Journal of Manipulative and Physiological Therapeutics最新文献_第8页

Immediate Effect of Instrument-Assisted Soft Tissue Mobilization Treatment in Patients with Plantar Fasciopathy and Asymptomatic Subjects 器械辅助软组织活动治疗足底筋膜病及无症状患者的即时效果。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-20 DOI: 10.1016/j.jmpt.2025.10.010

Yo-Rong Chen PhD, LAT, ATC , Troy Hooper PhD, PT, ATC, LAT , C. Roger James PhD , Timothy J. Pendergrass PT, ScD, MS, CSOMT , Lea Gunnell MD , Larry Munger PhD, LAT, ATC

Objectives

The purpose of this study was to investigate differences in immediate effects of a warm-up and Instrument-Assisted Soft Tissue Mobilization (IASTM) treatment in patients with symptomatic plantar fasciopathy (PF) and asymptomatic groups.

Methods

Twenty five subjects with PF and 25 asymptomatic subjects were recruited. Symptomatic subjects experienced plantar heel pain greater than 3 months, heel palpation discomfort, and pain with the first-morning step. Both groups received a warm-up and IASTM. Pre- and post-treatment measurements included visual analog scale (VAS) pain scores in the PF group, stiffness at the origin and navicular levels, origin thickness, ankle and 1^st metatarsal phalangeal joint (first MTPJ) weight-bearing ROM, and Foot Health Status Questionnaire (FHSQ). Two-way mixed ANOVAs determined group and intervention effects. The Wilcoxon Signed-Rank test was performed to examine PF group VAS changes, and correlations identified the association between tissue properties and clinical presentations.

Results

The intervention group showed significance in 1) reduced PF pain level (P < .001; d = 0.801), 2) increased weight-bearing 1st MTPJ (P = .039; η_p² = 0.08) and ankle ROM (P < .001; η_p² = 0.41) in both groups, and 3) decreased PF origin thickness between-group differences (P = .001; η_p² = 0.20). For all subjects, 1) the higher FHSQ pain level was associated with lesser origin stiffness and greater thickness, 2) higher origin stiffness was correlated with lesser ankle ROM, and 3) greater thickness was associated with less 1^st MTPJ ROM.

Conclusion

An IASTM treatment with warm-up immediately reduced PF symptoms, increased weight-bearing 1st MTPJ and ankle ROM in both groups, and decreased group differences in origin thickness.

目的：本研究的目的是探讨预热和器械辅助软组织动员（IASTM）治疗对有症状的足底筋膜病（PF）患者和无症状组的即时效果的差异。方法：招募25例PF患者和25例无症状患者。有症状的受试者经历足底后跟疼痛超过3个月，脚后跟触诊不适，第一次晨步时疼痛。两组均进行热身和IASTM。治疗前和治疗后的测量包括：PF组的视觉模拟评分（VAS）疼痛评分、关节原点和舟状关节处的僵硬度、关节原点厚度、踝关节和第一跖指关节（第一MTPJ）负重ROM以及足部健康状况问卷（FHSQ）。双向混合方差分析确定分组和干预效果。采用Wilcoxon sign - rank检验检查PF组VAS变化，并确定组织特性与临床表现之间的相关性。结果：干预组在1)降低两组PF疼痛程度（P < 0.001, d = 0.801）、2)增加负重第1 MTPJ （P = 0.039, ηp2 = 0.08）和踝关节ROM （P < 0.001, ηp2 = 0.41）、3)减小PF起源厚度组间差异（P = 0.001, ηp2 = 0.20）均有显著性意义。对于所有受试者，1)较高的FHSQ疼痛水平与较小的起点僵硬和较大的厚度相关，2)较高的起点僵硬与较小的踝关节ROM相关，3)较大的厚度与较小的第1 MTPJ ROM相关。结论：热身的IASTM治疗立即减轻了PF症状，增加了两组负重的第1 MTPJ和踝关节ROM，并减少了起点厚度的组间差异。

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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 Epub Date: 2025-10-04 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

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 Epub Date: 2025-10-10 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

Repetitions Necessary for Motor Learning of the Craniocervical Flexion Test 颅颈屈曲试验中运动学习的必要重复。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-07 DOI: 10.1016/j.jmpt.2025.10.011

Nicolas Kickhofel Weisshahn PhD , Inaihá Laureano Benincá MSc , Aline Luana Ballico MSc , Marcos De Noronha PhD , Alessandro Haupenthal PhD

Objective

This study aimed to identify the number of repetitions needed for familiarization before the result of the craniocervical flexion test (CCFT) is stable and the best performance can be scored.

