, acupuncture combined with calcium antagonists may be the most effective and safe treatment for hypertension in the elderly.

Conclusions

Current evidence suggests that acupuncture as adjuvant therapy could be effective and safe for elderly patients with hypertension, with the combination of acupuncture and calcium antagonists potentially being the optimal choice. However, due to potential biases, results should be interpreted cautiously.

目的：评价针刺辅助治疗老年高血压的有效性和安全性。方法：我们通过系统回顾和网络荟萃分析来评估针灸作为辅助治疗老年人高血压的效果。检索的数据库包括Cochrane Library、PubMed、Embase、Web of Science和中国国家知识基础设施数据库，检索时间从建立到2025年3月1日。主要终点是血压的平均变化，而次要终点是安全性，通过不良反应的发生率来评估。结果：共纳入24项研究（3044名受试者）。对于收缩压（SBP），针灸联合钙拮抗剂比单独使用钙拮抗剂、耳穴压联合钙拮抗剂、单独使用耳穴压、针灸联合ACE抑制剂、单独使用耳穴压联合ACE抑制剂、单独使用ACE抑制剂、单独使用针灸、电针和血管紧张素II (mean difference [MD]: 10.71、17.86、13.48、16.47、19.84、25.8、28.25、36.34；分别是27.23)。对于舒张压（DBP），针刺联合钙拮抗剂明显优于单独耳压、单独钙拮抗剂、电针、单独针刺、血管紧张素II、针刺加ACE抑制剂（MD分别为26.32、17.48、32.43、29.56、22.66、29.18、31.75、24.27、25.61）。基于排序概率，针灸联合钙拮抗剂可能是老年人高血压最有效、最安全的治疗方法。结论：目前的证据表明，针灸作为辅助治疗老年高血压患者是有效和安全的，针刺联合钙拮抗剂可能是最佳选择。然而，由于潜在的偏差，结果应谨慎解释。

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引用次数: 0

Comparing Costs and Utilization Between Provider Types for Back and Neck Pain: A Cross-Sectional Study 比较成本和利用提供者类型之间的背部和颈部疼痛：一项横断面研究。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-09-11 DOI: 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.

目的：本研究的目的是比较在Airrosti （AP）工作的执业脊医或物理治疗医生与由5种不同提供者类型组成的非AP提供者（NAP）的治疗费用和利用率。方法：本研究是一项回顾性、基于索赔的横断面研究，使用了德克萨斯州5年的索赔和入组数据。我们比较了在Airrosti工作的有执照的脊椎指压治疗医生或物理治疗医生与NAP。对背部和颈部疼痛的护理是用90天的清洁期形成的。我们使用反向概率加权的倾向得分来控制选择偏差。我们检查了提供者类型与每次发作总成本的关系，以及5种不同的利用指标：就诊次数、发作时间、住院、先进诊断成像的使用和手术的使用。结果：纳入了645799次独特的患者护理。骨科专家、物理医生和物理治疗师的费用和利用率高于AP，但骨科专家的访问量较低。除了住院外，初级保健提供者的成本和利用率低于AP，住院治疗没有差异。在成本和使用率方面，AP与脊医最为相似；然而，与脊医相比，AP有更高的高级诊断成像使用。与AP相比，脊医的就诊次数更多，发作时间更长。除初级保健提供者外，所有提供者类型的平均发作费用、发作时间和就诊次数的标准差都大于AP。结论：在研究的样本中，使用标准化治疗途径的提供者减少了脊柱疼痛患者的变化和成本。我们假设，坚持与推荐的临床实践指南一致的治疗途径，不鼓励使用诊断成像和手术作为治疗下背部和颈部疼痛的第一步，可能导致AP和NAP之间的显著成本和使用差异。

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引用次数: 0

Effects of 2 Training Protocols on Aspects of Pain in Older Women With Chronic Low Back Pain: A Randomized Clinical Trial 两种训练方案对老年女性慢性腰痛疼痛的影响：一项随机临床试验

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-09-10 DOI: 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.

