Pub Date : 2023-07-18DOI: 10.29011/2690-0149.100123
R. Schenk, Joseph Lorenzetti, Michael Ross, Ian J. Kulac, Kourtney Cox, Emily Gartenman, Anna Ruth Gsellman, Dylan Lodowski, Kristin Barnard, Joseph Baumgarden, Thomas E. Coleman, M. Geraci, David May, Amy Murdock, Melissa Ramsay, Edyta Sullivan, Colleen Kashino, J. Cleland
Background: Psychosocial aspects of pain are often associated with chronic low back pain, a condition for which the specific etiology is unknown. Psychosocial risk tools, such as the Yellow Flag Risk Form (YFRF) have been used to identify these factors and sub classify participants into clinically relevant subgroups, which are aligned with a specific intervention. The purpose of this research was to analyze patient outcomes in people with low back pain referred to physical therapists who utilize the YFRF Mechanical Diagnosis and Therapy (MDT), and Pain Mechanism Classification (PMCS) principles. Methods: One hundred seventy-nine people with Low Back Pain (LBP) were referred to a hospital-based physical therapy outpatient clinic in western New York State. Of the 179 participants, 26 met the exclusion criteria and 13 had incomplete data, resulting in an analysis of 140 participants. The participants were examined and classified based on MDT and the PMCS classifications by physical therapists trained in both systems. Participants were administered the YFRF, the Numerical Pain Rating Scale (NPRS), and the Focus on Therapeutic Outcomes (FOTO) tools at initial evaluation, at the 4 th visit, and at discharge. Results: Of the 140 participants, 65% were experiencing chronic duration of symptoms and 60.7% of the sample scored greater than or equal to 50 on the YFRF. Among these participants, 92/140 (65.7% of the sample were classified as responders and 48/140 (34.3%) were classified as non-responders based on a statistically significant change score on either FOTO or the NPRS. A regression analysis of YFRF findings and outcome indicated that the model performed well in classifying patients as responders or non-responders. Conclusion: This research suggests that a high percentage of participants receiving musculoskeletal care may have symptom chronicity and psychosocial risk and still respond to physical therapy intervention. Further, MDT may be an effective musculoskeletal approach for participants classified with a derangement irrespective of psychosocial risk factors as indicated by change in YFRF score as a predictor of patient outcome.
{"title":"Validity of the Yellow Flag Risk Form in People Treated for Low Back Pain with Mechanical Diagnosis and Therapy and the Pain Mechanism Classification System","authors":"R. Schenk, Joseph Lorenzetti, Michael Ross, Ian J. Kulac, Kourtney Cox, Emily Gartenman, Anna Ruth Gsellman, Dylan Lodowski, Kristin Barnard, Joseph Baumgarden, Thomas E. Coleman, M. Geraci, David May, Amy Murdock, Melissa Ramsay, Edyta Sullivan, Colleen Kashino, J. Cleland","doi":"10.29011/2690-0149.100123","DOIUrl":"https://doi.org/10.29011/2690-0149.100123","url":null,"abstract":"Background: Psychosocial aspects of pain are often associated with chronic low back pain, a condition for which the specific etiology is unknown. Psychosocial risk tools, such as the Yellow Flag Risk Form (YFRF) have been used to identify these factors and sub classify participants into clinically relevant subgroups, which are aligned with a specific intervention. The purpose of this research was to analyze patient outcomes in people with low back pain referred to physical therapists who utilize the YFRF Mechanical Diagnosis and Therapy (MDT), and Pain Mechanism Classification (PMCS) principles. Methods: One hundred seventy-nine people with Low Back Pain (LBP) were referred to a hospital-based physical therapy outpatient clinic in western New York State. Of the 179 participants, 26 met the exclusion criteria and 13 had incomplete data, resulting in an analysis of 140 participants. The participants were examined and classified based on MDT and the PMCS classifications by physical therapists trained in both systems. Participants were administered the YFRF, the Numerical Pain Rating Scale (NPRS), and the Focus on Therapeutic Outcomes (FOTO) tools at initial evaluation, at the 4 th visit, and at discharge. Results: Of the 140 participants, 65% were experiencing chronic duration of symptoms and 60.7% of the sample scored greater than or equal to 50 on the YFRF. Among these participants, 92/140 (65.7% of the sample were classified as responders and 48/140 (34.3%) were classified as non-responders based on a