Methods

This was a cross-sectional observational study of healthy participants conducted in a research laboratory. Participants performed 12 repetitions of the CCFT with a 1-minute interval between each test. The primary outcome was the performance in CCFT. The second, fourth, fifth, seventh, and 12th repetitions of the CCFT were compared using the Friedman and Wilcoxon post hoc tests. The test repetitions to be compared were chosen based on the CCFT protocol, mean performance stability, and sequential analysis method.

Results

Thirty participants were assessed and included in the analysis (age = 21. 9 ± 4.0 years). CCFT performance analysis revealed a difference between the 2nd and the 12th tests (P < .001; r = ‒0.74). When comparing the fifth test to the seventh test, a significant improvement in performance was observed (P = .015; r = ‒0.44); however, when comparing the 7th to the 12th test, there was no difference in performance (P = .071; r = ‒0.32). In addition, test’s mean scores became stable after the 6 tests, indicating that performance was improved until the seventh test.

Conclusion

Six repetitions were needed to obtain a stable performance and full familiarization to be achieved by participants.

目的：本研究旨在确定熟悉颅颈屈曲试验（CCFT）结果稳定所需的重复次数，并对其进行最佳评分。方法：这是一项在研究实验室进行的健康参与者的横断面观察研究。参与者进行了12次CCFT重复，每次测试之间间隔1分钟。主要结果是CCFT的表现。CCFT的第二次、第四次、第五次、第七次和第十二次重复使用Friedman和Wilcoxon事后检验进行比较。根据CCFT协议、平均性能稳定性和序列分析方法选择待比较的测试重复次数。结果：30名参与者被评估并纳入分析（年龄= 21岁）。9±4.0年)。CCFT性能分析显示第2次和第12次测试之间存在差异（P < 0.001; r = -0.74）。当将第五次测试与第七次测试进行比较时，观察到性能的显着改善（P = 0.015; r = -0.44）；然而，当第7次测试与第12次测试比较时，性能没有差异（P = 0.071; r = -0.32）。此外，6次测试后，测试的平均分数趋于稳定，表明成绩在第七次测试前有所提高。结论：需要6次重复才能获得稳定的表现，并使参与者完全熟悉。

{"title":"Repetitions Necessary for Motor Learning of the Craniocervical Flexion Test","authors":"Nicolas Kickhofel Weisshahn PhD , Inaihá Laureano Benincá MSc , Aline Luana Ballico MSc , Marcos De Noronha PhD , Alessandro Haupenthal PhD","doi":"10.1016/j.jmpt.2025.10.011","DOIUrl":"10.1016/j.jmpt.2025.10.011","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to identify the number of repetitions needed for familiarization before the result of the craniocervical flexion test (CCFT) is stable and the best performance can be scored.</div></div><div><h3>Methods</h3><div>This was a cross-sectional observational study of healthy participants conducted in a research laboratory. Participants performed 12 repetitions of the CCFT with a 1-minute interval between each test. The primary outcome was the performance in CCFT. The second, fourth, fifth, seventh, and 12th repetitions of the CCFT were compared using the Friedman and Wilcoxon post hoc tests. The test repetitions to be compared were chosen based on the CCFT protocol, mean performance stability, and sequential analysis method.</div></div><div><h3>Results</h3><div>Thirty participants were assessed and included in the analysis (age = 21. 9 ± 4.0 years). CCFT performance analysis revealed a difference between the 2nd and the 12th tests (<em>P</em> < .001; <em>r</em> = ‒0.74). When comparing the fifth test to the seventh test, a significant improvement in performance was observed (<em>P</em> = .015; <em>r</em> = ‒0.44); however, when comparing the 7th to the 12th test, there was no difference in performance (<em>P</em> = .071; <em>r</em> = ‒0.32). In addition, test’s mean scores became stable after the 6 tests, indicating that performance was improved until the seventh test.</div></div><div><h3>Conclusion</h3><div>Six repetitions were needed to obtain a stable performance and full familiarization to be achieved by participants.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 523-530"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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 Epub Date: 2025-10-24 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。