目的：本研究的目的是比较16周的功能性训练和双任务训练对慢性非特异性腰痛老年妇女疼痛方面的影响。方法：将38名年龄在60 ~ 79岁的患者随机分为两组：功能训练组（FT）和双任务训练组（DT）。我们评估了训练前和训练后16周躯干肌肉的压力疼痛阈值（PPT）、疼痛时间总和、条理性疼痛调节（CPM）、躯干不稳定性、等长强度和耐力。采用广义混合模型比较各组间的时间差异，P≤0.05。此外，还计算了效应量（Cohen’s d）。结果：功能训练和DT对PPT （d = 1.82、1.10）和CPM （d = 1.60、1.13）的提高有统计学意义。只有FT能促进PPT的增加，具有统计学意义（d = 1.23）。功能训练在PPT和CPM上优于DT （P < 0.05）。功能训练和DT增加了躯干伸肌的最大等长强度（d分别= 2.14和2.12,P < 0.05），组间差异无统计学意义。只有DT对躯干伸肌和侧屈肌的耐力有统计学意义的改善（d = 0.77; d = 0.69）。结论：FT和DT均能有效促进老年女性慢性非特异性腰痛患者痛压阈值升高、CPM改善和躯干功能，但对疼痛时间累积和躯干稳定性无影响。这些指标表明，建议的训练可以促进疼痛衰减和增加躯干功能。

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引用次数: 0

Influence of Obesity on Outcomes of Traction Therapy for Women With Chronic Low Back Pain: An Observational Study 肥胖对女性慢性腰痛牵引治疗结果的影响：一项观察性研究

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-07 DOI: 10.1016/j.jmpt.2025.10.036

Marzena Ratajczak PhD , Michał Wendt PhD , Damian Skrypnik PhD , Krzysztof Kusy PhD , Małgorzata Waszak PhD

Objective

This study aimed to determine whether obesity influences the effects of traction therapy on pain, disability, lumbar mobility, and the biomechanical and viscoelastic properties (BVPs) of tissues in the lumbar region in women with low back pain (LBP).

Methods

Women aged 34 to 50 years with chronic LBP and obesity (n = 26) or normal body weight (bw; n = 17) underwent 20 traction therapy sessions. LBP (on a visual analog scale), Oswestry Disability Index, BVPs, lumbar spine mobility, and trunk tissue fat were assessed before and then 3 days and 3 months after therapy. Two-way repeated measures ANOVAs were used.

Results

Pain and disability were significantly decreased (P < .01) and anterior lumbar flexion was increased (P < .05) after treatment and maintained at this level for 3 months in both women with obesity and normal body mass index (BMI). However, while stiffness was only reduced in women with normal BMI after treatment (P < .05), this effect was not maintained at follow-up. The mobility in posterior and lateral flexions and rotations did not change. All BVPs correlated with trunk tissue fat content (P < .01).

Conclusion

The outcomes of traction therapy with continuous mode at a force of 25% to 30% of the patient’s bw were not different for women with BMI ≥ 30 and <25 kg/m². Only the effect on muscle stiffness seems to be more beneficial for women without obesity. However, myotonometric results are strongly related to trunk fat content, subject to a potential measurement error in women with obesity.

目的：本研究旨在确定肥胖是否会影响牵引治疗对腰痛（LBP）女性疼痛、残疾、腰椎活动以及腰区组织的生物力学和粘弹性特性（BVPs）的影响。方法：34 ~ 50岁慢性腰痛合并肥胖（n = 26）或体重正常（n = 17）的女性接受20次牵引治疗。在治疗前、治疗后3天和治疗后3个月分别评估腰压（视觉模拟量表）、Oswestry残疾指数、bvp、腰椎活动度和躯干组织脂肪。采用双向重复测量方差分析。结果：治疗后，肥胖和体重指数（BMI）正常的女性疼痛和残疾明显减少（P < 0.01），腰椎前屈度增加（P < 0.05），并维持在该水平3个月。然而，虽然治疗后仅在BMI正常的女性中僵硬度降低（P < 0.05），但在随访中并未维持这种效果。后侧屈曲和旋转的活动度没有改变。bvp均与躯干组织脂肪含量相关（P < 0.01）。结论：对于BMI≥30和2的女性，持续模式下25% ~ 30%体重的牵引治疗效果无显著差异。只有对肌肉僵硬的影响似乎对没有肥胖的女性更有益。然而，肌肉测量结果与躯干脂肪含量密切相关，肥胖女性可能存在测量误差。

