Journal of Manipulative and Physiological Therapeutics最新文献_第7页

Evaluation of Cervical Proprioception in Type 2 Diabetes Individuals in Comparison to Healthy Individuals 2型糖尿病患者与健康人颈椎本体感觉的比较

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2025.10.042

Maryam Homafar MSc , Leila Abbasi PhD , Iman Rezaei PhD , Marzieh Mohamadi PhD , Fatemeh Jabari Fard MSc

Objective

This study aimed to assess cervical proprioception and Kinesthesia in individuals with Type 2 diabetes (T2D) compared to healthy subjects.

Methods

This observational-descriptive study was conducted using a cross-sectional approach. The study comprised 20 individuals with type 2 diabetes (10 females, 10 males, aged 40 to 65, diabetes duration ≥5 years, no prior neck issues) and 20 age- and sex-matched healthy individuals Participants underwent 3 sensorimotor tests: (1) the JPET to assess joint position sense, (2) the CCFT to evaluate the activation and endurance of deep cervical flexors, and (3) the Cervical Movement Sense Test to measure movement accuracy using a computer-based laser tracking system.

Results

The T2DM group demonstrated significantly greater joint position errors in flexion (mean ± SD: 5.01° ± 0.66), extension (6.92° ± 4.39), right rotation (6.70° ± 1.05), and left rotation (6.14° ± 2.41) compared to controls (all P < .05). In the CCFT, diabetic participants had a significantly lower cumulative performance index (58.50 ± 5.88) than healthy individuals (107.80 ± 9.07, P < .0001). The Movement Sense Test revealed significantly worse error scores in both zigzag and figure-8 patterns (eg, Zigzag/Right: −3.12 ± 2.43 in T2D vs −1.12 ± 0.76 in controls, P = .001).

Conclusion

Individuals with T2DM exhibited substantial impairments in cervical proprioception and kinesthesia, including deficits in joint position sense, deep cervical muscle activation, and movement accuracy. These impairments may contribute to balance dysfunction and increased fall risk, suggesting that early identification and targeted rehabilitation strategies may be implicated for improving postural stability in this population. While our findings support the presence of cervical sensorimotor impairments in T2DM, we acknowledge that causation cannot be established due to the cross-sectional nature of this study.

目的：本研究旨在评估2型糖尿病（T2D）患者与健康人的颈椎本体感觉和运动感。方法：本观察描述性研究采用横断面方法进行。该研究包括20名2型糖尿病患者（10名女性，10名男性，年龄40至65岁，糖尿病病程≥5年，无既往颈部问题）和20名年龄和性别匹配的健康个体，参与者进行了3项感觉运动测试：(1)JPET评估关节位置感，(2)CCFT评估颈深屈肌的激活和耐力，(3)颈椎运动感觉测试使用基于计算机的激光跟踪系统测量运动准确性。结果：T2DM组屈曲（平均±SD: 5.01°±0.66）、伸展（6.92°±4.39）、右旋（6.70°±1.05）、左旋（6.14°±2.41）关节位置误差明显大于对照组（均P < 0.05）。在CCFT中，糖尿病参与者的累积表现指数（58.50±5.88）显著低于健康者（107.80±9.07,P < 0.0001）。运动感觉测试显示，锯齿形和8字形图案的误差得分明显更差（例如，锯齿形/右：T2D组为-3.12±2.43，对照组为-1.12±0.76,P = .001）。结论：T2DM患者表现出颈椎本体感觉和运动感的严重损伤，包括关节位置感、颈深肌激活和运动准确性的缺陷。这些损伤可能导致平衡功能障碍和跌倒风险增加，提示早期识别和有针对性的康复策略可能与改善该人群的姿势稳定性有关。虽然我们的研究结果支持T2DM患者存在宫颈感觉运动障碍，但我们承认，由于本研究的横断面性质，无法确定因果关系。

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引用次数: 0

Cross-sectional Survey of the Evidence Implementation Environment of the Australian Chiropractic and Osteopathic Professions 澳大利亚脊骨疗法和整骨疗法专业证据实施环境的横断面调查。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2025.10.006

Matthew J. Leach BN, BN[Hons], ND, DipClinNutr, PhD

Objective

The purpose of this study was to explore the complex environment of the Australian chiropractic and osteopathic medicine (COM) professions to ascertain their preparedness for evidence implementation (EI).