{"title":"Pressure Pain Thresholds in Patients With Uncomplicated Back and Leg Pain: A Consecutive Case Series","authors":"Robert A. Leach DC, MS , Kate Hayes MS , Stephanie Sullivan DC, PhD , Ronald Hosek MPH, DC, PhD","doi":"10.1016/j.jmpt.2025.09.013","DOIUrl":"10.1016/j.jmpt.2025.09.013","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to determine whether tenderness would improve after chiropractic manipulative therapy (CMT) in patients with lower back pain.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Statistically significant improvements (<em>P</em> < .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 [<em>r<sub>rm</sub></em> = −0.59] and left [<em>r<sub>rm</sub></em> = −0.61] and Kemp Test provocation correlated moderately and inversely with PPTs at L5 both before and after CMT.</div></div><div><h3>Conclusion</h3><div>Findings suggest that there were correlations between tenderness, back and leg pain, ODI, and clinical tests after CMT.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"48 1","pages":"Pages 247-257"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of Low Back Pain History with the Mass and Amount of Intramuscular Noncontractile Tissue of the Back Muscles and Sagittal Spinal Alignment in Community-Dwelling Older Adults 社区居住老年人腰痛史与背部肌肉肌内非收缩组织的质量和数量以及矢状脊柱排列的关系

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-10-25 DOI: 10.1016/j.jmpt.2025.09.011

Mitsuhiro Masaki PT, PhD , Koki Mano PT , Keiko Saito PT , Ayaka Sugino PT , Hisatsugu Taoka PT , Masayo Tanaka MS , Hitomi Sasaki , Chisato Mihara , Hiroki Yachi , Yuki Onda

Objective

The purpose of this study was to examine the association of low back pain history (LBPH) with muscle mass, the amount of intramuscular noncontractile tissue of the back muscles, and sagittal spinal alignment in community-dwelling older adults.

Methods

The participants, 74 community-dwelling older adults in Japan, were classified into control (CTR) (n = 65; mean age, 85.1 ± 7.1 years) and LBPH (n = 9; mean age, 88.6 ± 2.1 years) groups according to the presence of LBPH. Muscle thickness and the echo intensity of the thoracic and lumbar erector spinae, lumbar multifidus, and quadratus lumborum muscles were measured using an ultrasound imaging device. Sagittal spinal alignment in the standing and prone positions (thoracic kyphosis, lumbar lordosis, and sacral anterior inclination angles) were measured using a Spinal Mouse.

Results

Multiple logistic regression analysis with forward selection showed that the muscle echo intensity of the lumbar multifidus muscle was a significant and independent factor of LBPH, while other factors were not. The muscle echo intensity of the lumbar multifidus muscle was significantly higher in the LBPH group than that in the CTR group.

Conclusion

The findings of this study suggest that LBPH is associated with increased intramuscular noncontractile tissue of the lumbar multifidus muscle rather than back muscle mass or sagittal spinal alignment in community-dwelling older adults.

目的：本研究的目的是研究社区居住的老年人腰痛史（LBPH）与肌肉质量、背部肌肉肌内非收缩组织的数量和矢状脊柱排列的关系。方法：74名日本社区老年人根据是否存在LBPH分为对照组（n = 65，平均年龄85.1±7.1岁）和LBPH组（n = 9，平均年龄88.6±2.1岁）。采用超声成像装置测量胸、腰竖脊肌、腰椎多裂肌和腰方肌的肌肉厚度和回声强度。使用spinal Mouse测量站立和俯卧位（胸后凸、腰椎前凸和骶骨前倾角）的矢状面脊柱对齐。结果：采用正向选择的多元logistic回归分析显示，腰多裂肌肌肉回声强度是影响LBPH的一个显著且独立的因素，而其他因素则不是。LBPH组腰多裂肌回声强度明显高于CTR组。结论：本研究结果表明，在社区居住的老年人中，LBPH与腰多裂肌肌内非收缩组织的增加有关，而不是与背部肌肉质量或矢状脊柱排列有关。