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引用次数: 0

Effect of Base of Support and Foot Positioning on Posture Evaluated Using the Postural Analysis Software: An Exploratory Study 用姿势分析软件评价支撑点和足部定位对姿势的影响：一项探索性研究。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-08 DOI: 10.1016/j.jmpt.2025.10.005

Elizabeth A. Ferreira PhD , Daniel V. Kolisch BPT , Daniela F. Carro MSc , Leda T.Y. Da Silveira PhD , João Simão De Melo-Neto PhD , Patrícia Driusso PhD , Adriana C. Lunardi PhD

Objectives

The purpose of this study was to evaluate the changes in posture with 2 different bases of support for static posture.

Methods

In this exploratory study, participants were photographed in a standing position from anterior, posterior, and lateral views, in both spontaneous standing base of support (SBoS) (feet in a freely adopted position) and closed feet base of support (CBoS) (feet held together). Styrofoam markers were attached to 32 anatomical reference points, and posture assessment was conducted using software (PAS/SAPO). The area of each base of support (BoS) and the deviation of the center of gravity (CG) from the reference point within the BoS were measured. Comparisons between CBoS and SBoS postures were performed using paired t-tests.

Results

One hundred and seven participants (81 women) and 856 photographs were evaluated. Average age was 25.65 ± 2.83 years and body mass index was 22.4 ± 2.8 kg/m². Alignment of the right and left lower limbs showed a difference in the frontal view; however, no differences were found in the posterior view. In the left lateral view, differences were noted in the hip angle (trunk and thigh), horizontal alignment of the pelvis, and knee angle. In the SBoS, the BoS area was greater, with a smaller deviation from the CG compared to the CBoS.

Conclusion

This study found that foot positioning can influence the alignment of lower limbs, pelvis, base of support, and balance, without affecting trunk postural assessment.

目的：本研究的目的是评估两种不同的支撑基础的静态姿势的变化。方法：在这项探索性研究中，参与者从前、后、侧三个角度拍摄站立姿势的照片，包括自发站立支撑点（SBoS）（脚处于自由选择的位置）和封闭支撑点（CBoS）（脚保持在一起）。将聚苯乙烯泡沫标记贴在32个解剖学参考点上，使用PAS/SAPO软件进行姿势评估。测量了各支撑点（BoS）的面积和支撑点内重心与参考点的偏差。cbo和sbo姿势的比较采用配对t检验。结果：107名参与者（81名女性）和856张照片被评估。平均年龄25.65±2.83岁，体重指数22.4±2.8 kg/m²。右下肢和左下肢的对齐显示出正面视图的差异；然而，在后视图中没有发现差异。在左侧侧位图中，观察到髋关节角度（躯干和大腿）、骨盆水平对齐和膝关节角度的差异。在sbo中，与cbo相比，BoS面积更大，与CG的偏差较小。结论：本研究发现足部定位可以影响下肢、骨盆、支撑基础和平衡的对齐，但不影响躯干姿势评估。

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引用次数: 0

Exercise-Induced Modulation of Inflammatory Biomarkers After Stroke: A Systematic Review and Meta-Analysis 卒中后运动诱导的炎症生物标志物调节：系统回顾和荟萃分析。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-05 DOI: 10.1016/j.jmpt.2025.10.002

Ana C.S. Bitencourt MS , Maria Eduarda S. Aveiro BS , Rodolfo P. Timóteo PhD , Rodrigo Bazan PhD , Eduardo E.V. Carvalho PhD , Gustavo J. Luvizutto PhD

Objective

The purpose of this study was to perform a systematic review of the literature on the effectiveness of physical exercise on cytokine levels after stroke.

Methods

The PubMed, LILACS, ScienceDirect, Web of Science, Scopus, and Embase databases were searched without language or date restriction through September 2025 using the terms “stroke” and “exercise” and “cytokines” and related terms. Eligible studies included patients with stroke (P), investigated aerobic or multimodal exercise interventions (I), compared them with a control group (C), and reported outcomes on cytokines or other systemic inflammatory biomarkers (O). To assess the risk of bias in each study, we used the criteria described in the Cochrane Handbook for Systematic Review of Interventions. Fixed-effect meta-analysis were performed for homogeneous outcomes.