Methods

This cross-sectional study, conducted between July and November 2024, used nonprobability sampling and a comprehensive recruitment strategy to engage students, academics, clinicians, managers, directors and administrators in COM to complete the 44-item online Global Assessment of the Evidence Implementation Environment (GENIE) questionnaire.

Results

The survey was completed by 157 respondents (59.2% chiropractors; 40.8% osteopaths). Overall, more than one-half of respondents believed the 34 indicators of EI preparedness in COM had been meet, although the strength of respondents’ convictions was mostly low. Respondents perceived the COM academic environment to be somewhat better prepared for EI (with 72.6% agreeing/strongly agreeing that the sector was ready for EI) relative to the clinical (70.7%) and regulatory sectors (68.1%). Notable challenges to EI were insufficient research funding, champions of evidence-based practice, evidence-based decision-support, and practitioner engagement in research and information literacy.

Conclusions

The majority of Australian COM professionals in this sample believed that key indicators of EI have been met. However, uncertainty remains about each profession’s overall readiness, with academic environments perceived to be better prepared than clinical and regulatory sectors.

目的：本研究的目的是探讨澳大利亚捏脊和整骨医学（COM）专业的复杂环境，以确定他们对证据实施（EI）的准备。方法：这项横断面研究于2024年7月至11月进行，采用非概率抽样和综合招聘策略，让COM的学生、学者、临床医生、管理人员、主任和管理人员完成44项在线证据实施环境全球评估（GENIE）问卷。结果：共有157名受访者完成调查，其中脊医占59.2%，整骨医生占40.8%。总体而言，超过一半的受访者认为COM的34项EI准备指标已经达到，尽管受访者的信念强度大多较低。受访者认为，相对于临床（70.7%）和监管部门（68.1%），COM的学术环境在某种程度上为EI做好了准备（72.6%的人同意/强烈同意该行业为EI做好了准备）。EI面临的显著挑战是研究经费不足、循证实践的拥护者、循证决策支持以及从业者参与研究和信息素养。结论：本样本中大多数澳大利亚COM专业人员认为EI的关键指标已经满足。然而，每个职业的总体准备情况仍然存在不确定性，学术环境被认为比临床和监管部门准备得更好。

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引用次数: 0

Reliability and Validity of Telehealth Spinal Examination Components: A Systematic Review 远程医疗脊柱检查组件的信度和效度：系统评价。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2025.08.008

Frank M. Bucki DC, Victoria A. Bensel DC, MS, Clarice H. Wallert DC, MS, Brittney N. Walters DC, MS

Objective

The purpose of this study was to systematically review the literature on the reliability or validity of telehealth spine examination components.

Methods

MEDLINE database from inception to May 17, 2022. Subject headings include virtual, telerehabilitation, telehealth, telemedicine, spine, spinal, neurologic, cervical, thoracic, lumbar, back, and examination. Studies not done synchronously, lacked comparisons to in-person, involved non-spine pathologies, or lacked reliability/validity were excluded. Reliability and validity data were captured using Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. Quality and risk of bias were assessed with Quality Appraisal Tool for Studies of Diagnostic Reliability and the Scottish Intercollegiate Guidelines Network diagnostic accuracy checklist.

Results

Six studies, with sample sizes of 11 to 100, were included. In 2 studies, Quality Appraisal Tool for Studies of Diagnostic Reliability was low, and the remaining were moderate to high. Two validity studies had high Scottish Intercollegiate Guidelines Network methodologic quality. Two studies suggested high validity and/or reliability for inspection, cranial nerve testing, pain localization, range of motion, deep neck flexion endurance, Lhermitte sign, and cervical spine neuroforaminal compression. Five studies suggested reliability for inspection, lower extremity muscle testing, pain localization, straight leg raise, Sorensen test, 5 repetitive sit-to-stand test, Lasègue test, reverse Lasègue test, Adams test, and pain on heel strike and poor postural inspection reliability.

