Journal of Manual & Manipulative Therapy最新文献

Objective: To evaluate the augmented effects of trigger point dry needling (TPDN) and instrument-assisted soft tissue mobilization (IASTM) on pain and function in patellofemoral pain syndrome (PFPS).

Methods: A single-blinded, randomized controlled trial was conducted with 102 participants (15-25 years) diagnosed with PFPS. Participants were randomly assigned to four groups: TPDN (n = 27), IASTM (n = 25), combined TPDN and IASTM (n = 26), and a control group (n = 24). The intervention groups received two treatment sessions per week for four consecutive weeks, in addition to a standardized exercise program for all groups. Primary (pressure pain threshold, PPT) and secondary (Kujala Anterior Knee Pain Scale, AKPS) outcomes were assessed at baseline and post-intervention.

Results: Combined TPDN+IASTM demonstrated superior improvements in both outcomes: PPT increased by 78% and AKPS scores improved by 39% in the combined group. By comparison, the TPDN group showed a 53% increase in PPT and a 24% increase in AKPS, while the IASTM group showed a 54% increase in PPT and a 25% increase in AKPS (p < 0.001).

Conclusion: Both TPDN and IASTM are effective in reducing pain and improving function in PFPS. However, their synergistic application offers enhanced clinical benefits over either intervention alone or exercise therapy. These findings support integrating multimodal approaches for managing PFPS.

Objective: The aim of the present study was to compare longus capitis and longus colli (LC/C) and sternocleidomastoid (SCM) activity during a craniocervical flexion (CCF) exercise task performed using the Spinertial device versus the pressure biofeedback unit (PBU).

Methods: A prospective, observational, cross-sectional study was conducted with 40 volunteers. Participants were eligible if they were at least 18 years old, had no history of neck pain, and were able to correctly perform the CCF test up to the fourth or fifth stages (28-30 mmHg). Each participant performed a standardized CCF exercise task using both devices. The linear depth (thickness) of the LC/C was measured with ultrasound imaging, and the electrical activity of the SCM via surface electromyography. Range of motion and friction forces were standardized across conditions.

Results: Forty participants (20 women and 20 men) were included in the study, with a mean age of 24.9 ± 3.4 years. The increase in LC/C thickness with the standardized CCF exercise task was significantly greater with Spinertial device than with the PBU (p = 0.015, d = 0.6). The SCM activity during the CCF exercise was significantly lower with the Spinertial device compared to the PBU (p < 0.001, d = 0.8).

Conclusion: Performing CCF with the Spinertial device facilities greater activation (thickness) of the LC/C with reduced SCM activity compared with the PBU. These findings support its potential clinical utility in targeted motor control training of the CCF.

Background: Patellofemoral Pain Syndrome is a common musculoskeletal condition characterized by anterior knee pain, especially among athletes and active individuals. Taping techniques such as Kinesio taping and rigid taping are widely used as conservative interventions. However, the effectiveness of taping on pain reduction and functional improvement remains debated.

Objective: To systematically review and synthesize the evidence on the effect of taping on pain and function in athletes with patellofemoral pain syndrome. Methods A comprehensive literature search was conducted across databases, including PubMed, Scopus, PEDro, and Web of Science. Randomized trials evaluating the effect of taping on pain with or without function in athletes with PFPS were included. Methodological quality was assessed by PEDro. Risk of bias was assessed by Cochrane's Risk of Bias Tool Version 2. Meta-analysis was conducted using Review Manager (RevMan 5.4).

Results: Out of 39 records retrieved, 20 full-text articles were assessed, and 5 studies met the inclusion criteria. Qualitative and quantitative analysis (pain: Z = 1.94, p = 0.05, SMD = -1.71, 95% CI = -3.44 and function: Z = 2.0, p = 0.05, SMD = 1.06, 95% CI = 0.02) showed a significant reduction in pain and improvement in function with taping, especially when combined with exercise therapy. Rigid taping showed more significant results than Kinesio taping.

Conclusion: This review concludes that rigid taping provides short-term benefits in reducing pain and improving function in patients with PFPS, especially when integrated with exercise-based rehabilitation.

Background: Cystic fibrosis (CF) is a severe hereditary disease that affects multiple organ systems. Among these, the musculoskeletal system is an under-explored area. This interview study aimed to explore experiences of musculoskeletal symptoms and of manual therapies as complementary care in this context.

Methods: Semi-structured interviews were used to collect data from ten respondents. The data were subsequently analyzed through content analysis with an inductive approach in accordance with the method of Elo and Kyngäs.

Results: The analysis resulted in three main categories; 1) Living with CF involves musculoskeletal health challenges, 2) Manual therapies impact daily life for people with CF, and 3) People with CF aspire for broader and more collaborative respiratory care.

Conclusion: The respondents described musculoskeletal symptoms in and around the thoracic cage. They experienced symptom relief and increased body awareness following manual therapy interventions (MTI) and recommended that these methods be offered as complementary care to enhance quality of life.

Background: Dry needling (DN) is a skilled intervention commonly used for pain relief and the management of movement disorders in neuromusculoskeletal conditions. Although systematic reviews indicate its effectiveness, variations in treatment parameters exist. This study surveyed U.S. healthcare professionals who utilize DN, examining their clinical techniques, rationale, and use of electrostimulation.

Methods: An electronic survey was created and distributed via Qualtrics™ to healthcare providers performing DN. The survey link was shared through social media and e-mail, and data were analyzed using non-parametric statistical methods (Mann-Whitney U, Spearman's rho) to identify significant patterns in DN practices.

Results: A total of 1,399 healthcare providers completed the survey, predominantly physical therapists (93.3%) with an average of 13.5 years of clinical experience and 5.2 years in DN. Most worked in outpatient orthopedics (90.3%). Common DN techniques included trigger point needling (95.8%) and deep needling (82.0%), with 44.5% using periosteal pecking. The majority of practitioners used up to 4 needles per session (68.1%), while 63.8% used more than 4. Electro-stimulation (e-stim) was commonly applied, with 62.5% using it after needle insertion and 55.6% combining it with needle manipulation. Differences in techniques were noted between physical and nonphysical therapists, particularly in the practice of leaving needles in place without manipulation.

Conclusion: This study highlights the widespread use and evolving methodologies of DN practices in the U.S. noting the integration of electrostimulation and multimodal approaches. It also highlights inconsistencies in treatment parameters, underscoring the need for standardized protocols to enhance clinical effectiveness and research validity. Future research should focus on the long-term efficacy of various DN techniques and their applications in neurological rehabilitation.

Objective: Describe the influence of maladaptive coping behaviors on the clinical presentation and management of an acute lumbar lateral shift.

Case description: A 39-year-old male sought chiropractic care for acute low back pain with an associated lumbar lateral shift of three days duration. The symptoms had remained refractory to chiropractic care and medication provided by visits to the emergency room and an orthopedist. In response to the severity of symptoms, heightened cognitive and emotional factors propagated passive coping that resulted in bed rest and work absenteeism.

Outcome: Providing an understanding of pain from a biopsychosocial perspective combined with self-management strategies involving the method of manual shift correction and graded exposure exercises decreased pain and catastrophizing in four visits over five days. The Revised Low Back Oswestry scored 82%, 0%, and 2% disability and the Yellow Flag Risk Form scored 96, 8, and 34 at intake, discharge and six months follow up.

Conclusion: The method of manual shift correction is discussed as a favorable biomedical procedure for lumbar lateral shifts, with little attribution to the multidimensional nature of low back pain. This case depicts the influence of maladaptive coping behaviors on a lumbar lateral shift.