Results

In total, 8 randomized clinical trials were included for qualitative analysis, and in the meta-analysis. The meta-analysis showed that aerobic training significantly reduced IL-6 (SMD −0.51; 95% CI −0.86 to −0.15; P = .006) and hs-CRP (SMD −1.46; 95% CI −2.18 to −0.75; P < .001), while no significant effect was observed for TNF-α (SMD −0.11; 95% CI −0.53 to 0.31; P = .60). Heterogeneity was high across studies.

Conclusions

Exercise interventions were associated with reductions in cytokine levels, particularly IL-6 and hs-CRP. These effects were mainly observed after aerobic training. Given the limited number of trials and the substantial heterogeneity, these findings should be interpreted with caution.

目的：本研究的目的是对中风后体育锻炼对细胞因子水平的影响进行系统的文献综述。方法：检索PubMed、LILACS、ScienceDirect、Web of Science、Scopus和Embase数据库，截止到2025年9月，检索词为“stroke”、“exercise”和“cytokines”及相关词，无语言和日期限制。符合条件的研究包括卒中患者(P)，调查有氧或多模式运动干预(I)，将其与对照组(C)进行比较，并报告细胞因子或其他系统性炎症生物标志物(O)的结果。为了评估每项研究的偏倚风险，我们使用了Cochrane干预措施系统评价手册中描述的标准。对均质结果进行固定效应荟萃分析。结果：共纳入8项随机临床试验进行定性分析，并纳入meta分析。荟萃分析显示，有氧训练可显著降低IL-6 （SMD -0.51; 95% CI -0.86至-0.15;P = 0.006）和hs-CRP (SMD -1.46; 95% CI -2.18至-0.75;P < 0.001)，而对TNF-α （SMD -0.11; 95% CI -0.53至0.31;P = 0.60）无显著影响。研究的异质性很高。结论：运动干预与细胞因子水平的降低有关，特别是IL-6和hs-CRP。这些影响主要在有氧训练后观察到。考虑到试验数量有限且存在很大的异质性，这些发现应谨慎解释。

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引用次数: 0

Inter- and Intra-Tester Reliability of Postural Stability Tests in Patients With Whiplash-Associated Disorder 鞭打相关疾病患者体位稳定性试验的测试者间和测试者内的可靠性。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-06 DOI: 10.1016/j.jmpt.2025.10.046

Niklas Särkilahti MHc , Airi Oksanen PhD , Eliisa Löyttyniemi MSc , Jenny Mäkelä BHc , Janette Kaukonen BHc , Jani Takatalo PhD, MD , Olli Tenovuo PhD, MD

Objective

Our study aimed to examine the inter- and intra-tester reliability of postural balance tests in patients with whiplash-associated disorder (WAD).

Methods

Fifteen adults with chronic WAD performed 7 different postural balance tests using a static force platform: in the neutral head position (neutral test), gaze rotated 20° (left and right), head rotated 20° (left and right), and neck torsioned 20° (left and right) positions. Inter- and intra-tester reliability were assessed for both individual tests and the differences between the neutral test and each test variant in sway velocity (mm/s) and velocity moment (mm²/s) parameters. This assessment utilized intra- and interclass correlation, mean differences of 2 measurements (paired t-test or Wilcoxon signed-rank test), the coefficient of within-subject variance, and the 95% percentile.

Results

Overall results showed at least a strong (≥0.70) correlation between the 2 testers and the tester’s 2 test sessions in the individual tests. Furthermore, the average results did not mainly differ between testers and test sessions, and no wide variability of results was noticeable, indicating that the results can be considered clinically meaningful. However, the correlations of the between-test differences primarily ranged from negligible to moderate, leaving the results clinically insignificant.

Conclusions

The results of this study suggest that individual postural balance tests yield clinically reliable results for patients with WAD. However, caution is warranted when assessing the difference between balance test variations. It is not yet known whether these tests can distinguish between different study groups and whether they are reliable in assessing different sensory systems.