Conclusion

This review found that components of telehealth spine examinations, such as those done in physical therapy or chiropractic clinical settings, were valid or reliable and provided support for clinical use.

目的：本研究的目的是系统地回顾有关远程医疗脊柱检查组件的信度或效度的文献。方法：MEDLINE数据库自成立至2022年5月17日。主题标题包括虚拟、远程康复、远程保健、远程医疗、脊柱、脊柱、神经、颈椎、胸椎、腰椎、背部和检查。未同步进行的研究、缺乏与现场比较、涉及非脊柱病变或缺乏信度/效度的研究被排除在外。可靠性和有效性数据使用系统评价和元分析标准的首选报告项目来获取。使用诊断可靠性研究质量评价工具和苏格兰校际指南网络诊断准确性检查表评估偏倚的质量和风险。结果：纳入6项研究，样本量为11 ~ 100。在2项研究中，诊断可靠性研究的质量评价工具较低，其余研究均为中至高。两项效度研究具有较高的苏格兰校际指南网络方法学质量。两项研究表明，检查、颅神经测试、疼痛定位、活动范围、深颈屈耐力、Lhermitte体征和颈椎神经孔压迫具有高效度和/或可靠性。5项研究提示检查信度、下肢肌肉测试、疼痛定位、直腿抬高、Sorensen测试、5重复坐立测试、las测试、反向las测试、Adams测试、足跟疼痛和姿势检查信度差。结论：本综述发现，远程医疗脊柱检查的组成部分，如在物理治疗或脊椎指压临床环境中进行的检查，是有效或可靠的，并为临床应用提供了支持。

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引用次数: 0

Information for Readers 读者资讯

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/S0161-4754(25)00121-6

引用次数: 0

Association of Cognitive Impairment and Spinal Pain in the Older Adult Population in the United States: A Cross-Sectional Study 美国老年人认知障碍和脊柱疼痛的关联：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 DOI: 10.1016/j.jmpt.2025.07.001

Haiou Yang PhD , Scott Haldeman DC, MD, PhD , Eric L. Hurwitz DC, PhD , Patricia A. Tavares DC , Bart N. Green DC, MSEd, PhD , Hannah Dale MChiro , Katie de Luca MChiro, PhD

Objective

The objective of this study was to explore the association between cognitive impairment and spinal pain in the older population in the United States.

Methods

We undertook a secondary analysis of cross-sectional data from the 1999 to 2000 and 2001 to 2002 National Health and Nutrition Examination Survey. The pooled data included a representative sample (n = 2975) of older adults (aged 60-85 years) in the United States. Cognitive impairment was assessed through the Digit Symbol Substitution Test. Spinal pain was defined with a multisite definition, including both nonspecific low back pain and neck pain present in the past 3 months. To account for the complex sampling design, logistic regression was performed using Taylor linearized variance estimation to compute weighted measures of associations.

Results

For older adults with spinal pain, the proportion of cognitive impairment increased with age, from 32.64% in the 60 to 64 age group to 93.83% in the 80 to 84 age group, which was also statistically significantly higher than the general population group and the group without spinal pain (P < .001). After controlling for demographic characteristics, socioeconomic status, and general health status, older adults with spinal pain had significantly increased odds of cognitive impairment (odds ratio 1.76, 95% confidence interval: 1.12, 2.79). Vulnerable subgroups (older, female, and less education) were identified.

Conclusion

There was a significant association between cognitive impairment and spinal pain in the older adult population in the United States. Within this population, there were vulnerable subgroups for which spinal pain and cognitive impairment had a greater impact, namely people who are older, female, and those with less education.

