Pub Date : 2025-01-01DOI: 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.
{"title":"Effect of Connective Tissue Manipulation on Clinical Symptoms and Pelvic Floor Muscles in Children With Lower Urinary Tract Dysfunction: a Randomized Clinical Trial","authors":"Melis Ünal MSc , Elif Develi PhD , Halil Tuğtepe","doi":"10.1016/j.jmpt.2025.10.037","DOIUrl":"10.1016/j.jmpt.2025.10.037","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>P</em> < .05).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 531-540"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471302","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.2025.10.039
Isabela R.S. Cavalcanti MSc , Adriana C. Lunardi PhD , Daniela F. Carro MSc , Leda T.Y. da Silveira PhD , Elizabeth A. Ferreira PhD
Objective
The purpose of this study was to analyze the description quality of interventions with pelvic floor muscle training (PFMT) for dyspareunia treatment and to describe treatment modalities and protocols.
Methods
This was a systematic review of randomized clinical trials, longitudinal studies, and before–after studies. We searched MEDLINE/PubMed, Web of Knowledge, Scopus, Cochrane, LILACS, PEDro, and Embase, last updated June 2024. The Consensus on Exercise Reporting Template recommendations and Consensus on Therapeutic Exercise Training document were used to analyze the description of PFMT protocols.
Results
Among 769 retrieved articles, 17 were included, involving 963 women 20 to 70 years of age with dyspareunia, vulvodynia, pelvic pain, and/or sexual dysfunction. Dyspareunia was assessed with tools such as numeric or subjective pain scales and questionnaires like the Female Sexual Function Index. The mean Consensus on Exercise Reporting Template score was 7.3 ± 2.7 (40% of items accomplished). The mean Consensus on Therapeutic Exercise Training score was 5.4 ± 1.3 (61% of items accomplished). Most protocols applied supervised exercises at outpatient clinics and prescribed nonsupervised home exercises. PFMT encompassed muscle contraction with varied duration (3-60 seconds) and intensity (phasic and tonic), followed by muscle relaxation. Most associated therapy was biofeedback, followed by manual therapy and electrical stimulation.
Conclusion
Most descriptions of PFMT protocols for dyspareunia treatment did not follow recommended consensus tools, making it difficult to compare data and transpose to clinical practice. Protocols of PFMT are heterogeneous among studies.
目的：本研究的目的是分析盆底肌训练（PFMT）治疗性交困难的描述质量，并描述治疗方式和方案。方法：这是一项随机临床试验、纵向研究和前后研究的系统综述。我们检索了MEDLINE/PubMed、Web of Knowledge、Scopus、Cochrane、LILACS、PEDro和Embase，最后更新于2024年6月。采用运动报告模板共识建议和治疗性运动训练共识文件对PFMT方案的描述进行分析。结果：在769篇检索文章中，纳入17篇，涉及963名20 - 70岁的女性，伴有性交困难、外阴痛、盆腔疼痛和/或性功能障碍。通过数字或主观疼痛量表和女性性功能指数等问卷来评估性交困难。平均共识运动报告模板得分为7.3±2.7（40%的项目完成）。治疗性运动训练的平均共识得分为5.4±1.3（61%的项目完成）。大多数协议在门诊诊所应用监督练习，并规定无监督的家庭练习。PFMT包括不同持续时间（3-60秒）和强度（相性和强直性）的肌肉收缩，随后是肌肉放松。大多数相关治疗是生物反馈，其次是手动治疗和电刺激。结论：大多数关于PFMT治疗性交困难方案的描述没有遵循推荐的共识工具，这使得比较数据和转移到临床实践变得困难。PFMT的方案在不同的研究中是不同的。
{"title":"Quality of Descriptions of Pelvic Floor Muscle Training Prescribed to Women With Dyspareunia: A Systematic Review","authors":"Isabela R.S. Cavalcanti MSc , Adriana C. Lunardi PhD , Daniela F. Carro MSc , Leda T.Y. da Silveira PhD , Elizabeth A. Ferreira PhD","doi":"10.1016/j.jmpt.2025.10.039","DOIUrl":"10.1016/j.jmpt.2025.10.039","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to analyze the description quality of interventions with pelvic floor muscle training (PFMT) for dyspareunia treatment and to describe treatment modalities and protocols.</div></div><div><h3>Methods</h3><div>This was a systematic review of randomized clinical trials, longitudinal studies, and before–after studies. We searched MEDLINE/PubMed, Web of Knowledge, Scopus, Cochrane, LILACS, PEDro, and Embase, last updated June 2024. The Consensus on Exercise Reporting Template recommendations and Consensus on Therapeutic Exercise Training document were used to analyze the description of PFMT protocols.