statistically significant change score on either FOTO or the NPRS. A regression analysis of YFRF findings and outcome indicated that the model performed well in classifying patients as responders or non-responders. Conclusion: This research suggests that a high percentage of participants receiving musculoskeletal care may have symptom chronicity and psychosocial risk and still respond to physical therapy intervention. Further, MDT may be an effective musculoskeletal approach for participants classified with a derangement irrespective of psychosocial risk factors as indicated by change in YFRF score as a predictor of patient outcome.","PeriodicalId":296965,"journal":{"name":"International Journal of Musculoskeletal Disorders","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133985127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-31DOI: 10.29011/2690-0149.000013
Z. Yıldız, Fadime Küçük
Dysferlinopathy is autosomal recessive neuromuscular diseases resulting from genetic dysferlin deficiency, a protein involved muscle repair. The aim of this study is to present information about evaluation, treatment program of patients with dysferlinopathy. 27-year-old female patient was treated 3 days a week for 7 months. Before and after treatment; it has been assessed that muscle strength with 0-5 Medical Research Council Scale, physical performance with Timed Physical Performance Test, fall worries with Falls Efficacy Scale International; number of falls, body mass index recorded. Kinesiotape, isotonicisometric-resistant exercises, PNF were applied to increase muscle strength; ear acupuncture was used for weight control. Timed performance durations, worries of falling, the number of falls and body mass index decreased significantly. Compared to pre-treatment muscle strength increased in all muscular groups included. It has been observed that isotonic, isometric, PNF exercises, kinesiotape application increase muscle strength, physical performance; decrease the number of falls, falls worries.
{"title":"Physiotherapy and Rehabilitation in Dysferlinopathy","authors":"Z. Yıldız, Fadime Küçük","doi":"10.29011/2690-0149.000013","DOIUrl":"https://doi.org/10.29011/2690-0149.000013","url":null,"abstract":"Dysferlinopathy is autosomal recessive neuromuscular diseases resulting from genetic dysferlin deficiency, a protein involved muscle repair. The aim of this study is to present information about evaluation, treatment program of patients with dysferlinopathy. 27-year-old female patient was treated 3 days a week for 7 months. Before and after treatment; it has been assessed that muscle strength with 0-5 Medical Research Council Scale, physical performance with Timed Physical Performance Test, fall worries with Falls Efficacy Scale International; number of falls, body mass index recorded. Kinesiotape, isotonicisometric-resistant exercises, PNF were applied to increase muscle strength; ear acupuncture was used for weight control. Timed performance durations, worries of falling, the number of falls and body mass index decreased significantly. Compared to pre-treatment muscle strength increased in all muscular groups included. It has been observed that isotonic, isometric, PNF exercises, kinesiotape application increase muscle strength, physical performance; decrease the number of falls, falls worries.","PeriodicalId":296965,"journal":{"name":"International Journal of Musculoskeletal Disorders","volume":"269 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133971009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-09DOI: 10.29011/2690-0149.000011
Camila da Luz Eltchechem, Jéssica Wouk, Luiz Augusto da Silva
Cerebellar diseases and disturbs cause speed, amplitude and strength deficiency. Among cerebellar dysfunctions, the spinocerebellar ataxia is a pathology characterized by the presence of progressive cerebellar ataxia. Spinocerebellar ataxia has as its initial clinic manifestations the deterioration of equilibrium and coordination, beyond eye disturbances, progressive postural oscillation associated with dysarthria, dysphagia and pyramidal and extrapyramidal signs. Cerebellar ataxias are caused by a cerebellum disorder and its connections, which may be attributed by root causes in the cases of congenital and hereditary ataxias. This review brings a brief historical perspective about cerebellar functions and in addition, a discussion about a specific cerebellar dysfunction, spinocerebellar ataxia, emphasizing its physiology to a better comprehension of the disease, its clinic and the several types of this pathology.