目的：本研究的目的是探讨美国老年人认知障碍和脊柱疼痛之间的关系。方法：对1999 ~ 2000年和2001 ~ 2002年全国健康与营养调查的横断面数据进行二次分析。汇总数据包括美国老年人（60-85岁）的代表性样本（n = 2975）。通过数字符号替代测试评估认知障碍。脊柱疼痛的定义是多部位的，包括过去3个月内出现的非特异性腰痛和颈部疼痛。为了解释复杂的抽样设计，使用泰勒线性化方差估计进行逻辑回归来计算关联的加权度量。结果：老年脊柱痛患者认知功能障碍比例随年龄增长而增加，从60 ~ 64岁年龄组的32.64%增加到80 ~ 84岁年龄组的93.83%，也明显高于普通人群和无脊柱痛组（P < 0.001）。在控制了人口统计学特征、社会经济地位和一般健康状况后，患有脊柱疼痛的老年人认知功能障碍的几率显著增加（优势比1.76,95%可信区间：1.12,2.79）。确定了弱势亚群体（老年人、女性和受教育程度较低）。结论：在美国老年人中，认知障碍和脊柱疼痛之间存在显著关联。在这一人群中，有一些易受伤害的亚群，他们的脊柱疼痛和认知障碍有更大的影响，即老年人、女性和受教育程度较低的人。

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引用次数: 0

Neurophysiological Outcomes of Human Touch and Related Clinical Assessments: A Scoping Review 人类触觉的神经生理学结果和相关的临床评估：范围综述。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2025.08.002

Manuela Deodato PT, PhD , Miriam Martini PT , Alessandro Tamma DO , Andrea Nitri DO , Raffaele Ornello MD , Ilaria Frattale MD , Eleonora De Matteis MD , Paolo Manganotti PhD, MD , Valeria Caponnetto PhD

Objectives

The purpose of this study was to summarize literature exploring pain modulation pathways in healthy humans undergoing human-hand touch via professional care without specific intervention as comparator. A secondary aim was to describe the clinical outcomes considered in the literature reporting neurophysiological outcomes.

Methods

A scoping review was performed on PubMed, Scopus, and Web of Science up to 10 September 2022. Included studies had to be primary and describe a human-hand touch intervention performed by professionals on healthy humans. Studies that described only patient-reported outcome measures or drug administration to subjects during touch stimulation were excluded. The study design, Country, setting, type of sample and number of subjects, age, number of females, intervention, type of professionals involved, assessed outcomes, and results were extracted.

Results

We included 1 observational study, 4clinical trials, and 5 randomized studies involving 323 subjects, conducted in clinical (n = 3) or academic (n = 7) settings. The summary of the findings suggest that human touch may induce activation and functional neurophysiological change in “pain matrix” through a convergence of the exteroceptive and interoceptive sensations which comes from lamina I to insula cortex and thalamus. This brain activation may be correlated with clinical improvements, especially in weight gain for preterm/neonates, and in pain modulation for adults. Dynamic human touch may be more pleasant and useful in pain relief than static touch and non-human touch. Finally, the cognitive status of operators may play a role in brain change of touched subjects.

Conclusions

This scoping review identified literature that suggests human touch may be associated with a central convergence and elaboration of sensory information from external and internal milieu, but also with a bi-directional cognitive modulation between operator and touched subject.

目的：本研究的目的是总结在没有特殊干预的情况下，通过专业护理对健康人进行人手触摸时疼痛调节通路的文献研究。第二个目的是描述报道神经生理结果的文献中考虑的临床结果。方法：到2022年9月10日，对PubMed、Scopus和Web of Science进行范围综述。纳入的研究必须是初级的，并且描述了由专业人员对健康人进行的人-手接触干预。仅描述患者在触摸刺激过程中报告的结果测量或药物管理的研究被排除在外。提取研究设计、国家、环境、样本类型和受试者数量、年龄、女性人数、干预措施、参与的专业人员类型、评估结果和结果。结果：我们纳入了1项观察性研究、4项临床试验和5项随机研究，涉及323名受试者，分别在临床（n = 3）和学术（n = 7）环境中进行。研究结果表明，人的触觉可能通过从I层到脑岛皮层和丘脑的外感受和内感受的聚合，诱导“疼痛基质”的激活和功能性神经生理变化。这种大脑激活可能与临床改善有关，特别是早产儿/新生儿体重增加和成人疼痛调节。动态的人类触摸可能比静态触摸和非人类触摸更令人愉快，更有助于缓解疼痛。最后，操作者的认知状态可能在被触摸者的大脑变化中起作用。结论：本综述确定了一些文献，表明人类触觉可能与来自外部和内部环境的感官信息的集中汇聚和细化有关，但也与操作者和被触摸者之间的双向认知调节有关。

