Pub Date : 2022-06-01DOI: 10.1016/j.jcm.2022.02.005
Giselle Notini Arcanjo PhD , Juliana Lerche Vieira Rocha Pires MSc , Maria Edna Mateus Jacinto PT , Josué Magalhães Colares PT , Lurdyanne Maria Cavalcante Belo PT , Pedro Olavo de Paula Lima PhD , José Vilaça-Alves PhD
Objective
The purpose of this clinical trial was to compare the effects of 4 different interventions on electromyographic activity of the pelvic floor muscles in women with stress urinary incontinence (UI).
Methods
Fifty-one women with stress UI were randomized into 4 groups: a global osteopathic protocol (myofascial, visceral, and articular techniques); 1 manipulation technique (high-velocity, low-amplitude/thrust) of the sacroiliac joint and T10-L2; training of the pelvic floor muscles; and no intervention (control). Electromyographic activity of the pelvic floor muscles was evaluated at 5 different times (baseline, immediately after the procedure, 30 minutes, 1 hour, and 4 weeks after intervention).
Results
Forty women completed the study. There were no immediate or late effects on the myoelectric activity of any type of muscle fiber in any of the groups analyzed.
Conclusion
There were no significant between-groups differences of electromyography in women with symptoms of stress UI.
{"title":"Comparison of the Effect of Osteopathic Manipulations and Exercises on the Myoelectric Activity of the Pelvic Floor: A Randomized Controlled Trial","authors":"Giselle Notini Arcanjo PhD , Juliana Lerche Vieira Rocha Pires MSc , Maria Edna Mateus Jacinto PT , Josué Magalhães Colares PT , Lurdyanne Maria Cavalcante Belo PT , Pedro Olavo de Paula Lima PhD , José Vilaça-Alves PhD","doi":"10.1016/j.jcm.2022.02.005","DOIUrl":"10.1016/j.jcm.2022.02.005","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this clinical trial<span> was to compare the effects of 4 different interventions on electromyographic activity of the pelvic floor<span> muscles in women with stress urinary incontinence (UI).</span></span></p></div><div><h3>Methods</h3><p>Fifty-one women with stress UI were randomized into 4 groups: a global osteopathic protocol (myofascial, visceral, and articular techniques); 1 manipulation technique (high-velocity, low-amplitude/thrust) of the sacroiliac joint and T10-L2; training of the pelvic floor muscles; and no intervention (control). Electromyographic activity of the pelvic floor muscles was evaluated at 5 different times (baseline, immediately after the procedure, 30 minutes, 1 hour, and 4 weeks after intervention).</p></div><div><h3>Results</h3><p>Forty women completed the study. There were no immediate or late effects on the myoelectric activity of any type of muscle fiber in any of the groups analyzed.</p></div><div><h3>Conclusion</h3><p>There were no significant between-groups differences of electromyography in women with symptoms of stress UI.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 2","pages":"Pages 97-107"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40551259","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 : 2022-06-01DOI: 10.1016/j.jcm.2022.02.007
Mahip Acharya BPharm , Divyan Chopra MS , Allen M. Smith PharmD , Julie M. Fritz PhD, PT , Bradley C. Martin PharmD, PhD
Objective
The objective of this study was to estimate the association between early use of physical therapy (PT) or chiropractic care and incident opioid use and long-term opioid use in individuals with a low back pain (LBP) diagnosis.
Methods
A retrospective cohort study was conducted using data from Arkansas All Payers’ Claims Database. Adults with incident LBP diagnosed in primary care or emergency departments between July 1, 2013, and June 30, 2017, were identified. Participants were required to be opioid naïve in the 6-month baseline period and without cancer, cauda equina syndrome, osteomyelitis, lumbar fracture, and paraplegia/quadriplegia in the entire study period. PT and chiropractic treatment were documented over the ensuing 30 days starting on the date of LBP. Any opioid use and long-term opioid use (LTOU) in 1-year follow-up were assessed. Multivariable logistic regressions controlling for covariates were estimated.