</div></div><div><h3>Results</h3><div>Among 769 retrieved articles, 17 were included, involving 963 women 20 to 70 years of age with dyspareunia, vulvodynia, pelvic pain, and/or sexual dysfunction. Dyspareunia was assessed with tools such as numeric or subjective pain scales and questionnaires like the Female Sexual Function Index. The mean Consensus on Exercise Reporting Template score was 7.3 ± 2.7 (40% of items accomplished). The mean Consensus on Therapeutic Exercise Training score was 5.4 ± 1.3 (61% of items accomplished). Most protocols applied supervised exercises at outpatient clinics and prescribed nonsupervised home exercises. PFMT encompassed muscle contraction with varied duration (3-60 seconds) and intensity (phasic and tonic), followed by muscle relaxation. Most associated therapy was biofeedback, followed by manual therapy and electrical stimulation.</div></div><div><h3>Conclusion</h3><div>Most descriptions of PFMT protocols for dyspareunia treatment did not follow recommended consensus tools, making it difficult to compare data and transpose to clinical practice. Protocols of PFMT are heterogeneous among studies.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 550-559"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471384","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.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。
{"title":"Exercise-Induced Modulation of Inflammatory Biomarkers After Stroke: A Systematic Review and Meta-Analysis","authors":"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","doi":"10.1016/j.jmpt.2025.10.002","DOIUrl":"10.1016/j.jmpt.2025.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>P = .</em>006) and hs-CRP (SMD −1.46; 95% CI −2.18 to −0.75; <em>P < .</em>001), while no significant effect was observed for TNF-α (SMD −0.11; 95% CI −0.53 to 0.31; <em>P = .</em>60). Heterogeneity was high across studies.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 373-384"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452311","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.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.
{"title":"Inter- and Intra-Tester Reliability of Postural Stability Tests in Patients With Whiplash-Associated Disorder","authors":"Niklas Särkilahti MHc , Airi Oksanen PhD , Eliisa Löyttyniemi MSc , Jenny Mäkelä BHc , Janette Kaukonen BHc , Jani Takatalo PhD, MD , Olli Tenovuo PhD, MD","doi":"10.1016/j.jmpt.2025.10.046","DOIUrl":"10.1016/j.jmpt.2025.10.046","url":null,"abstract":"<div><h3>Objective</h3><div>Our study aimed to examine the inter- and intra-tester reliability of postural balance tests in patients with whiplash-associated disorder (WAD).</div></div><div><h3>Methods</h3><div>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 (mm<sup>2</sup>/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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 404-421"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452338","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.2024.08.005
Baojiang Chen PhD , Henry S. Brown PhD , David Douphrate PhD , Jud Janak PhD , Kelley Pettee Gabriel MS, PhD , Trent Peng PhD, DC, MS
Objective
This study aimed to examine the trends in the utilization and expenditure of chiropractic care in a representative sample of US adults, aged ≥18 years.
Methods
Serial cross-sectional data (2007-2016) from the Medical Expenditure Panel Survey (MEPS) were examined. Weighted descriptive statistics were analyzed to obtain national estimates of chiropractic utilization and expenditure, and time-series linear regression was used to assess trends over time. Socio-demographic characteristics and musculoskeletal diagnoses associated with chiropractic use were also reported.