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引用次数: 0

Efficacy of Integrated Neuromuscular Inhibition Versus Postisometric Relaxation Technique on Rhomboid Latent Myofascial Trigger Points: A Randomized Clinical Trial 综合神经肌肉抑制与测后松弛技术对菱形潜伏肌筋膜触发点的疗效：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 DOI: 10.1016/j.jmpt.2025.09.006

Aliaa M. Elabd PhD, PT , Omar M. Elabd PhD, PT , Waleed T. Mansour PhD, PT , Radwa F. Hammam PhD, PT

Objective

The purpose of this study was to compare the efficacy of the Integrated Neuromuscular Inhibition Technique (INIT) and postisometric relaxation (PIR) techniques on rhomboid muscle latent trigger points (LTrPs).

Methods

Seventy-five patients with rhomboid muscle LTrPs were randomly divided into 3 groups and treated for 4 weeks: group A (control): conventional treatment (infrared radiation, ultrasonic therapy, and transcutaneous electrical nerve stimulation); group B: PIR with conventional treatment; and group C: INIT with conventional treatment. Pre- and post-treatment measurements were taken for shoulder pain and disability, neck pain intensity, neck disability, and pressure pain threshold (PPT) at 3 spots on each side. A 2-way MANOVA was used for data analysis.

Results

Group C experienced significantly lower shoulder pain and disability than A and B and less neck pain intensity than A. Both groups, B and C, had significantly higher PPT for the upper and lower right points than A. PPT for the right middle, upper, and lower left points was higher in Group C than in A or B. Group C had a higher PPT of the middle-left point than A. There were significant changes in all outcomes within all groups (P < .05), except that the control group showed no significant alterations in PPT measurements.

Conclusions

Both approaches help treat rhomboids and muscle LTrPs when combined with conventional treatment, even though INIT may be more successful than PIR.

目的：比较综合神经肌肉抑制技术（INIT）和测量后松弛技术（PIR）对菱形肌潜在触发点（LTrPs）的影响。方法：将75例菱形肌ltps患者随机分为3组，治疗4周：A组（对照组）：常规治疗（红外辐射、超声治疗、经皮神经电刺激）；B组：PIR联合常规治疗；C组：INIT +常规治疗。治疗前和治疗后分别在每侧3个点测量肩部疼痛和残疾、颈部疼痛强度、颈部残疾和压痛阈值（PPT）。采用双因素方差分析进行数据分析。结果:肩膀疼痛和残疾C组经历了显著低于A和B和颈部疼痛强度低于A组,B和C,显著提高PPT了上部和下部的分比A . PPT的中间,上层,左下角点是在C组高于A或B, C组有一个PPT中左点高于A在所有组内的所有结果有显著变化(P < . 05),除了对照组的PPT测量没有明显的变化。结论：两种方法联合常规治疗都有助于治疗菱形和肌肉ltps，尽管INIT可能比PIR更成功。

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引用次数: 0

Training, Professional Skills, and Experiences of Doctors of Chiropractic Working in U.S. Federally Qualified Health Centers: A Mixed Methods Study 在美国联邦合格医疗中心工作的脊椎指压治疗医生的培训、专业技能和经验：一项混合方法研究。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2025.09.007

Andrea K. Albertson DC , Michele J. Maiers DC, MPH, PhD , Alane G. Lucht DC, PhD, LADC, LPCC , Paul Ratté ND , Charles E. Sawyer DC

Objective

The purpose of this study was to examine the training, professional skills, and experiences of Doctors of Chiropractic (DCs) working in Federally Qualified Health Centers (FQHCs).

Methods

Identified FQHC-employed DCs in the United States were invited to participate in a survey about their training and practice, administered between November and December 2023. A subset of these DCs, along with FQHC administrators and colleagues, participated in qualitative interviews to explore their experiences and the skills necessary for a DC to practice effectively in FQHCs, between February and May 2024. Survey analysis utilized descriptive statistics and content analysis, while reflexive thematic analysis was applied to the interviews by identifying notable themes and creating a codebook.

