Journal of Manipulative and Physiological Therapeutics最新文献

{"title":"Chronic Neck Pain Influence on Oculomotor Performance During Near Point Convergence and Fitts’s Tasks: a cross-sectional study","authors":"Michayla M. Esteves MSc ,&nbsp;Brian MacNeil PhD ,&nbsp;Ganesh Tailor MSc ,&nbsp;Cheryl M. Glazebrook PhD ,&nbsp;Michael G. Johnson MD, FRCSC ,&nbsp;Steven R. Passmore DC, PhD","doi":"10.1016/j.jmpt.2025.08.005","DOIUrl":"10.1016/j.jmpt.2025.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to quantify the influence of musculoskeletal dysfunction on oculomotor performance by evaluating oculomotor convergence and volitional gaze performance in participants with chronic neck pain compared with controls.</div></div><div><h3>Methods</h3><div>Twelve participants with chronic neck pain were age/sex matched to 12 asymptomatic participants. All participants completed a series of tests in neutral, trunk rotated right, and trunk rotated left positions. A Royal Air Force ruler was used to measure near point convergence (NPC), a convergence insufficiency (CI) measurement. Oculomotor performance was assessed using an oculomotor Fitts’s Law task. Questionnaire data included the neck disability index (NDI) and CI symptom survey (CISS).</div></div><div><h3>Results</h3><div>A significant reduction in NPC was found in participants with neck pain for the neutral and rotated left positions. Movement time increased for targets at farther amplitudes for both groups. Reaction time increased for targets at shorter amplitudes for the symptomatic group, indicating motor planning challenges. Significant correlations were found between CISS and NPC scores, as well as between CISS and NDI scores, indicating CISS scores are associated with convergence performance deficits. Greater NDI scores related to larger CISS scores, correlating to increased CI symptoms.</div></div><div><h3>Conclusion</h3><div>Significant differences between groups were found for NPC suggesting that symptomatic participants have difficulties controlling convergent eye movements compared with asymptomatic participants. Reaction time was found to be longer for index of difficulty at a shorter amplitude for the symptomatic group. Correlations between CISS scores with NPC and NDI scores respectively were found, providing evidence of a relationship between CI and neck disability.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 119-128"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149320","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}

{"title":"Intrarater and Interrater Reliability of Scapulothoracic and Glenohumeral Strength Measurements by the Belt-Stabilized Handheld Dynamometer in Individuals With Subacromial Pain Syndrome","authors":"Guilherme A.P. Custódio PT ,&nbsp;Camila F. Gobatto PT ,&nbsp;Jaqueline Martins PT, MSc ,&nbsp;Érik C. Terroni PT ,&nbsp;Anamaria S. de Oliveira PT, PhD","doi":"10.1016/j.jmpt.2025.10.004","DOIUrl":"10.1016/j.jmpt.2025.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the intrarater and interrater reliability of glenohumeral and scapulothoracic muscle strength measured in individuals with chronic, unilateral subacromial pain syndrome.</div></div><div><h3>Methods</h3><div>Fifty individuals with shoulder pain were evaluated in 2 sessions using a belt-stabilized handheld dynamometer (HHD) for maximum isometric strength of the glenohumeral flexion, extension, abduction, lateral and medial rotation, and elevation, protraction, retraction, and retraction with scapular depression. Reliability was determined using the intraclass correlation coefficient (ICC_2,3) with the standard error of measurement (SEM), the minimal detectable change (MDC), and a percentage of average strength (%SEM and %MDC).</div></div><div><h3>Results</h3><div>The values of intraclass correlation coefficient, SEM, and %SEM for glenohumeral muscles ranged from 0.93 to 0.98, 1 kg, and 7% to 14%, respectively, and for scapulothoracic muscles from 0.90 to 0.98, 2 to 4 kg, and 10% to 17%, respectively. The MDC and %MDC values ranged from 2 to 4 kg and 19% to 38% for glenohumeral muscles and 4 to 11 kg and 27% to 47% for scapulothoracic muscles, respectively.</div></div><div><h3>Conclusion</h3><div>Belt-stabilized handheld dynamometer demonstrated excellent reliability to measure scapulothoracic and glenohumeral muscle strength in patients with chronic, unilateral subacromial pain syndrome. Guidelines for correct positioning and measurement of the strength of the shoulder complex along with their clinical viability are presented.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 357-364"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145438010","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}

{"title":"Acupuncture as Adjuvant Therapy for Hypertension in the Elderly: A Network Meta-Analysis","authors":"Huiqi Lv MD ,&nbsp;Ming Li MD ,&nbsp;Hong Liu MD ,&nbsp;Yucheng Zhong MD ,&nbsp;Hao Wen MD ,&nbsp;Xiang Wang MD","doi":"10.1016/j.jmpt.2025.10.061","DOIUrl":"10.1016/j.jmpt.2025.10.061","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the effectiveness and safety of acupuncture as adjuvant therapy for hypertension in elderly patients.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 473-482"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452259","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}