Results
A statistically significantly increasing trend was observed for the number of adults receiving chiropractic care (p < .05), number of visits (p < .05) and utilization rate (P < .05) from 2007 to 2016. A similar trend was not found for chiropractic expenditure during this period (P > .05). The mean number of visits was 8.3 visits per year, with a mean expenditure of $86.94 USD per visit and $721.43 USD per person per year. Mean age of adult chiropractic users each year ranged between 48.6 and 51.2 years old, and users were primarily female (56.3%-60.4%), White persons (90.1%-93.5%), and privately insured (77.3%-82.8%). The most prevalent musculoskeletal diagnoses associated with chiropractic use were low back conditions (45.4%-58.1%), inflammatory/degenerative disc or joint conditions (21.2%-26.8%) and head and neck complaints (9.8%-13.7%).
Conclusion
The findings showed statistically significant increasing trends for the number of adult chiropractic users, the number of visits, and percent utilization of chiropractic care from 2007 to 2016. Conversely, we found a statistically null trend for the total annual expenditure on chiropractic care during the same time period. Findings from this analysis imply that, while chiropractic care appears to be growing, it may still be under-utilized, and more efforts should be devoted to ensuring sustained growth and a larger role in the management of musculoskeletal health.
{"title":"National Trends in the Utilization and Expenditure of Chiropractic Care in U.S. Adults: Analysis of the 2007-2016 Medical Expenditure Panel Survey","authors":"Baojiang Chen PhD , Henry S. Brown PhD , David Douphrate PhD , Jud Janak PhD , Kelley Pettee Gabriel MS, PhD , Trent Peng PhD, DC, MS","doi":"10.1016/j.jmpt.2024.08.005","DOIUrl":"10.1016/j.jmpt.2024.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to examine the trends in the utilization and expenditure of chiropractic care in a representative sample of US adults, aged ≥18 years.</div></div><div><h3>Methods</h3><div>Serial cross-sectional data (2007-2016) from the Medical Expenditure Panel Survey (MEPS) were examined. Weighted descriptive statistics were analyzed to obtain national estimates of chiropractic utilization and expenditure, and time-series linear regression was used to assess trends over time. Socio-demographic characteristics and musculoskeletal diagnoses associated with chiropractic use were also reported.</div></div><div><h3>Results</h3><div>A statistically significantly increasing trend was observed for the number of adults receiving chiropractic care (<em>p</em> < .05), number of visits (<em>p</em> < .05) and utilization rate (<em>P</em> < .05) from 2007 to 2016. A similar trend was not found for chiropractic expenditure during this period (<em>P</em> > .05). The mean number of visits was 8.3 visits per year, with a mean expenditure of $86.94 USD per visit and $721.43 USD per person per year. Mean age of adult chiropractic users each year ranged between 48.6 and 51.2 years old, and users were primarily female (56.3%-60.4%), White persons (90.1%-93.5%), and privately insured (77.3%-82.8%). The most prevalent musculoskeletal diagnoses associated with chiropractic use were low back conditions (45.4%-58.1%), inflammatory/degenerative disc or joint conditions (21.2%-26.8%) and head and neck complaints (9.8%-13.7%).</div></div><div><h3>Conclusion</h3><div>The findings showed statistically significant increasing trends for the number of adult chiropractic users, the number of visits, and percent utilization of chiropractic care from 2007 to 2016. Conversely, we found a statistically null trend for the total annual expenditure on chiropractic care during the same time period. Findings from this analysis imply that, while chiropractic care appears to be growing, it may still be under-utilized, and more efforts should be devoted to ensuring sustained growth and a larger role in the management of musculoskeletal health.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 1-9"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348179","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.2024.08.004
Baojiang Chen PhD , Henry S. Brown PhD , David Douphrate PhD , Jud Janak PhD , Kelley Pettee Gabriel MS, PhD , Trent Peng PhD, DC, MS
Objective
This study aimed to evaluate the prospective associations of baseline personal characteristics with utilization frequency and expenditure of chiropractic care in US adults (≥18 years).
Methods
Data are from the 1358 respondents to the 2014 to 2016 Medical Expenditure Panel Survey who utilized chiropractic care. Individual, familial, health-related, and behavioral factors were included as covariates in the multivariate analytic model. Poisson and multinominal logistic regressions were modeled to examine the associations between the predictors and chiropractic utilization and expenditure.