{"title":"Genetic Mutations and Treatment of Spinocerebellar Ataxias","authors":"Camila da Luz Eltchechem, Jéssica Wouk, Luiz Augusto da Silva","doi":"10.29011/2690-0149.000011","DOIUrl":"https://doi.org/10.29011/2690-0149.000011","url":null,"abstract":"Cerebellar diseases and disturbs cause speed, amplitude and strength deficiency. Among cerebellar dysfunctions, the spinocerebellar ataxia is a pathology characterized by the presence of progressive cerebellar ataxia. Spinocerebellar ataxia has as its initial clinic manifestations the deterioration of equilibrium and coordination, beyond eye disturbances, progressive postural oscillation associated with dysarthria, dysphagia and pyramidal and extrapyramidal signs. Cerebellar ataxias are caused by a cerebellum disorder and its connections, which may be attributed by root causes in the cases of congenital and hereditary ataxias. This review brings a brief historical perspective about cerebellar functions and in addition, a discussion about a specific cerebellar dysfunction, spinocerebellar ataxia, emphasizing its physiology to a better comprehension of the disease, its clinic and the several types of this pathology.","PeriodicalId":296965,"journal":{"name":"International Journal of Musculoskeletal Disorders","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130677311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-06DOI: 10.29011/2690-0149.000007
K. Sundaram, S. Culler, A. Simon, D. Jevsevar, I. Gitajn, Michael J. Schlosser
Background: This paper reports trends in care and costs associated with hip fracture admissions among Medicare Beneficiaries (MB). Methods: This retrospective study identified 1,558,428 primary hip fracture admissions using the Medicare Provider Analysis and Review Files from fiscal years 2010 through fiscal year 2015. Results: The total number of admissions rose from 246,825 to 276,659; however, rate per 1000 MB was 4.96 in 2010 and 4.98 in 2015. In all years, the patients were mostly female, Caucasian, and over age 80. Patient complexity increased as evidenced by greater comorbidity reporting. Most patients received an Open Reduction and Internal Fixation (ORIF) or partial hip arthroplasty, although there was a slight decline in partial hip arthroplasty and concurrent rise in total hip replacement. The cost per patient rose from $12,363 to $14093 (p<0.0001) despite a fall in average LOS from 5.8 to 5.42 days (p<0.0001) and a fall in in-hospital mortality from 2.6% to 2.2%. Reimbursements fell $1,118 from $10,304 in 2010 to $9,186 in 2015. Conclusions: Average hospital cost per beneficiary rose during our study period while inflation-adjusted reimbursements fell. We found lower average LOS and postop mortality. Rates of AKI on presentation and co-morbid infection have risen. The number of patients receiving THA has risen but the most common treatment is femur repair. Background On July 25, 2016, the Department of Health & Human Services (HHS) proposed a new model that expands bundled payments to include Surgical Hip and Femur Fracture Treatment (SHFFT) [1-2]. This progression theoretically shifts Medicare payments from quantity to quality by creating strong incentives for hospitals to deliver better care at a lower cost [3-4]. An estimated 300,000 Medicare beneficiaries suffer a hip fracture per year [5]. In 2014, an average of 5.8 beneficiaries per 1,000 suffered a hip fracture [6]. The primary objective of this study is to report on trends associated with MBs admitted to US hospitals with a primary diagnosis of hip fracture from fiscal years 2010 through fiscal year 2015. We report outcomes among patients receiving Total Hip Arthroplasty (THA), Partial Hip Arthroplasty (PH), femur repair, and non-operative care. We predicted higher prevalence of baseline comorbidities, higher costs, and lower reimbursements due to national policies favoring cost settings in the setting of an increasingly older US population. Citation: Sundaram K, Culler S, Simon A, Jevsevar DS, Gitajn IL, et al. (2018) Hip Fracture Admissions among Medicare Beneficiaries 2010-2015-Rising hospital costs and falling reimbursements. Int J Musculoskelet Disord: IJMD-107 DOI: 10.29011/ IJMD-107. 000007 2 Volume 2018; Issue 02 Methods Data Source Center for Medicare and Medicaid Services maintains a database called Med PAR that contains all submitted claims for services provided to MBs. We obtained a data set from this database that spanned from 2010 to 2015. Study Population Select