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引用次数: 0

Relationships Between Trunk Endurance, Low Back Pain Severity and Functional Disability in a United States Veteran Population: A Cross-sectional Retrospective Study 美国退伍军人躯干耐力、腰痛严重程度和功能残疾之间的关系：一项横断面回顾性研究。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-09-27 DOI: 10.1016/j.jmpt.2025.08.001

Wren M. Burton DC, MPH , Alec L. Schielke DC , Robert J. Butler DC , David B. Huberman PhD , Matthew H. Kowalski DC , Peter M. Wayne PhD , Jeff Teraoka MD , Robert Vining DC, DHSc

Objective

The purpose of this study was to examine the relationships between low back pain (LBP) and trunk endurance (TE) in a United States Veteran population.

Methods

Data were collected from the Veterans Affairs Palo Alto Healthcare System electronic health records (01/2019-12/2019) to identify adults aged 18-89 years presenting with nonsurgical LBP for a chiropractic consultation. Coefficient estimates, standard error, and P-values were calculated from multivariable linear regression for primary (LBP severity) and secondary (functional disability) outcomes, controlling for age, sex, and body composition.

Results

A total of 85 patients (mean age 53.6 years) were included. Trunk endurance was significantly associated with LBP severity (β: −0.042, P < .001) and Oswestry disability index (ODI) scores (β: −0.334, P < .001) suggesting that participants with greater TE (ie, longer prone bridge (plank) test time) had lower LBP severity and lower functional disability than those with poorer TE.

Conclusion

In this sample of Veterans, higher LBP severity and greater functional disability (ODI scores) were associated with reduced TE. Body mass index did not significantly influence these relationships.

目的：本研究的目的是研究美国退伍军人中腰痛（LBP）和躯干耐力（TE）之间的关系。方法：收集退伍军人事务帕洛阿尔托医疗系统电子健康记录（2019年1月1日- 2019年12月）的数据，以确定年龄在18-89岁之间的非手术性腰痛患者进行脊椎按摩咨询。在控制年龄、性别和身体组成的情况下，通过多变量线性回归计算主要（LBP严重程度）和次要（功能性残疾）结局的系数估计、标准误差和p值。结果：共纳入85例患者，平均年龄53.6岁。躯干耐力与腰痛严重程度（β: -0.042, P < .001）和Oswestry残疾指数（ODI）评分（β: -0.334, P < .001）显著相关，表明TE越高（即俯卧桥（平板）测试时间越长）的参与者的腰痛严重程度和功能残疾越低。结论：在退伍军人样本中，较高的腰痛严重程度和较大的功能残疾（ODI评分）与TE降低有关。身体质量指数对这些关系没有显著影响。

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引用次数: 0

Effect of Aerobic Exercise on Fatigue and Quality of Life in Individuals With Fibromyalgia: A Systematic Review of Randomized Controlled Trials 有氧运动对纤维肌痛患者疲劳和生活质量的影响：一项随机对照试验的系统综述。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-06 DOI: 10.1016/j.jmpt.2025.10.023

Cristiano Carvalho PhD , Patricia Gabrielli Vassão PhD , Thatiane Izabele Ribeiro Santos PT , Julia Risso Parisi PhD , Homero Garcia-Motta MSc , Ana Claudia Muniz Renno PhD

Objective

The purpose of this study was to investigate the literature for the effects of aerobic exercise on fatigue and quality of life in individuals with fibromyalgia.

Methods

The Medline/PubMed, Embase and Web of Science databases were searched for relevant articles up to February 2023. We included studies involving individuals with fibromyalgia submitted to aerobic exercise compared to a control group. The Cochrane Risk of Bias Tool was used to appraise the risk of bias, and the level of evidence was analyzed using the Grading of Recommendations, Assessment, Development, and Evaluation approach.

Results

Five articles met the inclusion criteria. The blinding of participants and personnel was insufficient in all studies. Four studies reported an adequate randomization method and 3 supplied sufficient information to assess whether allocation concealment was properly ensured. The risk of detection bias was low in 4 studies, as incomplete outcome data were sufficiently addressed. The risk of reporting bias was low in 3 studies and unclear in 2 studies. Fatigue was assessed in 3 studies; the level of evidence was very low and without effect for this outcome. All studies assessed quality of life, for which level of evidence was low and without effect.