Results
The mean annual number of visits was 8.2 visits (95% confidence interval [CI]: 7.9, 8.5), with annual expenditure of $677.43 U.S. dollars (95% CI: $595.47-$759.39) and $84.84 (95% CI: $77.89-$91.78) per visit. Female sex was associated with a 19% higher number of visits (rate ratio [RR] = 1.19, 95% CI: 1.01, 1.41) than males. Publicly insured and uninsured were associated with a 44% higher (RR = 1.44, 95% CI: 1.14, 1.82) and 36% lower (RR = 0.64, 95% CI: 0.48, 0.86) visit frequency, respectively, than those privately insured. Rheumatoid arthritis was associated with 7.38 times the risk of high expenditure (95% CI: 2.61, 24.67) than medium expenditure, compared to no arthritis. Relative to physically active individuals, physical inactivity was associated with a 27% higher visit frequency (RR = 1.27, 95% CI: 1.09, 1.49) and an 82% higher risk (relative risk ratio = 1.82, 95% CI: 1.05, 3.14) of high expenditure than low expenditure.
Conclusion
This analysis found distinct usage and expenditure patterns that vary according to specific baseline predictors. Female sex, being publicly insured, having rheumatoid arthritis, and physically inactive were associated with variance in expenditure. Results from this study may help identify chiropractic patients with tendencies for higher utilization or spending and may indirectly assist in predicting patients with slower response to care.
{"title":"Predictors of Utilization Frequency of and Expenditure Amount for Chiropractic Care in U.S. Adults: A Retrospective Cohort Study","authors":"Baojiang Chen PhD , Henry S. Brown PhD , David Douphrate PhD , Jud Janak PhD , Kelley Pettee Gabriel MS, PhD , Trent Peng PhD, DC, MS","doi":"10.1016/j.jmpt.2024.08.004","DOIUrl":"10.1016/j.jmpt.2024.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the prospective associations of baseline personal characteristics with utilization frequency and expenditure of chiropractic care in US adults (≥18 years).</div></div><div><h3>Methods</h3><div>Data are from the 1358 respondents to the 2014 to 2016 Medical Expenditure Panel Survey who utilized chiropractic care. Individual, familial, health-related, and behavioral factors were included as covariates in the multivariate analytic model. Poisson and multinominal logistic regressions were modeled to examine the associations between the predictors and chiropractic utilization and expenditure.</div></div><div><h3>Results</h3><div>The mean annual number of visits was 8.2 visits (95% confidence interval [CI]: 7.9, 8.5), with annual expenditure of $677.43 U.S. dollars (95% CI: $595.47-$759.39) and $84.84 (95% CI: $77.89-$91.78) per visit. Female sex was associated with a 19% higher number of visits (rate ratio [RR] = 1.19, 95% CI: 1.01, 1.41) than males. Publicly insured and uninsured were associated with a 44% higher (RR = 1.44, 95% CI: 1.14, 1.82) and 36% lower (RR = 0.64, 95% CI: 0.48, 0.86) visit frequency, respectively, than those privately insured. Rheumatoid arthritis was associated with 7.38 times the risk of high expenditure (95% CI: 2.61, 24.67) than medium expenditure, compared to no arthritis. Relative to physically active individuals, physical inactivity was associated with a 27% higher visit frequency (RR = 1.27, 95% CI: 1.09, 1.49) and an 82% higher risk (relative risk ratio = 1.82, 95% CI: 1.05, 3.14) of high expenditure than low expenditure.</div></div><div><h3>Conclusion</h3><div>This analysis found distinct usage and expenditure patterns that vary according to specific baseline predictors. Female sex, being publicly insured, having rheumatoid arthritis, and physically inactive were associated with variance in expenditure. Results from this study may help identify chiropractic patients with tendencies for higher utilization or spending and may indirectly assist in predicting patients with slower response to care.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 10-26"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348180","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.2025.10.030
John F. Hoops ScD , Carla M. James ScD , Charles Nichols ScD , Jean-Michel Brismee ScD , Peter J. Rundquist PhD , Lee Atkins PhD , Stéphane Sobczak PhD
Objectives
The purpose of this study was to determine if different force magnitudes, loading cycle repetitions, and loading speeds alter creep deformation (CD) during cyclical traction loading of human cadaveric coracohumeral ligaments (CHL).