Results
A total of 40 929 individuals were included in the final sample, with an average age of 41 years and 65% being women. Only 5% and 6% received PT and chiropractic service, respectively, within the first 30 days. Sixty-four percent had incident opioid use, and 4% had LTOU in the follow-up period. PT was not associated with incident opioid use (odds ratio [OR], 1.07; 95% confidence interval [CI], 0.98-1.18) or LTOU (OR, 1.19; 95% CI, 0.97-1.45). Chiropractic care decreased the odds of opioid use (OR, 0.88; 95% CI, 0.80-0.97) and LTOU (OR, 0.56; 95% CI, 0.40-0.77).
Conclusion
In this study we found that receipt of chiropractic care, though not PT, may have disrupted the need for opioids and, in particular, LTOU in newly diagnosed LBP.
{"title":"Associations Between Early Chiropractic Care and Physical Therapy on Subsequent Opioid Use Among Persons With Low Back Pain in Arkansas","authors":"Mahip Acharya BPharm , Divyan Chopra MS , Allen M. Smith PharmD , Julie M. Fritz PhD, PT , Bradley C. Martin PharmD, PhD","doi":"10.1016/j.jcm.2022.02.007","DOIUrl":"10.1016/j.jcm.2022.02.007","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this study was to estimate the association between early use of physical therapy (PT) or chiropractic care and incident opioid use and long-term opioid use in individuals with a low back pain (LBP) diagnosis.</p></div><div><h3>Methods</h3><p><span><span>A retrospective cohort study<span> was conducted using data from Arkansas All Payers’ Claims Database. Adults with incident LBP diagnosed in primary care or </span></span>emergency departments between July 1, 2013, and June 30, 2017, were identified. Participants were required to be opioid naïve in the 6-month baseline period and without cancer, </span>cauda equina syndrome<span><span>, osteomyelitis, lumbar fracture, and paraplegia/quadriplegia in the entire study period. PT and chiropractic </span>treatment<span> were documented over the ensuing 30 days starting on the date of LBP. Any opioid use and long-term opioid use (LTOU) in 1-year follow-up were assessed. Multivariable logistic regressions controlling for covariates were estimated.</span></span></p></div><div><h3>Results</h3><p>A total of 40 929 individuals were included in the final sample, with an average age of 41 years and 65% being women. Only 5% and 6% received PT and chiropractic service, respectively, within the first 30 days. Sixty-four percent had incident opioid use, and 4% had LTOU in the follow-up period. PT was not associated with incident opioid use (odds ratio [OR], 1.07; 95% confidence interval [CI], 0.98-1.18) or LTOU (OR, 1.19; 95% CI, 0.97-1.45). Chiropractic care decreased the odds of opioid use (OR, 0.88; 95% CI, 0.80-0.97) and LTOU (OR, 0.56; 95% CI, 0.40-0.77).</p></div><div><h3>Conclusion</h3><p>In this study we found that receipt of chiropractic care, though not PT, may have disrupted the need for opioids and, in particular, LTOU in newly diagnosed LBP.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 2","pages":"Pages 67-76"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10812692","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}
This study aimed to determine within-day intra-rater reliability of ultrasound measurements of the right and left hemidiaphragm thickness and contractility (quantified by percentage thickness change) in supine position during deep breathing in individuals with nonspecific chronic neck pain.
Methods
Seventeen volunteers (20-55 years of age) participated in this observational study. Bilateral diaphragm muscle thickness and contractility (percentage thickness change) were compared between 2 measurement sessions administered by a radiologist using B-mode real-time ultrasound (30 minutes apart). Intraclass correlation coefficient (ICC [3, 3]) as well as the standard error of measurement (SEM), minimal detectable change (MDC), and the coefficient of variation (CV) were used to determine the intra-rater reliability.