{"title":"Effect of Base of Support and Foot Positioning on Posture Evaluated Using the Postural Analysis Software: An Exploratory Study","authors":"Elizabeth A. Ferreira PhD ,&nbsp;Daniel V. Kolisch BPT ,&nbsp;Daniela F. Carro MSc ,&nbsp;Leda T.Y. Da Silveira PhD ,&nbsp;João Simão De Melo-Neto PhD ,&nbsp;Patrícia Driusso PhD ,&nbsp;Adriana C. Lunardi PhD","doi":"10.1016/j.jmpt.2025.10.005","DOIUrl":"10.1016/j.jmpt.2025.10.005","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to evaluate the changes in posture with 2 different bases of support for static posture.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>This study found that foot positioning can influence the alignment of lower limbs, pelvis, base of support, and balance, without affecting trunk postural assessment.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 587-595"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471356","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}

{"title":"Influence of Obesity on Outcomes of Traction Therapy for Women With Chronic Low Back Pain: An Observational Study","authors":"Marzena Ratajczak PhD ,&nbsp;Michał Wendt PhD ,&nbsp;Damian Skrypnik PhD ,&nbsp;Krzysztof Kusy PhD ,&nbsp;Małgorzata Waszak PhD","doi":"10.1016/j.jmpt.2025.10.036","DOIUrl":"10.1016/j.jmpt.2025.10.036","url":null,"abstract":"<div><h3>Objective</h3><div>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).</div></div><div><h3>Methods</h3><div>Women aged 34 to 50 years with chronic LBP and obesity (<em>n</em> = 26) or normal body weight (bw; <em>n</em> = 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.</div></div><div><h3>Results</h3><div>Pain and disability were significantly decreased (<em>P</em> &lt; .01) and anterior lumbar flexion was increased (<em>P</em> &lt; .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 (<em>P</em> &lt; .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 (<em>P</em> &lt; .01).</div></div><div><h3>Conclusion</h3><div>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 &lt;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.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 502-512"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471453","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}

{"title":"Observational Study of the Safety of Chiropractic vs Medical Care Among Older Adults With Neck Pain","authors":"James M. Whedon DC, MS ,&nbsp;Brian Anderson DC, PhD ,&nbsp;Todd A. Mackenzie PhD ,&nbsp;Leah Grout PhD ,&nbsp;Steffany Moonaz PhD ,&nbsp;Jon D. Lurie MD, MS ,&nbsp;Scott Haldeman DC, MD, PhD","doi":"10.1016/j.jmpt.2025.07.002","DOIUrl":"10.1016/j.jmpt.2025.07.002","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the risk of selected adverse outcomes for older adults with a new episode of neck pain (NP) receiving chiropractic care compared to those receiving primary medical care with Prescription Drug Therapy (PDT) or primary care without medication.</div></div><div><h3>Methods</h3><div>Through analysis of Medicare claims data, we designed a retrospective cohort study including 291 604 patients with a new office visit for NP in 2019. We developed 3 mutually exclusive exposure groups: the <em>Chiropractic Manipulative Therapy (CMT)</em> group received spinal manipulative therapy from a chiropractor with no primary care visits; the <em>PDT</em> group visited primary care and filled an analgesic prescription within 7 days without chiropractic care, and the <em>Primary Care Only (PCO)</em> group visited primary care without chiropractic care or analgesic prescriptions. We analyzed possible complications, including adverse drug events, vertebrobasilar insufficiency, and other selected adverse outcomes, calculating incidence rate ratios over 24 months using Poisson regression with robust standard errors and inverse propensity weighing to balance the exposure groups regarding patient characteristics.</div></div><div><h3>Results</h3><div>Among 291 604 patients, 182 596 (63%) received chiropractic care. For <em>CMT</em> vs <em>PDT</em>, the rate for any measured adverse outcome was 20% lower; for <em>CMT</em> vs <em>PCO</em>, the rate was 14% lower, and for <em>PDT</em> vs <em>PCO</em>, the rate was 6% higher. <em>PDT</em> had the highest risk of any measured adverse outcome.</div></div><div><h3>Conclusion</h3><div>For Medicare Part B beneficiaries with new onset NP, management with <em>chiropractic care</em> was associated with lower rates of adverse events than primary medical care. The PDT group had the highest risk of any measured adverse outcome.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 37-46"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023444","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}

{"title":"Attitudes, Beliefs, and Values of Italian Osteopaths Toward the Management of Patients With Tension-Type Headache: A Categorical Content Analysis","authors":"Alessio Iacopini MSc ,&nbsp;Jorge E. Esteves PhD ,&nbsp;Giacomo Consorti MSc, DO ,&nbsp;Christian Lunghi BSc ,&nbsp;Francesco Cerritelli PhD","doi":"10.1016/j.jmpt.2025.08.009","DOIUrl":"10.1016/j.jmpt.2025.08.009","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 99-111"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137733","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}