Methods
Fifteen unembalmed human cadaveric CHL specimens were assigned to 3 groups based on maximal force and loading speed: (1) 40Nslow: 40N; 0.83 mm/s; (2) 20Nslow: 20N; 0.83 mm/s; (3) 20Nfast: 20N; 2.5 mm/s. All specimens underwent 360 cycles of traction loading in a material testing system. The material testing system collected CD during loading at 60-cycle intervals. Micrometer measurements determined CD 60 minutes after loading. Friedman’s ANOVA was used to compare within-group CD changes, and Kruskal-Wallis ANOVA was used to compare between-group CD differences.
Results
All groups demonstrated increased CD during 360 cycles (P < .003) without differences between groups at any 60-cycle interval (P > .05). Sixty minutes after loading, CD was 7% (±5) in the 20Nslow, 15% (±12) in the 40Nslow, and 13% (±7) in the 20Nfast groups without between-group differences (P = .353).
Conclusion
Cyclical traction loading cadaveric CHL specimens with 20N and 40N forces increased CD without a difference between groups. Creep deformation was partially retained 60 minutes after loading. No CD differences were found using 20N loads at 2 different loading speeds.
{"title":"Traction Loading Human Coracohumeral Ligaments With 20 and 40 Newton Forces and Sustained Creep Deformation: A Preliminary Cadaveric Investigation","authors":"John F. Hoops ScD , Carla M. James ScD , Charles Nichols ScD , Jean-Michel Brismee ScD , Peter J. Rundquist PhD , Lee Atkins PhD , Stéphane Sobczak PhD","doi":"10.1016/j.jmpt.2025.10.030","DOIUrl":"10.1016/j.jmpt.2025.10.030","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to determine if different force magnitudes, loading cycle repetitions, and loading speeds alter creep deformation (CD) during cyclical traction loading of human cadaveric coracohumeral ligaments (CHL).</div></div><div><h3>Methods</h3><div>Fifteen unembalmed human cadaveric CHL specimens were assigned to 3 groups based on maximal force and loading speed: (1) 40Nslow: 40N; 0.83 mm/s; (2) 20Nslow: 20N; 0.83 mm/s; (3) 20Nfast: 20N; 2.5 mm/s. All specimens underwent 360 cycles of traction loading in a material testing system. The material testing system collected CD during loading at 60-cycle intervals. Micrometer measurements determined CD 60 minutes after loading. Friedman’s ANOVA was used to compare within-group CD changes, and Kruskal-Wallis ANOVA was used to compare between-group CD differences.</div></div><div><h3>Results</h3><div>All groups demonstrated increased CD during 360 cycles (<em>P</em> < .003) without differences between groups at any 60-cycle interval (<em>P</em> > .05). Sixty minutes after loading, CD was 7% (±5) in the 20Nslow, 15% (±12) in the 40Nslow, and 13% (±7) in the 20Nfast groups without between-group differences (<em>P</em> = .353).</div></div><div><h3>Conclusion</h3><div>Cyclical traction loading cadaveric CHL specimens with 20N and 40N forces increased CD without a difference between groups. Creep deformation was partially retained 60 minutes after loading. No CD differences were found using 20N loads at 2 different loading speeds.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 483-489"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458635","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.2025.10.033
Mackenzie A. Keller DC , Brent S. Russell MS, DC , Ronald S. Hosek PhD, DC, MPH , Edward F. Owens Jr MS, DC
Objective
The purpose of this study was to examine characteristics of cervical axial rotation and other motion components during cervical spine manipulation.
Methods
Eleven doctors of chiropractic (DCs), 10 chiropractic students with patient experience, and 16 inexperienced students from our institution each performed 4 thrusts on a mannequin. The thrust measured is an essential component of chiropractic cervical spine manipulation, also known as a chiropractic adjustment. The mannequin was designed for chiropractic education and outfitted with inertial measurement units for motion capture. Data were analyzed in Excel for rotation, lateral bending, and flexion-extension at thrust onsets and peaks. Differences between groups were analyzed in R (R Foundation) using Kruskal-Wallis tests, followed by Dunn tests for pairwise comparisons.