Results
The right and left hemidiaphragm thickness showed good to excellent reliability at the end of deep inspiration (ICC, 0.90; 95% confidence interval [CI], 0.72-0.96; and ICC, 0. 93; 95% CI, 0.81-0.97, respectively) as well as at the end of deep expiration (ICC, 0.91; 95% CI, 0.75-0.96; ICC, 0.91; 95% CI, 0.77-0.97; SEM, 0.19; MDC, 0.54; and CV, 7.84%, respectively) and the percentage thickness change (ICC, 0.83; 95% CI, 0.54-0.94; and ICC, 0.93; 95% CI, 0.82-0.97, respectively).
Conclusion
This study found that diagnostic ultrasound measurements of the right and left hemidiaphragm thickness and contractility in supine position during deep breathing in individuals with nonspecific chronic neck pain was reliable. The SEM, MDC, and CV reported may allow for accurate interpretation of diaphragm assessment in a clinical research setting.
{"title":"Intra-Rater Reliability of Ultrasound Measurements of Diaphragm Thickness and Contractility in Individuals with Nonspecific Chronic Neck Pain","authors":"Alieh Zendehdel Jadehkenari MSc , Hamid Reza Haghighatkhah MD , Javad Sarrafzadeh PhD , Ismail Ebrahimi Takamjani PhD , Amir Massoud Arab PhD , Maryam Ziaeifar PhD","doi":"10.1016/j.jcm.2022.02.006","DOIUrl":"10.1016/j.jcm.2022.02.006","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to determine within-day intra-rater reliability of ultrasound measurements of the right and left hemidiaphragm<span><span> thickness and contractility (quantified by percentage thickness change) in </span>supine position<span> during deep breathing in individuals with nonspecific chronic neck pain.</span></span></p></div><div><h3>Methods</h3><p>Seventeen volunteers (20-55 years of age) participated in this observational study. Bilateral diaphragm muscle thickness and contractility (percentage thickness change) were compared between 2 measurement sessions administered by a radiologist using B-mode real-time ultrasound (30 minutes apart). Intraclass correlation coefficient<span> (ICC [3, 3]) as well as the standard error of measurement (SEM), minimal detectable change (MDC), and the coefficient of variation (CV) were used to determine the intra-rater reliability.</span></p></div><div><h3>Results</h3><p>The right and left hemidiaphragm thickness showed good to excellent reliability at the end of deep inspiration (ICC, 0.90; 95% confidence interval [CI], 0.72-0.96; and ICC, 0. 93; 95% CI, 0.81-0.97, respectively) as well as at the end of deep expiration (ICC, 0.91; 95% CI, 0.75-0.96; ICC, 0.91; 95% CI, 0.77-0.97; SEM, 0.19; MDC, 0.54; and CV, 7.84%, respectively) and the percentage thickness change (ICC, 0.83; 95% CI, 0.54-0.94; and ICC, 0.93; 95% CI, 0.82-0.97, respectively).</p></div><div><h3>Conclusion</h3><p>This study found that diagnostic ultrasound measurements of the right and left hemidiaphragm thickness and contractility in supine position during deep breathing in individuals with nonspecific chronic neck pain was reliable. The SEM, MDC, and CV reported may allow for accurate interpretation of diaphragm assessment in a clinical research setting.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 2","pages":"Pages 116-123"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40562168","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}
The purpose of this study was to establish within-day intrarater reliability values of ultrasound measurements (excursion and resting thickness).
Methods
Seventeen volunteers met the inclusion criteria for this preliminary study. The right and left hemidiaphragm excursion and resting thickness were compared between 2 measurement sessions using M-mode and B-mode real-time ultrasound, respectively (30 min apart). Intraclass coefficients, coefficients of variation, standard errors of measurement, and minimal detectable changes were calculated to determine intrarater reliability.