Conclusion

The level of evidence was very low and without effect for fatigue, and low and without effect for quality of life. The AE programs did not promote any improvement in fatigue or quality of life in individuals with FM compared to the control group among studies analyzed in this review. Thus, future studies should be developed to clarify the efficacy of such treatment on these outcomes. Furthermore, there is a lack of studies with AE programs using the revised version of the FIQ (FIQR). Performance fatigue also needs to be used assessed more precisely.

目的：本研究的目的是研究有氧运动对纤维肌痛患者疲劳和生活质量的影响。方法：检索Medline/PubMed、Embase和Web of Science数据库截至2023年2月的相关文章。我们纳入了与对照组相比，纤维肌痛患者进行有氧运动的研究。使用Cochrane偏倚风险工具评估偏倚风险，并使用分级推荐、评估、发展和评价方法分析证据水平。结果：5篇文章符合纳入标准。在所有的研究中，参与者和工作人员的盲法都是不够的。4项研究报告了适当的随机化方法，3项研究提供了足够的信息来评估分配隐藏是否得到适当保证。4项研究的检测偏倚风险较低，因为不完整的结果数据得到了充分处理。3项研究报告偏倚风险较低，2项研究报告偏倚风险不明确。3项研究对疲劳进行评估；证据水平非常低，对这一结果没有影响。所有的研究都评估了生活质量，这方面的证据水平很低，没有效果。结论：证据水平很低，对疲劳无影响，对生活质量低，无影响。在本综述分析的研究中，与对照组相比，AE计划并没有促进FM患者疲劳或生活质量的改善。因此，未来的研究应该发展，以阐明这种治疗对这些结果的疗效。此外，还缺乏使用修正版FIQR （FIQR）的AE程序的研究。性能疲劳也需要更精确地评估。

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引用次数: 0

Short-term Results of Wobble Board-Based Exergame Training on Balance, Functionality, and Fear of Movement in Individuals with Ankle Instability: A Randomized Trial 基于摇摆板的运动训练对踝关节不稳定患者的平衡、功能和运动恐惧的短期效果：一项随机试验。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-04 DOI: 10.1016/j.jmpt.2025.10.003

Behiç Turhan MSc , Özgül Öztürk PhD

Objectives

The purpose of this study was to explore the effect of wobble board-based exergame training on static and dynamic balance ability, functionality, and fear of movement in individuals with functional ankle instability (FAI).

Methods

Forty individuals with FAI were randomized into 2 groups. The exercise group (EG) (n = 20) received wobble board-based exergame training 3 times a week for 4 weeks, while control group (CG) (n = 20) had no intervention but continued their usual activities. Measurements included Star Excursion Balance Test (SEBT), Foot and Ankle Ability Measure (FAAM), Fear Avoidance Beliefs Questionnaire, Short Form-12, perceived treatment effect, time-in-balance, and foot lift test.

Results

Significant group-by-time interactions were detected for time-in-balance (P < .031), foot lift (P = .046), and fear of movement (P = .035) in favor of the EG. Both groups displayed improvements in FAAM scores without a significant difference between the groups (P > .05). The EG did not display superior results in SEBT despite significant within-group improvements after 4-week intervention (P > .05).

Conclusions

This study found that wobble board-based exergame training improved static balance and reduced fear of movement in individuals with FAI in the short term.

目的：本研究的目的是探讨基于摆动板的运动训练对功能性踝关节不稳定（FAI）患者的静态和动态平衡能力、功能和运动恐惧的影响。方法：40例FAI患者随机分为2组。运动组（EG）（n = 20）每周接受3次基于摇摆板的运动训练，持续4周，而对照组（CG）（n = 20）不进行干预，但继续进行日常活动。测量包括星偏移平衡测试（SEBT）、足踝能力测试（FAAM）、恐惧回避信念问卷、短表12、感知治疗效果、平衡时间和足举测试。结果：在时间平衡（P < 0.031）、足部抬起（P = 0.046）和运动恐惧（P = 0.035）方面，发现了显著的组-时间相互作用，有利于EG。两组FAAM评分均有改善，组间差异无统计学意义（P < 0.05）。尽管干预4周后组内显著改善，但EG在SEBT中并未显示出优越的结果（P < 0.05）。结论：本研究发现，基于摇摆板的运动训练在短期内改善了FAI患者的静态平衡，减少了对运动的恐惧。