Results
Mean rotation for DCs was 19.3° at thrust onset and 33.9° at peak; mean peak lateral bending and cervical extension were 32.0° and 10.4°, respectively. On average, 14.6° of rotation occurred in 144 milliseconds between onset and peak, with rotational velocity and acceleration maximum values of 192.9°/s and 4427°/s2, respectively. Most student characteristics were similar, but DCs’ acceleration means were significantly higher (Kruskal-Wallis P = .019), and experienced students used significantly greater lateral bending at onset (Kruskal-Wallis P = .049) and peak (P = .023).
Conclusion
Mean axial rotation for DCs during chiropractic cervical spinal adjustments was less than 34° at peak; most other measures were similar to previously reported findings.
目的：本研究的目的是研究颈椎推拿过程中颈椎轴向旋转和其他运动部件的特征。方法：我院11名捏脊医生、10名有临床经验的捏脊学生和16名无临床经验的捏脊学生分别对人体模型进行4次推力。测量的推力是捏脊颈椎手法的重要组成部分，也称为捏脊调整。该人体模型是为脊椎按摩教育设计的，并配备了用于运动捕捉的惯性测量单元。在Excel中分析了推力开始和峰值时的旋转、侧弯和屈伸数据。采用Kruskal-Wallis检验分析组间差异，随后采用Dunn检验进行两两比较。结果：DCs的平均旋转在推力开始时为19.3°，峰值为33.9°；平均侧弯峰和颈椎伸展峰分别为32.0°和10.4°。在144毫秒内，平均发生14.6°旋转，转速和加速度最大值分别为192.9°/s和4427°/s2。大多数学生的特征相似，但DCs的加速度平均值明显更高（Kruskal-Wallis P = 0.019），经验丰富的学生在开始时（Kruskal-Wallis P = 0.049）和峰值时（P = 0.023）使用了更大的侧向弯曲。结论：颈椎整复过程中DCs的平均轴向旋转峰值小于34°；大多数其他测量结果与先前报道的结果相似。
{"title":"Angular Kinematic Analysis of Supine Cervical Thrusts Performed by Chiropractors and Chiropractic Students on Mannequins","authors":"Mackenzie A. Keller DC , Brent S. Russell MS, DC , Ronald S. Hosek PhD, DC, MPH , Edward F. Owens Jr MS, DC","doi":"10.1016/j.jmpt.2025.10.033","DOIUrl":"10.1016/j.jmpt.2025.10.033","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to examine characteristics of cervical axial rotation and other motion components during cervical spine manipulation.</div></div><div><h3>Methods</h3><div>Eleven doctors of chiropractic (DCs), 10 chiropractic students with patient experience, and 16 inexperienced students from our institution each performed 4 thrusts on a mannequin. The thrust measured is an essential component of chiropractic cervical spine manipulation, also known as a chiropractic adjustment. The mannequin was designed for chiropractic education and outfitted with inertial measurement units for motion capture. Data were analyzed in Excel for rotation, lateral bending, and flexion-extension at thrust onsets and peaks. Differences between groups were analyzed in R (R Foundation) using Kruskal-Wallis tests, followed by Dunn tests for pairwise comparisons.</div></div><div><h3>Results</h3><div>Mean rotation for DCs was 19.3° at thrust onset and 33.9° at peak; mean peak lateral bending and cervical extension were 32.0° and 10.4°, respectively. On average, 14.6° of rotation occurred in 144 milliseconds between onset and peak, with rotational velocity and acceleration maximum values of 192.9°/s and 4427°/s<sup>2</sup>, respectively. Most student characteristics were similar, but DCs’ acceleration means were significantly higher (Kruskal-Wallis <em>P</em> = .019), and experienced students used significantly greater lateral bending at onset (Kruskal-Wallis <em>P</em> = .049) and peak (<em>P</em> = .023).</div></div><div><h3>Conclusion</h3><div>Mean axial rotation for DCs during chiropractic cervical spinal adjustments was less than 34° at peak; most other measures were similar to previously reported findings.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 490-501"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471214","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 effects of weight-bearing and nonweight-bearing aerobic exercises on bone morphometry, muscle fiber types, and oxidative stress markers.