Results
The intraclass coefficients of right hemidiaphragm excursion were 0.91 and 0.94 during quiet and deep breathing, respectively. The intraclass coefficient of left hemidiaphragm excursion was 0.95 during quiet breathing. The intraclass coefficients of diaphragm resting thickness were 0.99 and 0.97 in the right and left hemidiaphragm, respectively, which showed high intrarater reliability for ultrasound measurements of both sides of the diaphragm.
Conclusion
This preliminary study suggests that diagnostic ultrasonography could be used as a potential method for measuring the resting thickness and excursion of the right and left hemidiaphragm in people with chronic low back pain. Future research with a larger sample size is needed to confirm these findings.
{"title":"Intrarater Reliability of Diaphragm Excursion and Resting Thickness Using Ultrasound Imaging in Subjects With Nonspecific Chronic Low Back Pain","authors":"Maryam Ziaeifar PhD , Shohreh Noorizadeh Dehkordi PhD , Hamid Reza Haghighatkhah MD , Javad Sarrafzadeh PhD , Amir Masoud Arab PhD , Alieh Zendehdel Jadehkenari MSc","doi":"10.1016/j.jcm.2022.02.001","DOIUrl":"10.1016/j.jcm.2022.02.001","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to establish within-day intrarater reliability values of ultrasound measurements (excursion and resting thickness).</p></div><div><h3>Methods</h3><p>Seventeen volunteers met the inclusion criteria for this preliminary study. The right and left hemidiaphragm<span> excursion and resting thickness were compared between 2 measurement sessions using M-mode and B-mode real-time ultrasound, respectively (30 min apart). Intraclass coefficients, coefficients of variation, standard errors of measurement, and minimal detectable changes were calculated to determine intrarater reliability.</span></p></div><div><h3>Results</h3><p>The intraclass coefficients of right hemidiaphragm excursion were 0.91 and 0.94 during quiet and deep breathing, respectively. The intraclass coefficient of left hemidiaphragm excursion was 0.95 during quiet breathing. The intraclass coefficients of diaphragm resting thickness were 0.99 and 0.97 in the right and left hemidiaphragm, respectively, which showed high intrarater reliability for ultrasound measurements of both sides of the diaphragm.</p></div><div><h3>Conclusion</h3><p>This preliminary study suggests that diagnostic ultrasonography could be used as a potential method for measuring the resting thickness and excursion of the right and left hemidiaphragm in people with chronic low back pain. Future research with a larger sample size is needed to confirm these findings.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 1","pages":"Pages 15-22"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393943","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 : 2022-03-01DOI: 10.1016/j.jcm.2022.02.008
Michael Mortenson DC , Anna Montgomery MPH , Glenn Buttermann MD
Objective
The purpose of this case study is to describe chiropractic care of the cervical spine for a patient who previously underwent cervical total disk replacement (CTDR) of the C5-6 and C6-7 disks.
Clinical Features
A 42-year-old female veteran of the U.S. Army presented to a Veterans Affairs chiropractic clinic with chronic cervical pain and radiculopathy. She had previously undergone CTDR surgery of the C5-6 disk 9 years earlier, but the pain had become severe and radicular symptoms had returned in the upper left extremity. Imaging taken before the chiropractic referral demonstrated significant joint space narrowing and disk herniation of the C6-7 disk with protrusion to the left side.
Intervention and Outcome
The patient received spinal manipulative therapy, trigger-point therapy, and manual traction to the cervical spine. However, these treatments were not effective in reducing her cervical pain and radiculopathy. She then opted for CTDR of the C6-7 disk. After surgery, the patient reported that radicular symptoms were mostly relieved and cervical pain had decreased by 50%. After 6 additional spinal manipulative therapy treatments, she reported having no neurologic symptoms and that her pain had decreased more than 70% from presurgery levels.
Conclusion
This case report is the first reported example of chiropractic care after CTDR within an integrated health care environment. The patient's cervical pain and radiculopathy improved with CTDR along with postsurgical chiropractic care.