目的：我们的研究旨在检验腰扭伤相关障碍（WAD）患者体位平衡测试的测试者之间和测试者内部的可靠性。方法：15例成人慢性WAD患者采用静力平台进行7种不同的体位平衡测试：头部中立位（中立测试），凝视旋转20°（左右），头部旋转20°（左右），颈部扭转20°（左右）。测试者之间和测试者内部的信度评估了个体测试和中性测试与每个测试变体在摇摆速度（mm/s）和速度矩（mm2/s）参数上的差异。该评估利用了类内和类间相关性、2个测量值的平均差异（配对t检验或Wilcoxon符号秩检验）、受试者内方差系数和95%百分位。结果：总体结果显示，在个体测试中，2名测试人员与测试人员的2个测试阶段之间至少存在强（≥0.70）的相关性。此外，平均结果在测试者和测试阶段之间没有主要差异，结果没有明显的大变异性，表明结果可以被认为是有临床意义的。然而，试验间差异的相关性主要从可忽略到中等，使得结果在临床上不显著。结论：本研究的结果表明，个体体位平衡测试对WAD患者产生了临床可靠的结果。然而，在评估平衡测试变量之间的差异时，需要谨慎。目前尚不清楚这些测试是否能区分不同的研究组，以及它们在评估不同的感觉系统时是否可靠。

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引用次数: 0

Attitudes, Beliefs, and Values of Italian Osteopaths Toward the Management of Patients With Tension-Type Headache: A Categorical Content Analysis 意大利整骨医生对紧张性头痛患者的态度、信念和价值观：分类内容分析。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-09-25 DOI: 10.1016/j.jmpt.2025.08.009

Alessio Iacopini MSc , Jorge E. Esteves PhD , Giacomo Consorti MSc, DO , Christian Lunghi BSc , Francesco Cerritelli PhD

Objective

Tension-type headache (TTH) is among the 20 leading causes of disability worldwide. Due to the difficulty in diagnosis and the variable association of other symptoms, the management of this clinical condition is often unsatisfactory. Osteopathic manipulative treatment combined with exercise, diet, and general relaxation therapies may be valid for TTH. This study investigated osteopaths’ common attitudes, beliefs, and values when treating and managing individuals experiencing TTH.

Methods

This is a qualitative study using thematic analysis with elements of grounded theory. Osteopaths with expertise in treating patients with primary headache conditions were recruited through purposive sampling methods. Data were gathered from individual, semistructured interviews and transcribed verbatim and then analyzed through thematic analysis. Ten osteopaths who met the inclusion criteria were recruited.

Results

Four main themes were generated from data analysis: (1) osteopathy and its alternative perspective on patients’ perception of osteopathic intervention; (2) osteopaths’ clinical decision making regarding the selection of treatment approaches; (3) the person’s management through an individualized case treatment model; (4) a person-centered approach, setting the treatment in a particular environment to achieve the fulfillment of an individual’s potential.

Conclusion

The present study highlights that this sample of osteopaths endorse a person-centered renewed approach. The participants regularly assess the clinical conditions and disabilities associated with TTH to tailor their treatment approach. These osteopaths consider that these tailored treatment approaches directed at improving and promoting the individual’s wellbeing alongside a reduction of their symptoms should be the main aim of osteopathic treatment.

目的：紧张性头痛（TTH）是全球20种主要致残原因之一。由于诊断困难和其他症状的可变关联，这种临床状况的管理往往不令人满意。整骨疗法结合运动、饮食和一般放松疗法可能对TTH有效。本研究调查了整骨治疗师在治疗和管理经历TTH的个体时的共同态度、信念和价值观。方法：本研究采用专题分析，结合扎根理论的要素进行定性研究。通过有目的的抽样方法招募具有治疗原发性头痛患者专业知识的整骨医生。数据从个人半结构化访谈中收集，并逐字记录，然后通过专题分析进行分析。招募了10名符合纳入标准的整骨医生。结果：数据分析产生了四个主要主题：(1)整骨疗法及其替代观点对患者对整骨疗法干预的看法；(2)骨科医生在选择治疗方法方面的临床决策；(3)通过个体化治疗模式对患者进行管理；(4)以人为本，将治疗置于特定的环境中，以实现个体潜能的实现。结论：目前的研究强调，这个样本的整骨医生支持一个以人为本的新方法。参与者定期评估与TTH相关的临床状况和残疾，以定制他们的治疗方法。这些整骨治疗师认为，这些量身定制的治疗方法旨在改善和促进个人的健康，同时减少他们的症状，这应该是整骨疗法的主要目标。