Results

Of 206 DCs invited, 101 completed the survey (49.0%). Respondents averaged 18.2 years in practice (range: 1-48), and 44.8% participated in the Public Services Loan Forgiveness program. Fewer than half reported prior experience in multidisciplinary settings (47.4%), additional training through certificates (43.8%), or advanced degrees (28.1%). Many (41.8%) reported using a non-English language with patients, predominantly Spanish (80.5%). DCs frequently performed joint manipulation and soft tissue therapies, primarily for spinal and chronic pain. Interviews involved 12 DCs, 10 administrators, and 7 colleagues. Each group appreciated DCs’ instructional abilities (eg, communication, patient education), patient-centered orientation, and interprofessional competencies (eg, teamwork, collaboration). DCs valued providing chiropractic access to underserved communities and focusing on patient care over business practices.

Conclusions

DCs working in FQHCs demonstrated a “team mentality” including patient-centered care, interprofessional collaboration, and communication. Their integration into FQHCs enhances team-based care and expands access to nonpharmacologic pain management.

目的：本研究的目的是考察在联邦合格医疗中心（fqhc）工作的脊医（DCs）的培训、专业技能和经验。方法：邀请美国已确定的fqhc雇用的dc参加一项关于其培训和实践的调查，调查于2023年11月至12月进行。2024年2月至5月期间，这些DC的一部分以及FQHC的管理人员和同事参加了定性访谈，以探索DC在FQHC中有效实践所需的经验和技能。调查分析采用描述性统计和内容分析，而反思性主题分析则通过识别值得注意的主题和创建代码本来应用于访谈。结果：在被邀请的206个区议会中，101个完成调查，占49.0%。受访者平均从业18.2年（1 ~ 48年），44.8%的人参加了公共服务贷款减免计划。不到一半的人报告有多学科背景的经验（47.4%），通过证书的额外培训（43.8%）或高级学位（28.1%）。许多（41.8%）报告使用非英语语言与患者交流，主要是西班牙语（80.5%）。DCs经常进行关节操作和软组织治疗，主要用于脊柱和慢性疼痛。采访涉及12名dc、10名管理员和7名同事。每个小组都对临床医生的教学能力（如沟通、患者教育）、以患者为中心的取向和跨专业能力（如团队合作、协作）表示赞赏。区议会重视向服务不足的社区提供脊椎指压疗法，重视病人护理而不是商业实践。结论：在fqhc工作的临床医生表现出“团队精神”，包括以患者为中心的护理、跨专业合作和沟通。他们与FQHCs的整合加强了团队护理，扩大了非药物疼痛管理的可及性。

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引用次数: 0

Impact of Acupressure on Pain, Functional Status, and Quality of Life in Individuals With Knee Osteoarthritis 穴位按压对膝关节骨关节炎患者疼痛、功能状态和生活质量的影响。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2025.09.001

Tugba Aydemir RN, PhD , Rabiye Çirpan RN, PhD , Pınar Tekinsoy Kartin RN, PhD

Objective

The purpose of this study was to ascertain the impact of acupressure on pain perception, functional status, and overall quality of life in individuals afflicted with knee OA.

Methods

The research was executed as an experimental study employing both pre- and post-test assessments, featuring a control group. Ninety participants were divided into 2 groups: acupressure and control. The acupressure intervention was administered twice weekly, once daily, for a duration of 4 weeks, totaling eight sessions. It adhered to the guidelines for acupuncture application as outlined by the researcher, targeting 6 specific acupuncture points. Data were collected both before and after the acupressure sessions, utilizing assessment tools such as the Visual Analogue Scale (VAS), the 36-Item Short-Form Health Survey (SF-36), and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC).

Results

The study was conducted with a total of 90 participants, comprising 45 individuals in the acupressure group (comprising 88.9% females, with a mean age of 62.88 ± 9.55 years) and 45 individuals in the control group (also comprising 88.9% females, with a mean age of 58.93 ± 10.19 years). Before the acupressure intervention, the acupressure group exhibited higher scores in pain, stiffness, and physical function compared to the control group. Nevertheless, after the interventions, a noteworthy enhancement was detected in the VAS scores, WOMAC scores, and SF-36 scores within the acupressure group (P < .001).