{"title":"Chiropractic Care of a Female Veteran After Cervical Total Disk Replacement: A Case Report","authors":"Michael Mortenson DC , Anna Montgomery MPH , Glenn Buttermann MD","doi":"10.1016/j.jcm.2022.02.008","DOIUrl":"10.1016/j.jcm.2022.02.008","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this case study is to describe chiropractic<span> care of the cervical spine for a patient who previously underwent cervical </span></span>total disk replacement (CTDR) of the C5-6 and C6-7 disks.</p></div><div><h3>Clinical Features</h3><p><span><span>A 42-year-old female veteran of the U.S. Army presented to a </span>Veterans Affairs chiropractic clinic with chronic cervical pain and </span>radiculopathy<span>. She had previously undergone CTDR surgery of the C5-6 disk 9 years earlier, but the pain had become severe and radicular symptoms had returned in the upper left extremity. Imaging taken before the chiropractic referral demonstrated significant joint space narrowing and disk herniation of the C6-7 disk with protrusion to the left side.</span></p></div><div><h3>Intervention and Outcome</h3><p><span>The patient received spinal manipulative therapy, trigger-point therapy, and manual </span>traction<span><span> to the cervical spine. However, these treatments were not effective in reducing her cervical pain and radiculopathy. She then opted for CTDR of the C6-7 disk. After surgery, the patient reported that radicular symptoms were mostly relieved and cervical pain had decreased by 50%. After 6 additional spinal manipulative therapy treatments, she reported having no </span>neurologic symptoms and that her pain had decreased more than 70% from presurgery levels.</span></p></div><div><h3>Conclusion</h3><p>This case report is the first reported example of chiropractic care after CTDR within an integrated health care environment. The patient's cervical pain and radiculopathy improved with CTDR along with postsurgical chiropractic care.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 1","pages":"Pages 60-65"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393944","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 : 2022-03-01DOI: 10.1016/j.jcm.2022.01.005
Aaron J. Wholohan PhD , Ted Jedynak BPod
Objective
The purpose of this study was to quantify the variability in the force applied during 20 cycles of Maitland's grade IV anteroposterior ankle mobilization measured on 2 occasions.
Methods
Thirteen healthy adults (mean age, 25 ± 5 years; height, 170 ± 7 cm; weight, 71 ± 16 kg) received 20 cycles of Maitland's grade IV ankle mobilization on 2 sessions separated by 1 week. A force transducer was used to measure the peak force, loading rate, and impulse applied during each load cycle. Mean within-session coefficient of variation, standard error of measurement, and 95% level of agreement were estimated during each mobilization session.
Results
The mean peak force during the anteroposterior mobilization technique was 70 ± 12 N and 58 ± 10 N during sessions 1 and 2, respectively. The mean within-session coefficients of variation in peak force, loading rate, and impulse applied during 20 loading cycles were 10% to 13%, 15%, and 21% to 43%, respectively. There was a significant difference between sessions in mean peak force (−17%, t12 = 2.445, P = .031) and impulse (−51%, t12 = 2.306, P = .040), with large 95% levels of agreement in applied peak force (±33 N) and impulse (±128 N s) compared to their mean values (approximately ±50% and 110%, respectively).
Conclusion
The peak force and loading rate applied by an experienced practitioner during a Maitland's grade IV anteroposterior talar mobilization session varied over 20 loading cycles. Variability between repeated mobilization sessions by the same practitioner was even greater, with respect to peak applied force and loading rate. The large variability in force applied during a Maitland's grade IV talar mobilization may underpin differential clinical effects reported in the joint-mobilization literature. The findings of this study highlight the need for strategies that standardize the application of force during talar mobilization.