背景:本文报告了医疗保险受益人(MB)髋部骨折入院的护理和费用趋势。方法:本回顾性研究从2010财政年度到2015财政年度，利用医疗保险提供者分析和审查文件，确定了1,558,428例原发性髋部骨折入院。结果:入院总人数由246825人增至276659人;然而，2010年每1000 MB的速率为4.96,2015年为4.98。在所有年份中，患者以女性、白种人和80岁以上为主。更多的合并症报告证明了患者复杂性的增加。大多数患者接受切开复位内固定(ORIF)或部分髋关节置换术，尽管部分髋关节置换术略有下降，同时全髋关节置换术有所上升。每位患者的费用从12,363美元上升到14093美元(p<0.0001)，尽管平均LOS从5.8天下降到5.42天(p<0.0001)，住院死亡率从2.6%下降到2.2%。报销额从2010年的10304美元下降到2015年的9186美元，下降了1118美元。结论:在我们的研究期间，每位受益人的平均医院成本上升，而通货膨胀调整后的报销下降。我们发现较低的平均LOS和术后死亡率。AKI的出现率和合并感染率已经上升。接受人工髋关节置换术的患者数量有所增加，但最常见的治疗方法是股骨修复。2016年7月25日，美国卫生与公众服务部(HHS)提出了一种新的模式，将捆绑支付扩大到包括手术髋关节和股骨骨折治疗(SHFFT)[1-2]。从理论上讲，这一进展通过为医院创造强有力的激励，以更低的成本提供更好的医疗服务，将医疗保险支付从数量转向质量[3-4]。据估计，每年有30万医疗保险受益人髋部骨折[5]。2014年，平均每1000名受益人中有5.8人髋部骨折[6]。本研究的主要目的是报告2010财年至2015财年美国医院以髋部骨折为主要诊断的MBs的相关趋势。我们报告了接受全髋关节置换术(THA)、部分髋关节置换术(PH)、股骨修复和非手术治疗的患者的结果。我们预测基线合并症的患病率更高，成本更高，报销更低，因为国家政策在美国人口老龄化的背景下支持成本设置。引用本文:Sundaram K, Culler S, Simon A, Jevsevar DS, Gitajn IL，等。(2018)2010-2015年医疗保险受益人髋部骨折入院情况。国际肌肉骨骼疾病杂志:IJMD-107 DOI: 10.29011/ IJMD-107。000007 2卷2018;医疗保险和医疗补助服务数据源中心维护一个名为Med PAR的数据库，其中包含向mb提供服务的所有提交的索赔。我们从这个数据库中获得了从2010年到2015年的数据集。研究人群选择100%的医疗保险A部分和C部分索赔被纳入。在研究期间，CMS要求每次住院索赔，确保c部分没有遗漏索赔。65岁以下的个人可能因残疾而有资格享受医疗保险。经过仔细考虑，我们基于先前的文献决定纳入这一人群，这些文献表明，大多数40-50岁的患者与65岁以上的患者有一个共同的机制——骨质疏松性脆性骨折，摔倒是诱发事件[7]。此外，Kaiser-Family基金会之前的研究发现，65岁以下的mb与65岁以上的mb中有5种或更多疾病的比例相似(31%对28%)，这表明共病负担相似[8]。由于我们的数据集的限制，65岁以下的终末期肾病患者符合医疗保险资格，但先前的研究表明，他们占医疗保险总人口的比例不到1%[9-10]。Med Par数据集包括基本人口统计信息、多达25个带有入院(POA)标志的诊断ICD-9-CM代码、主要程序代码、多达24个附加ICD-9-CM程序代码、LOS(以天计算)、出院状态(出院处置或地点)、总费用和医疗保险计划的总报销。在仔细考虑了先前的文献后，我们使用ICD-9代码识别患者。数据支持使用“股骨颈骨折”相对于图表复习(PPV=0.85-0.93)[11-14]。虽然“病理性骨折”通常指骨质疏松性脆性骨折，但一些临床医生可能会将该代码用于转移性疾病的患者。先前的研究表明，在Medicare人群中，转移相关的肿瘤性骨折发生率非常低(每1000 MB 0.3例)，并且在排除“病理性骨折”时存在假阴性的风险，因此我们选择使用ICD-9代码733.14来诊断股骨颈病理性骨折[15-16]。
{"title":"Hip Fracture Admissions Among Medicare Beneficiaries 2010-2015 -Rising Hospital Costs and Falling Reimbursements","authors":"K. Sundaram, S. Culler, A. Simon, D. Jevsevar, I. Gitajn, Michael J. Schlosser","doi":"10.29011/2690-0149.000007","DOIUrl":"https://doi.org/10.29011/2690-0149.000007","url":null,"abstract":"Background: This paper reports trends in care and costs associated with hip fracture admissions among Medicare Beneficiaries (MB). Methods: This retrospective study identified 1,558,428 primary hip fracture admissions using the Medicare Provider Analysis and Review Files from fiscal years 2010 through fiscal year 2015. Results: The total number of admissions rose from 246,825 to 276,659; however, rate per 1000 MB was 4.96 in 2010 and 4.98 in 2015. In all years, the patients were mostly female, Caucasian, and over age 80. Patient complexity increased as evidenced by greater comorbidity reporting. Most patients received an Open Reduction and Internal Fixation (ORIF) or partial hip arthroplasty, although there was a slight decline in partial hip arthroplasty and concurrent rise in total hip replacement. The cost per patient rose from $12,363 to $14093 (p<0.0001) despite a fall in average LOS from 5.8 to 5.42 days (p<0.0001) and a fall in in-hospital mortality from 2.6% to 2.2%. Reimbursements fell $1,118 from $10,304 in 2010 to $9,186 in 2015. Conclusions: Average hospital cost per beneficiary rose during our study period while inflation-adjusted reimbursements fell. We found lower average LOS and postop mortality. Rates of AKI on presentation and co-morbid infection have risen. The number of patients receiving THA has risen but the most common treatment is femur repair. Background On July 25, 2016, the Department of Health & Human Services (HHS) proposed a new model that expands bundled payments to include Surgical Hip and Femur Fracture Treatment (SHFFT) [1-2]. This progression theoretically shifts Medicare payments from quantity to quality by creating strong incentives for hospitals to deliver better care at a lower cost [3-4]. An estimated 300,000 Medicare beneficiaries suffer a hip fracture per year [5]. In 2014, an average of 5.8 beneficiaries per 1,000 suffered a hip