Methods
Eighteen 15-month-old male rats were divided into control, swimming, and running groups (n = 6 each). After a 2-week adaptation period, the exercise groups underwent 8 weeks of moderate-intensity swimming or running. Blood, gastrocnemius muscle, and femur bone samples were collected postexercise. Parameters analyzed included total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) in blood, muscle fiber types by immunohistochemistry, and bone characteristics by histostereology.
Results
OSI values were similar across groups (P > .05), but oxidative stress was elevated in the exercise groups. The ratio of type I fibers was higher in the exercise groups compared to controls (P < .05) and similar between swimming and running groups (P > .05). Type IIa fiber ratio was highest in the control group and lowest in the running group (P < .05). Bone surface area, trabecular thickness, and cortical thickness were greater in the running group than in controls (P < .05). The swimming group had a higher distal femur bone area and trabecular width than controls (P < .05), but no significant differences were found between the exercise groups (P > .05).
Conclusions
Weight-bearing and nonweight-bearing exercises had a significant effect on muscle fiber composition, bone structure, and oxidative stress in elderly rats. Running particularly enhanced bone surface area and thickness, while swimming also benefited bone health. Both exercises increased oxidative stress and antioxidant capacity.
{"title":"Effects of Swimming and Running Exercise-Induced Changes in Muscle Fibers, Bone Structure, and Oxidative Stress in Aging Rats","authors":"Mahmut Sürmeli PhD , Fikret Gevrek PhD , Elif Azize Özşahin Delibaş PhD , Funda Demirtürk PhD , Eylem Tütün Yümin PhD","doi":"10.1016/j.jmpt.2025.10.048","DOIUrl":"10.1016/j.jmpt.2025.10.048","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to investigate the effects of weight-bearing and nonweight-bearing aerobic exercises on bone morphometry, muscle fiber types, and oxidative stress markers.</div></div><div><h3>Methods</h3><div>Eighteen 15-month-old male rats were divided into control, swimming, and running groups (n = 6 each). After a 2-week adaptation period, the exercise groups underwent 8 weeks of moderate-intensity swimming or running. Blood, gastrocnemius muscle, and femur bone samples were collected postexercise. Parameters analyzed included total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) in blood, muscle fiber types by immunohistochemistry, and bone characteristics by histostereology.</div></div><div><h3>Results</h3><div>OSI values were similar across groups (<em>P</em> > .05), but oxidative stress was elevated in the exercise groups. The ratio of type I fibers was higher in the exercise groups compared to controls (<em>P</em> < .05) and similar between swimming and running groups (<em>P</em> > .05). Type IIa fiber ratio was highest in the control group and lowest in the running group (<em>P</em> < .05). Bone surface area, trabecular thickness, and cortical thickness were greater in the running group than in controls (<em>P</em> < .05). The swimming group had a higher distal femur bone area and trabecular width than controls (<em>P</em> < .05), but no significant differences were found between the exercise groups (<em>P</em> > .05).</div></div><div><h3>Conclusions</h3><div>Weight-bearing and nonweight-bearing exercises had a significant effect on muscle fiber composition, bone structure, and oxidative stress in elderly rats. Running particularly enhanced bone surface area and thickness, while swimming also benefited bone health. Both exercises increased oxidative stress and antioxidant capacity.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 617-630"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471460","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 explore the hemodynamic effects of standing back extension exercise (SBEE) on the lumbar erector spinae (LES) after adoption of the lumbar flexion position.
Methods
Hemodynamics and activities of the LES were measured in 16 asymptomatic adults (8 men and 8 women; mean age, 20.3 ± 0.5 years) using near-infrared spectroscopy of oxygenated hemoglobin and myoglobin (Hb + Mb) levels and surface electromyography in resting prone and Biering-Sørensen test positions to evaluate both resting and contraction states of the LES before and after 5 minutes of adopting the lumbar flexion position. After adopting the lumbar flexion position, all participants randomly performed two 3-second repetitions of SBEE and maintained a relaxed sitting position (control [CON]) separated by at least a 1-day interval.