{"title":"Immediate Effects of Manual Therapy Techniques on Ankle Dorsiflexion: A Randomized Clinical Trial","authors":"Matheus de Castro Silva PT, MSc ,&nbsp;Arthur de Sá Ferreira PT, PhD ,&nbsp;Rodrigo de Marche Baldon PT, PhD ,&nbsp;Carolina Lins PT, PhD ,&nbsp;Gustavo Martins de Andrade ,&nbsp;Gustavo Barros Braga de Castro Pereira ,&nbsp;Natalia Camin Silva PT, MSc ,&nbsp;Lilian Ramiro Felício PhD","doi":"10.1016/j.jmpt.2025.09.002","DOIUrl":"10.1016/j.jmpt.2025.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate the effects of combined techniques on ROM, performance, and dynamic postural balance in young adults.</div></div><div><h3>Methods</h3><div>Sixty participants were recruited, with a mean age of 25.35 (±8.00) years and ankle dorsiflexion ROM below 40° in closed kinetic chain (CKC). The participants were randomly divided into 2 groups: Joint mobilization based on the Mulligan Concept (Group 1); Joint mobilization based on the Mulligan Concept, together with the Maitland Method (Group 2). The participants were evaluated preintervention (A0), immediately after the intervention (A1), and 3 to 4 days after the intervention (A2). Primary outcome: DF ROM in CKC. Secondary outcomes: ROM in open kinetic chain, performance, and balance.</div></div><div><h3>Results</h3><div>Group 2 presented superior performance in the Triple Hop Test in evaluations A1 (Cohen’s d = 1.45) and A2 (Cohen’s d = 1.21), and after the intervention (A2) showed greater displacement (Cohen’s d = 3.22) in the Y Balance Test. Both groups showed increases of DF ROM in CKC and performance.</div></div><div><h3>Conclusions</h3><div>The combination of joint mobilization techniques can provide additional benefits in functional performance. Both techniques are effective for increasing ankle DF ROM.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 166-176"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206631","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}

{"title":"Factors Influencing Initial Trial Planning for Low Back Pain Among Veterans Health Administration Chiropractors: A Descriptive Observational Survey","authors":"Victoria A. Bensel DC, MPH, MS ,&nbsp;Paul E. Dougherty DC ,&nbsp;Brenda T. Fenton PhD ,&nbsp;Anthony J. Lisi DC","doi":"10.1016/j.jmpt.2025.08.007","DOIUrl":"10.1016/j.jmpt.2025.08.007","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to assess how chiropractors within the Veterans Health Administration (VHA) determine their perceived-optimal dosage (number of visits and trial duration) when planning initial trials of care for patients with low back pain, and to describe factors perceived to influence these decisions, as well as barriers and facilitators to implementation.</div></div><div><h3>Methods</h3><div>A cross-sectional electronic survey was distributed to all chiropractors with an active VHA appointment as of July 1, 2024 (N = 384). The survey, based on prior qualitative interviews and pilot testing, included a clinical vignette and questions related to perceived-optimal visit number and duration, modifying factors, and implementation. Descriptive and inferential statistics (Pearson’s chi-squares) were used to analyze responses in SAS 9.4.</div></div><div><h3>Results</h3><div>A total of 181 VHA chiropractors completed the survey (47.1% response rate). The most frequently reported perceived-optimal initial trial was 6 visits over 6 weeks (21.5%). Respondents reported that increasing patient age, higher pain intensity, greater functional impairment, and shorter duration of symptoms would increase the planned visit dosage. There was considerable variation in chiropractors’ perceptions of the ideal initial treatment trial. Most clinicians (62%) reported they were able to implement their preferred initial trial less than half of the time. The same barriers (including number of available chiropractic clinicians and treatment rooms) and facilitators (including the ability to collaborate with non-DC clinicians and the presence of clinical support staff) were reported by both the &lt;25% and ≥75% optimal implementation groups. However, more chiropractors in the &lt;25% optimal implementation group reported barriers than did those in the ≥75% optimal implementation group for the number of DC Clinicians (74% vs 39%, <em>p</em> = .0002), and clinical access parameters (67% vs 36%, <em>p</em> = .0002).</div></div><div><h3>Conclusions</h3><div>This study revealed that VHA chiropractors reported variable perceived-optimal initial trial dosages and endorsed several clinical and system-level factors that influence trial planning. Reported barriers to implementation were common, particularly those related to staffing and space limitations, with more chiropractors in the low implementation group reporting barriers.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 155-165"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206682","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}

{"title":"Analysis of Nociceptive Pain and Related Psychosocial Factors in Women With Endometriosis: A Cross-sectional Study","authors":"Anna Arnal-Gómez PhD ,&nbsp;Beatriz Arranz-Martín PhD ,&nbsp;Lucas Monzani PhD ,&nbsp;Celia Martínez-Alexandre MSc ,&nbsp;Adriana Hortelano-Molina MSc ,&nbsp;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> &lt; .05; η2 &gt; 0.14). EG participants had lower PPT in all abdominal and lumbar measurements (<em>P</em> &lt; .05; d &gt; 0.8). Sexual function and quality of life were significantly lower (<em>P</em> &lt; .05; d &gt; 0.8), while catastrophizing and kinesiophobia were significantly higher (<em>P</em> &lt; .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}