fracture [6]. The primary objective of this study is to report on trends associated with MBs admitted to US hospitals with a primary diagnosis of hip fracture from fiscal years 2010 through fiscal year 2015. We report outcomes among patients receiving Total Hip Arthroplasty (THA), Partial Hip Arthroplasty (PH), femur repair, and non-operative care. We predicted higher prevalence of baseline comorbidities, higher costs, and lower reimbursements due to national policies favoring cost settings in the setting of an increasingly older US population. Citation: Sundaram K, Culler S, Simon A, Jevsevar DS, Gitajn IL, et al. (2018) Hip Fracture Admissions among Medicare Beneficiaries 2010-2015-Rising hospital costs and falling reimbursements. Int J Musculoskelet Disord: IJMD-107 DOI: 10.29011/ IJMD-107. 000007 2 Volume 2018; Issue 02 Methods Data Source Center for Medicare and Medicaid Services maintains a database called Med PAR that contains all submitted claims for services provided to MBs. We obtained a data set from this database that spanned from 2010 to 2015. Study Population Select","PeriodicalId":296965,"journal":{"name":"International Journal of Musculoskeletal Disorders","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123038980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-31DOI: 10.29011/2690-0149.000010
Vladimir Midavaine, C. Molinaro, L. Lejeune, M. Molinaro
Background: Jones’ techniques consist of the use of an analgesic position of correction to release guarding muscles and the kinetic dysfunction. For some authors, those techniques may have an impact on pain perception and sympathetic nervous system. The aim of this study is to find clinical evidences supporting a theoretical neurological model and to evaluate jones technique effectiveness on three different axes such as mobility (measured and experienced), pain and impact on sympathetic nervous system (here on cardiac issues). Methods: For this study 60 volunteers, 34 men and 26 women, with a mean age of 31.17 (± 9.88) were recruited. This study was a simple-blind randomised trial with an experimental group (N=30) in which a jones technique for the normalisation of the 4th thoracic vertebra in right rotation was performed and a control group (N=30) which stayed steadily for an equivalent duration. There were no significant differences of sex (17 men and 13 women in each) or age (F=1.76; NS) between the two groups. Results: Results show a significant effectiveness (p<0.05) of jones technique treating osteopathic dysfunctions with a resolution rate of 75% in experimental group against 11% for the control group. Tenderness of tender points has decreased significantly (p<0.05) of 65% in the experimental group against 5% in the control group. Mobility tests show a significate increase of flexion range of motion (p<0.05; +0.493cm between two groups in post-test and p<0.05; +0.527 for the before/after in experimental group). There is no significant difference in back pain, cardiac frequency or arterial pressure. Conclusion: These results shown effectiveness of Jones’ technique on mobility and presence of somatic dysfunctions. Those techniques had, however, no impacts on activity of vegetative nervous system. Introduction Jones’ techniques (aka strain-counter strain) were described by Lawrence Hugh Jones (American osteopath) in 1981, based on clinical experimentations for more than 40 years, to treat his patients. Those techniques are based on three main principles which are: use of Tender Points (TP) for diagnosis, analgesic position for correction and its effect on neuromuscular spindles allowing to relax tense muscle and therefore free from kinetic restriction [1]. In 1991, R.L. Van Buskirk has developed another approach which presumes that those techniques may have an impact on pain perception and Vegetative Nervous System (VNS) for stimulate an organ (heart for example) through Sympathetic Nervous System (SNS). He thus described a neurological model able to explain all the effects of Jones’ techniques. Nonetheless, this model is merely theoretical and has never been proven clinically [2]. In this latter, the author explains that the somatic dysfunction is not local musculoskeletal disruption, but rather a disorder binding those last disruptions with other phenomenon such as pain, vegetative arousal and visceral dysfunction. Nociceptor’s activation b