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引用次数: 0

Effect of Manual Therapy and Transcranial Magnetic Stimulation on Pain in Knee Osteoarthritis: A Randomized Clinical Trial 手工疗法和经颅磁刺激对膝关节骨关节炎疼痛的影响：一项随机临床试验。

IF 1.4 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Manipulative and Physiological Therapeutics

Pub Date : 2025-01-01 Epub Date: 2025-11-03 DOI: 10.1016/j.jmpt.2025.10.009

Andrea Tavares Dantas PhD , Mannaly Braga MSc , Gabriel Barreto PhD , Lorena Melo PhD , Camilla Fonseca BSc , Maíra Lima BSc , Tiago Siqueira de Sousa BSc , Maria das Graças Rodrigues de Araújo PhD , Katia Monte-Silva PhD

Objectives

The purpose of this study was to compare the immediate and long-term effects of repetitive transcranial magnetic stimulation (rTMS) and manual therapy (MT), alone or combined, on knee osteoarthritis (KOA) pain.

Methods

In this single session, double-blind, randomized, and controlled clinical trial, 36 KOA patients were randomly assigned to a single session of real rTMS (rTMS; n = 12), sham rTMS paired with MT (sham rTMS/MT; n = 12), or real rTMS paired with MT (rTMS/MT; n = 12). Pain intensity, pain sensitivity, range of motion, and functional mobility were assessed before (T0) and immediately after the session (T1). Pain intensity was also assessed at follow-ups of five (T2), 15 (T3), and 30 days (T4). Physical disability was assessed in T0 and T2.

Results

Pain intensity decreased in rTMS and sham rTMS/MT at T1. The reduction was greater in rTMS than in sham rTMS/MT at T1 (Cohen's d = 0.95, P = .03) and T2 (Cohen's d = 2.57, P = .39) but not at T3 (P = .41) and T4 (P = .75). rTMS with MT resulted in less pain reduction than rTMS alone (Cohen's d = 0.75, P = .04). The groups presented no differences in pain sensitivity, range of motion, or functional mobility. rTMS presented lower physical disability than sham rTMS/MT at T2 (P = .04).

Conclusions

Manual therapy applied immediately after rTMS impaired the analgesic effect of brain stimulation and showed that a single session of rTMS was enough to reduce pain intensity in participants with KOA.

目的：本研究的目的是比较重复经颅磁刺激（rTMS）和手工疗法（MT），单独或联合，对膝骨关节炎（KOA）疼痛的近期和长期效果。方法：在这项单期、双盲、随机对照的临床试验中，36例KOA患者被随机分配到单期真实rTMS （rTMS, n = 12）、假rTMS联合MT（假rTMS/MT， n = 12）或真实rTMS联合MT （rTMS/MT, n = 12）。在治疗前（T0）和治疗后（T1）分别评估疼痛强度、疼痛敏感性、活动范围和功能活动能力。在随访5天（T2）、15天（T3）和30天（T4）时评估疼痛强度。在T0和T2评估身体残疾。结果：T1时，rTMS组和假rTMS/MT组疼痛强度降低。在T1 （Cohen’s d = 0.95, P = 0.03）和T2 （Cohen’s d = 2.57, P = 0.39）时，rTMS组比假rTMS/MT组减少更多，但在T3 （P = 0.41）和T4 （P = 0.75）时则没有。rTMS联合MT的疼痛减轻效果小于单独rTMS （Cohen’s d = 0.75, P = 0.04）。两组在疼痛敏感性、活动范围或功能活动度方面没有差异。在T2时，rTMS较sham rTMS/MT出现更低的肢体残疾（P = 0.04）。结论：在rTMS后立即进行的手工治疗削弱了脑刺激的镇痛作用，并表明单次rTMS足以减轻KOA参与者的疼痛强度。

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引用次数: 0