Conclusion

In conclusion, acupressure was found to reduce pain severity and enhance the functional status and quality of life in patients diagnosed with knee OA.

Trial Registration

ClinicalTrials.gov, ID: NCT05238350.

目的：本研究的目的是确定指压对膝关节OA患者疼痛感知、功能状态和整体生活质量的影响。方法：本研究采用实验研究，采用测试前和测试后评估，并设有对照组。90名受试者分为穴位按压组和对照组。穴位按摩干预每周2次，每日1次，持续4周，共8次。它遵循研究者概述的针灸应用指南，针对6个特定的穴位。利用视觉模拟量表（VAS）、36项简短健康调查（SF-36）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）等评估工具，在穴位按压之前和之后收集数据。结果：共纳入90例受试者，其中穴位按压组45例（女性占88.9%，平均年龄62.88±9.55岁），对照组45例（女性占88.9%，平均年龄58.93±10.19岁）。在穴位按压干预前，穴位按压组在疼痛、僵硬和身体功能方面的得分高于对照组。然而，干预后，穴位按压组VAS评分、WOMAC评分和SF-36评分显著增强（P < 0.001）。结论：穴位按压可减轻膝关节OA患者的疼痛程度，改善患者的功能状态和生活质量。试验注册：ClinicalTrials.gov, ID: NCT05238350。

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引用次数: 0

Pressure Pain Thresholds in Patients With Uncomplicated Back and Leg Pain: A Consecutive Case Series 无并发症腰痛和腿痛患者的压力疼痛阈值：连续病例系列。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 DOI: 10.1016/j.jmpt.2025.09.013

Robert A. Leach DC, MS , Kate Hayes MS , Stephanie Sullivan DC, PhD , Ronald Hosek MPH, DC, PhD

Objectives

The purpose of this study was to determine whether tenderness would improve after chiropractic manipulative therapy (CMT) in patients with lower back pain.

Methods

This study was a consecutive case series of 98 patients who completed an initial trial of CMT (1-6 weeks of care) in a private practice from 2018-2021. Charts were retrospectively reviewed. Variables included algometric measurement of L5 paraspinal pressure pain thresholds (PPTs), Modified Oswestry Disability Index (ODI), Numeric Rating Scale (NRS) pain ratings for location and maximum intensity of self-rated back and/or leg pain, as well as level and location of pain reported during posterior oblique trunk movement (operationalized Kemp Test). Statistical analysis included Wilcoxon Signed Rank Test and the Repeated Measures Correlation Test.

Results

Statistically significant improvements (P < .05) for 13 of 15 clinical measures included back and leg pain, ODI, PPT asymmetry and thresholds, and Kemp Test provocation. ODI scores were inversely associated with increases in paraspinal PPTs both on the right [r_rm = −0.59] and left [r_rm = −0.61] and Kemp Test provocation correlated moderately and inversely with PPTs at L5 both before and after CMT.

Conclusion

Findings suggest that there were correlations between tenderness, back and leg pain, ODI, and clinical tests after CMT.

目的：本研究的目的是确定压痛是否会改善后捏脊手法治疗（CMT）患者的腰痛。方法：本研究是一个连续的病例系列，包括98名患者，他们从2018年到2021年在一家私人诊所完成了CMT的初始试验（1-6周的治疗）。对图表进行回顾性审查。变量包括L5椎旁压力疼痛阈值（PPTs）的测量，改良Oswestry残疾指数（ODI），自评背部和/或腿部疼痛的位置和最大强度的数值评定量表（NRS）疼痛评分，以及后斜躯干运动时报告的疼痛水平和位置（操作性Kemp测试）。统计分析采用Wilcoxon sign Rank检验和重复测量相关检验。结果：15项临床指标中的13项有统计学显著改善（P < 0.05），包括腰腿疼痛、ODI、PPT不对称和阈值、Kemp试验激发。ODI评分与右侧和左侧棘旁PPTs的增加呈负相关[rrm = -0.59]， Kemp Test激发与CMT前后L5点PPTs呈中度和负相关。结论：研究结果表明，CMT后的压痛、背部和腿部疼痛、ODI和临床试验之间存在相关性。

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