{"title":"Effects of Jones’ Techniques on Joints Mobility, Back Pain and Cardiac Regulation","authors":"Vladimir Midavaine, C. Molinaro, L. Lejeune, M. Molinaro","doi":"10.29011/2690-0149.000010","DOIUrl":"https://doi.org/10.29011/2690-0149.000010","url":null,"abstract":"Background: Jones’ techniques consist of the use of an analgesic position of correction to release guarding muscles and the kinetic dysfunction. For some authors, those techniques may have an impact on pain perception and sympathetic nervous system. The aim of this study is to find clinical evidences supporting a theoretical neurological model and to evaluate jones technique effectiveness on three different axes such as mobility (measured and experienced), pain and impact on sympathetic nervous system (here on cardiac issues). Methods: For this study 60 volunteers, 34 men and 26 women, with a mean age of 31.17 (± 9.88) were recruited. This study was a simple-blind randomised trial with an experimental group (N=30) in which a jones technique for the normalisation of the 4th thoracic vertebra in right rotation was performed and a control group (N=30) which stayed steadily for an equivalent duration. There were no significant differences of sex (17 men and 13 women in each) or age (F=1.76; NS) between the two groups. Results: Results show a significant effectiveness (p<0.05) of jones technique treating osteopathic dysfunctions with a resolution rate of 75% in experimental group against 11% for the control group. Tenderness of tender points has decreased significantly (p<0.05) of 65% in the experimental group against 5% in the control group. Mobility tests show a significate increase of flexion range of motion (p<0.05; +0.493cm between two groups in post-test and p<0.05; +0.527 for the before/after in experimental group). There is no significant difference in back pain, cardiac frequency or arterial pressure. Conclusion: These results shown effectiveness of Jones’ technique on mobility and presence of somatic dysfunctions. Those techniques had, however, no impacts on activity of vegetative nervous system. Introduction Jones’ techniques (aka strain-counter strain) were described by Lawrence Hugh Jones (American osteopath) in 1981, based on clinical experimentations for more than 40 years, to treat his patients. Those techniques are based on three main principles which are: use of Tender Points (TP) for diagnosis, analgesic position for correction and its effect on neuromuscular spindles allowing to relax tense muscle and therefore free from kinetic restriction [1]. In 1991, R.L. Van Buskirk has developed another approach which presumes that those techniques may have an impact on pain perception and Vegetative Nervous System (VNS) for stimulate an organ (heart for example) through Sympathetic Nervous System (SNS). He thus described a neurological model able to explain all the effects of Jones’ techniques. Nonetheless, this model is merely theoretical and has never been proven clinically [2]. In this latter, the author explains that the somatic dysfunction is not local musculoskeletal disruption, but rather a disorder binding those last disruptions with other phenomenon such as pain, vegetative arousal and visceral dysfunction. Nociceptor’s activation b","PeriodicalId":296965,"journal":{"name":"International Journal of Musculoskeletal Disorders","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126622738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-15DOI: 10.29011/2690-0149.000009
S. Mahmood, N. Ebraheim, J. Stirton, Aaran Varatharajan