Results
After participants had assumed the lumbar flexion position, compared with SBEE, CON was significantly associated with more positive changes in the deoxygenated[Hb + Mb] levels in the prone position (P = .028, w = 0.76, power = 0.99). Deoxygenated[Hb + Mb] levels in the prone (P = .026, d = 0.71, power = 0.73) and Biering-Sørensen test positions (P = .036, d = 0.32, power = 0.22) were significantly lower for SBEE than for CON.
Conclusion
Compared with CON, SBEE resulted in lower deoxygenated[Hb + Mb] levels in the LES at rest and during sustained muscle contraction after participants adopted the lumbar flexion position. These results suggest that the physiological effects of using SBEE on low back pain are caused by partial ischemia of the LES due to maintaining a flexed trunk posture.
目的：探讨采用腰椎屈曲体位后，站立后伸运动（SBEE）对腰竖脊肌（LES）血流动力学的影响。方法：对16例无症状成人（男8名，女8名，平均年龄20.3±0.5岁）采用近红外光谱法测定静息俯卧位和biering - s - ørensen试验体位的氧合血红蛋白和肌红蛋白（Hb + Mb）水平和表面肌电图，评估采用腰椎屈曲体位前后5分钟LES的静息和收缩状态。采用腰椎屈曲体位后，所有参与者随机进行两次3秒的SBEE重复，并保持放松的坐姿（对照[CON]），间隔至少1天。结果：受试者采取腰椎屈曲姿势后，与SBEE相比，CON与俯卧姿势的脱氧[Hb + Mb]水平的积极变化显著相关（P = 0.028, w = 0.76，功率= 0.99）。在俯卧位（P = 0.026, d = 0.71，功率= 0.73）和biberlin - s - ørensen试验体位（P = 0.036, d = 0.32，功率= 0.22）中，SBEE组的脱氧[Hb + Mb]水平显著低于CON组。结论：与CON组相比，采用腰椎屈曲体位后，SBEE组在休息和持续肌肉收缩时的LES中脱氧[Hb + Mb]水平较CON组低。这些结果表明，使用SBEE对腰痛的生理影响是由于保持躯干屈曲姿势引起的LES局部缺血引起的。
{"title":"Effects of Standing Back Extension Exercise on Lumbar Erector Spinae Hemodynamics and Muscle Activity After Prolonged Lumbar Flexion","authors":"Hiroshi Ishida PhD , Tadanobu Suehiro PhD , Chiharu Kurozumi PhD","doi":"10.1016/j.jmpt.2025.10.012","DOIUrl":"10.1016/j.jmpt.2025.10.012","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the hemodynamic effects of standing back extension exercise (SBEE) on the lumbar erector spinae (LES) after adoption of the lumbar flexion position.</div></div><div><h3>Methods</h3><div>Hemodynamics and activities of the LES were measured in 16 asymptomatic adults (8 men and 8 women; mean age, 20.3 ± 0.5 years) using near-infrared spectroscopy of oxygenated hemoglobin and myoglobin (Hb + Mb) levels and surface electromyography in resting prone and Biering-Sørensen test positions to evaluate both resting and contraction states of the LES before and after 5 minutes of adopting the lumbar flexion position. After adopting the lumbar flexion position, all participants randomly performed two 3-second repetitions of SBEE and maintained a relaxed sitting position (control [CON]) separated by at least a 1-day interval.</div></div><div><h3>Results</h3><div>After participants had assumed the lumbar flexion position, compared with SBEE, CON was significantly associated with more positive changes in the deoxygenated[Hb + Mb] levels in the prone position (<em>P</em> = .028, <em>w</em> = 0.76, power = 0.99). Deoxygenated[Hb + Mb] levels in the prone (<em>P</em> = .026, d = 0.71, power = 0.73) and Biering-Sørensen test positions (<em>P</em> = .036, d = 0.32, power = 0.22) were significantly lower for SBEE than for CON.</div></div><div><h3>Conclusion</h3><div>Compared with CON, SBEE resulted in lower deoxygenated[Hb + Mb] levels in the LES at rest and during sustained muscle contraction after participants adopted the lumbar flexion position. These results suggest that the physiological effects of using SBEE on low back pain are caused by partial ischemia of the LES due to maintaining a flexed trunk posture.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 319-327"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145438039","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号