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引用次数: 0

Analysis of Nociceptive Pain and Related Psychosocial Factors in Women With Endometriosis: A Cross-sectional Study 子宫内膜异位症患者痛觉性疼痛及相关心理社会因素分析：一项横断面研究。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-08 DOI: 10.1016/j.jmpt.2025.10.057

Anna Arnal-Gómez PhD , Beatriz Arranz-Martín PhD , Lucas Monzani PhD , Celia Martínez-Alexandre MSc , Adriana Hortelano-Molina MSc , Laura Fuentes-Aparicio PhD

Objectives

The purpose of this study was to explore the associations and compare differences in abdominal and lumbar pain pressure thresholds, pelvic floor state, and pain- and movement-related psychosocial factors in women with and without endometriosis.

Methods

A cross-sectional study was conducted on women (18-50 years). Participants with endometriosis (EG) were compared to age-matched counterparts without endometriosis (CG). Clinical symptoms were recorded, and pain pressure thresholds (PPT) and pelvic floor muscles (PFM) tone and strength were measured. Psychosocial factors such as catastrophizing, kinesiophobia, sexual function, and health-related quality of life were assessed. Univariate and multivariate analyses of covariance were conducted.

Results

In total, 46 participants were analyzed (EG: 22; CG: 24). After isolating the effect of the participants’ psychosocial factors, statistically significant differences between the groups regarding pain were still observed (P < .05; η2 > 0.14). EG participants had lower PPT in all abdominal and lumbar measurements (P < .05; d > 0.8). Sexual function and quality of life were significantly lower (P < .05; d > 0.8), while catastrophizing and kinesiophobia were significantly higher (P < .05; d ≥ 0.8) in the EG compared to CG.

Conclusions

After isolating the effect of the psychological factors, pain remained a specific symptom of endometriosis. Woman with endometriosis had lower PPT in the lumbar and abdominal muscles, engaged more frequently in catastrophizing, kinesiophobia, and reported significantly lower quality of life. These findings underscore the need for a multidimensional approach that addresses both the physical and psychological aspects of women with endometriosis.

目的：本研究的目的是探讨有和没有子宫内膜异位症的妇女在腹部和腰椎疼痛压力阈值、骨盆底状态、疼痛和运动相关的社会心理因素方面的关联和比较差异。方法：对18-50岁的女性进行横断面研究。患有子宫内膜异位症（EG）的参与者与没有子宫内膜异位症（CG）的年龄匹配的参与者进行比较。记录临床症状，测量疼痛压力阈值（PPT）和盆底肌张力和强度。评估了灾难化、运动恐惧症、性功能和健康相关生活质量等社会心理因素。进行单因素和多因素协方差分析。结果：共分析了46名参与者（EG: 22; CG: 24）。在分离受试者心理社会因素的影响后，两组之间在疼痛方面的差异仍有统计学意义（P < 0.05; η2 bb0 0.14）。EG参与者在所有腹部和腰椎测量中PPT都较低（P < 0.05; d < 0.8）。EG组的性功能和生活质量显著低于CG组（P < 0.05, d≥0.8），灾难化和运动恐惧症显著高于CG组（P < 0.05, d≥0.8）。结论：在排除心理因素的影响后，疼痛仍是子宫内膜异位症的特异性症状。患有子宫内膜异位症的女性腰肌和腹肌PPT较低，更频繁地发生灾难，运动恐惧症，并报告生活质量明显降低。这些发现强调需要一个多维的方法来解决子宫内膜异位症妇女的生理和心理方面。