Purpose: This literature review is intended to provide oversight on the anatomy, incidence, etiology, presentation, diagnosis, and treatment of coccydynia. Relevant articles were retrieved with PubMed using keywords such as “coccydynia”, “coccyx”, “coccyx pain”, and “coccygectomy”. Methods: Literature accumulated for this study was accumulated from PubMed using sources dating back to 1859. All sources were read thoroughly, compared, and combined to form this study. Images were also added from three separate sources to aid in the understanding of the coccyx and coccydynia. Focal points of this study included the anatomy of the coccyx, etiology and presentation of coccydynia, how to properly diagnose coccydynia, and possible treatments for the variety of etiologies. Results: The coccyx morphology is defined using different methods by different authors as presented in this study. There is no conclusive quantitative data on the incidence of coccydynia; however, there are important factors that lead to increased risk of coccydynia such as obesity, age, and female gender. Injury to the coccyx or coccygeal joints with surrounding tissue inflammation and contraction of the muscles attached to the coccyx causes coccydynia. Diagnosis is made predominantly in clinical examinations with static standard radiographs, CT, and routine blood tests. Treatment options include conservative care, physical therapy, intrarectal massage and manipulation, sacrococcygeal injections (including ganglion impar block), and coccygectomy.
{"title":"Coccydynia: A Literature Review of Its Anatomy, Etiology, Presentation, Diagnosis, and Treatment","authors":"S. Mahmood, N. Ebraheim, J. Stirton, Aaran Varatharajan","doi":"10.29011/2690-0149.000009","DOIUrl":"https://doi.org/10.29011/2690-0149.000009","url":null,"abstract":"Purpose: This literature review is intended to provide oversight on the anatomy, incidence, etiology, presentation, diagnosis, and treatment of coccydynia. Relevant articles were retrieved with PubMed using keywords such as “coccydynia”, “coccyx”, “coccyx pain”, and “coccygectomy”. Methods: Literature accumulated for this study was accumulated from PubMed using sources dating back to 1859. All sources were read thoroughly, compared, and combined to form this study. Images were also added from three separate sources to aid in the understanding of the coccyx and coccydynia. Focal points of this study included the anatomy of the coccyx, etiology and presentation of coccydynia, how to properly diagnose coccydynia, and possible treatments for the variety of etiologies. Results: The coccyx morphology is defined using different methods by different authors as presented in this study. There is no conclusive quantitative data on the incidence of coccydynia; however, there are important factors that lead to increased risk of coccydynia such as obesity, age, and female gender. Injury to the coccyx or coccygeal joints with surrounding tissue inflammation and contraction of the muscles attached to the coccyx causes coccydynia. Diagnosis is made predominantly in clinical examinations with static standard radiographs, CT, and routine blood tests. Treatment options include conservative care, physical therapy, intrarectal massage and manipulation, sacrococcygeal injections (including ganglion impar block), and coccygectomy.","PeriodicalId":296965,"journal":{"name":"International Journal of Musculoskeletal Disorders","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129279008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-09DOI: 10.29011/2690-0149.000008
Müberra Tanrıverdi, S. Yurdalan, F. Cakir
Background: Musculoskeletal influence in childhood cancers is a matter that is ignored. The aim in our study is to present the results of musculoskeletal evaluation in our case with childhood cancer. Case: Assessment of the musculoskeletal system of childhood cancer, directed to physiotherapy and rehabilitation, was performed by a oncophysiotherapist. An 11-year-old male patient was included. Acute Lymphoblastic Leukemia (ALL) was diagnosed at the age of 6 years. While no asymmetry and limitations were observed in anthropometric and goniometric measurements, weakness in muscle testing and musculoskeletal disorders in posture analysis were observed. Discussion: Physical functioning and participation in assessing functional health status and health-related quality of life in childhood cancers should be assessed. The treatment will be optimal considering the level of musculoskeletal influence. There is a need for further work by physiotherapists to evaluate the children in a comprehensive manner in the clinic and research related to functional health status and for the necessary oncophysiotherapy program.