{"title":"Analysis of Nociceptive Pain and Related Psychosocial Factors in Women With Endometriosis: A Cross-sectional Study","authors":"Anna Arnal-Gómez PhD , Beatriz Arranz-Martín PhD , Lucas Monzani PhD , Celia Martínez-Alexandre MSc , Adriana Hortelano-Molina MSc , Laura Fuentes-Aparicio PhD","doi":"10.1016/j.jmpt.2025.10.057","DOIUrl":"10.1016/j.jmpt.2025.10.057","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to explore the associations and compare differences in abdominal and lumbar pain pressure thresholds, pelvic floor state, and pain- and movement-related psychosocial factors in women with and without endometriosis.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on women (18-50 years). Participants with endometriosis (EG) were compared to age-matched counterparts without endometriosis (CG). Clinical symptoms were recorded, and pain pressure thresholds (PPT) and pelvic floor muscles (PFM) tone and strength were measured. Psychosocial factors such as catastrophizing, kinesiophobia, sexual function, and health-related quality of life were assessed. Univariate and multivariate analyses of covariance were conducted.</div></div><div><h3>Results</h3><div>In total, 46 participants were analyzed (EG: 22; CG: 24). After isolating the effect of the participants’ psychosocial factors, statistically significant differences between the groups regarding pain were still observed (<em>P</em> < .05; η2 > 0.14). EG participants had lower PPT in all abdominal and lumbar measurements (<em>P</em> < .05; d > 0.8). Sexual function and quality of life were significantly lower (<em>P</em> < .05; d > 0.8), while catastrophizing and kinesiophobia were significantly higher (<em>P</em> < .05; d ≥ 0.8) in the EG compared to CG.</div></div><div><h3>Conclusions</h3><div>After isolating the effect of the psychological factors, pain remained a specific symptom of endometriosis. Woman with endometriosis had lower PPT in the lumbar and abdominal muscles, engaged more frequently in catastrophizing, kinesiophobia, and reported significantly lower quality of life. These findings underscore the need for a multidimensional approach that addresses both the physical and psychological aspects of women with endometriosis.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 606-616"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471153","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}

引用次数: 0

Effect of Connective Tissue Manipulation on Clinical Symptoms and Pelvic Floor Muscles in Children With Lower Urinary Tract Dysfunction: a Randomized Clinical Trial 结缔组织手法对下尿路功能障碍儿童临床症状和盆底肌肉的影响：一项随机临床试验

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-07 DOI: 10.1016/j.jmpt.2025.10.037

Melis Ünal MSc , Elif Develi PhD , Halil Tuğtepe

Objective

The aim of the study was to examine the impact of a combined approach involving connective tissue manipulation (CTM) and pelvic floor muscle (PFM) exercises on symptoms, uroflowmetry parameters, and PFM activation in children with lower urinary tract disorders.

Methods

Forty children with lower urinary tract disorder were randomized into 2 groups: (1) PFM group and (2) CTM+PFM exercise group (CTG). The treatment was performed 3 times a week for 8 weeks. Children were evaluated with electromyography-uroflowmetry, bladder ultrasonography, bladder diary, electromyography-PFM activation, and the Dysfunctional Voiding and Incontinence Scoring System at baseline and 8 weeks after interventions.

Results

A comparison of the 2 groups revealed that the CTG group demonstrated greater improvement in mean flow rate (Q-Ave), maximum voiding volume, incontinence frequency, PFM contraction activation (work average), and Dysfunctional Voiding and Incontinence Scoring System scores (P < .05).

Conclusion

Connective tissue manipulation applied in addition to pelvic floor muscle exercises was more effective on certain uroflow and bladder diary parameters, symptom severity score, and certain PFM activation parameters. Connective tissue manipulation applied together with PFM exercises may be a novel approach in children with lower urinary tract disorders, a noninvasive and accessible manual therapy method.

目的：本研究的目的是检查结缔组织操作（CTM）和盆底肌（PFM）运动联合入路对下尿路疾病儿童症状、尿流测量参数和PFM激活的影响。方法：将40例下尿路障碍患儿随机分为两组：(1)PFM组和(2)CTM+PFM运动组（CTG）。治疗每周3次，连续8周。在基线和干预后8周，通过肌电图-尿流仪、膀胱超声、膀胱日记、肌电图- pfm激活和功能障碍排尿和失禁评分系统对儿童进行评估。结果：两组比较发现，CTG组在平均流量（Q-Ave）、最大排尿量、失禁频率、PFM收缩激活（工作平均）、功能障碍排尿和失禁评分系统评分方面均有较大改善（P < 0.05）。结论：结缔组织手法加盆底肌锻炼对尿流和膀胱日记参数、症状严重程度评分和PFM激活参数更有效。结缔组织操作结合PFM练习可能是治疗儿童下尿路疾病的一种新方法，是一种无创且易于使用的手工治疗方法。

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引用次数: 0