{"title":"Oncophysiotherapy Assessments of Musculoskeletal Disorders in Childhood: A Case Report","authors":"Müberra Tanrıverdi, S. Yurdalan, F. Cakir","doi":"10.29011/2690-0149.000008","DOIUrl":"https://doi.org/10.29011/2690-0149.000008","url":null,"abstract":"Background: Musculoskeletal influence in childhood cancers is a matter that is ignored. The aim in our study is to present the results of musculoskeletal evaluation in our case with childhood cancer. Case: Assessment of the musculoskeletal system of childhood cancer, directed to physiotherapy and rehabilitation, was performed by a oncophysiotherapist. An 11-year-old male patient was included. Acute Lymphoblastic Leukemia (ALL) was diagnosed at the age of 6 years. While no asymmetry and limitations were observed in anthropometric and goniometric measurements, weakness in muscle testing and musculoskeletal disorders in posture analysis were observed. Discussion: Physical functioning and participation in assessing functional health status and health-related quality of life in childhood cancers should be assessed. The treatment will be optimal considering the level of musculoskeletal influence. There is a need for further work by physiotherapists to evaluate the children in a comprehensive manner in the clinic and research related to functional health status and for the necessary oncophysiotherapy program.","PeriodicalId":296965,"journal":{"name":"International Journal of Musculoskeletal Disorders","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128318662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-16DOI: 10.29011/2690-0149.000006
A. Markowski, Maureen K. Watkins, Peter Dzaugis, Victoria Etzel, Alyssa Lindau
Objective: To assess the need for implementation of ultrasound imaging (USI) education into physical therapy (PT) curricula through: a review of educational standards, literature search and students’ perspective survey. Background: As USI technology becomes more accessible and applicable, it is important to consider the educational opportunities for students and PT programs. Methods: A needs assessment including; A literature search on USI as a teaching tool in PT education. A review of current PT educational standards to determine guidelines on the instruction of USI. A survey to assess PT students’ perspective, interest and knowledge of USI. Results: The literature search resulted in limited publications but provide initial evidence that USI is an effective teaching tool. Educational guidelines require up-to-date education on imaging technology, requirements specific to USI in PT curricula is limited. Students’ surveyed identified interest in using USI to learn anatomy and applications in the clinic. Conclusions: Physical Therapy programs must have education consistent with current technology. This needs assessment suggests USI should be introduced early and longitudinally in the curriculum as an adjunct learning tool for students to gain fundamental knowledge of equipment, anatomy and clinical applications.
{"title":"Incorporating Real Time Ultrasound Imaging Education Within a Doctor of Physical Therapy Program: A Needs Assessment","authors":"A. Markowski, Maureen K. Watkins, Peter Dzaugis, Victoria Etzel, Alyssa Lindau","doi":"10.29011/2690-0149.000006","DOIUrl":"https://doi.org/10.29011/2690-0149.000006","url":null,"abstract":"Objective: To assess the need for implementation of ultrasound imaging (USI) education into physical therapy (PT) curricula through: a review of educational standards, literature search and students’ perspective survey. Background: As USI technology becomes more accessible and applicable, it is important to consider the educational opportunities for students and PT programs. Methods: A needs assessment including; A literature search on USI as a teaching tool in PT education. A review of current PT educational standards to determine guidelines on the instruction of USI. A survey to assess PT students’ perspective, interest and knowledge of USI. Results: The literature search resulted in limited publications but provide initial evidence that USI is an effective teaching tool. Educational guidelines require up-to-date education on imaging technology, requirements specific to USI in PT curricula is limited. Students’ surveyed identified interest in using USI to learn anatomy and applications in the clinic. Conclusions: Physical Therapy programs must have education consistent with current technology. This needs assessment suggests USI should be introduced early and longitudinally in the curriculum as an adjunct learning tool for students to gain fundamental knowledge of equipment, anatomy and clinical applications.","PeriodicalId":296965,"journal":{"name":"International Journal of Musculoskeletal Disorders","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116871793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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