{"title":"Intraclinician Variability in Force Application During Anteroposterior Mobilization of the Ankle Joint","authors":"Aaron J. Wholohan PhD , Ted Jedynak BPod","doi":"10.1016/j.jcm.2022.01.005","DOIUrl":"10.1016/j.jcm.2022.01.005","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to quantify the variability in the force applied during 20 cycles of Maitland's grade IV anteroposterior ankle mobilization measured on 2 occasions.</p></div><div><h3>Methods</h3><p>Thirteen healthy adults (mean age, 25 ± 5 years; height, 170 ± 7 cm; weight, 71 ± 16 kg) received 20 cycles of Maitland's grade IV ankle mobilization on 2 sessions separated by 1 week. A force transducer was used to measure the peak force, loading rate, and impulse applied during each load cycle. Mean within-session coefficient of variation, standard error of measurement, and 95% level of agreement were estimated during each mobilization session.</p></div><div><h3>Results</h3><p>The mean peak force during the anteroposterior mobilization technique was 70 ± 12 N and 58 ± 10 N during sessions 1 and 2, respectively. The mean within-session coefficients of variation in peak force, loading rate, and impulse applied during 20 loading cycles were 10% to 13%, 15%, and 21% to 43%, respectively. There was a significant difference between sessions in mean peak force (−17%, <em>t</em><sub>12</sub> = 2.445, <em>P</em> = .031) and impulse (−51%, <em>t</em><sub>12</sub> = 2.306, <em>P</em> = .040), with large 95% levels of agreement in applied peak force (±33 N) and impulse (±128 N s) compared to their mean values (approximately ±50% and 110%, respectively).</p></div><div><h3>Conclusion</h3><p>The peak force and loading rate applied by an experienced practitioner during a Maitland's grade IV anteroposterior talar mobilization session varied over 20 loading cycles. Variability between repeated mobilization sessions by the same practitioner was even greater, with respect to peak applied force and loading rate. The large variability in force applied during a Maitland's grade IV talar mobilization may underpin differential clinical effects reported in the joint-mobilization literature. The findings of this study highlight the need for strategies that standardize the application of force during talar mobilization.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 1","pages":"Pages 9-14"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393950","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 : 2022-03-01DOI: 10.1016/j.jcm.2022.01.002
Clinton J. Daniels DC, MS , Derek R. Anderson PhD , Zachary A. Cupler DC, MS
Objective
The purpose of this case series is to describe coordination of care between chiropractic and behavioral health practitioners within an integrated hospital-based system.
Clinical Features
Three individuals presented to a US Veterans Affairs Health Care system with musculoskeletal complaints for chiropractic care. Each person demonstrated symptoms of depression or anxiety and in 2 cases indicated passive suicidal ideation.
Intervention and Outcome
The chiropractors referred the patients to a mental health provider for co-management. Different approaches to mental health care were offered to each of these patients to meet their individual preferences and needs as part of an evidence informed approach. One patient underwent individual cognitive behavioral therapy; 1 patient responded well to individual cognitive behavioral therapy before transitioning to group-based pain skills, resiliency, and mindfulness therapy; and 1 patient required additional referral to Primary Care-Mental Health Integration for pharmacologic treatment. The 3 patients responded positively to interdisciplinary care and realized functional improvements and improved patient reported outcomes as assessed with the 11-point Numerical Pain Rating Scale and Neck or Back Bournemouth Questionnaire.
Conclusion
This case series describes the recognition of mental health symptoms, referral to behavioral health providers, and the subsequent treatment approaches. This case series presents the first description of co-managed care for US veterans by a chiropractor and psychologist.
{"title":"Coordination of Care Between Chiropractic and Behavioral Health Practitioners Within the US Department of Veterans Affairs Health Care System: A Report of 3 Patients With Pain and Mental Health Symptoms","authors":"Clinton J. Daniels DC, MS , Derek R. Anderson PhD , Zachary A. Cupler DC, MS","doi":"10.1016/j.jcm.2022.01.002","DOIUrl":"10.1016/j.jcm.2022.01.002","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this case series is to describe coordination of care between chiropractic and behavioral health practitioners within an integrated hospital-based system.</p></div><div><h3>Clinical Features</h3><p>Three individuals presented to a US Veterans Affairs<span> Health Care<span> system with musculoskeletal complaints for chiropractic care. Each person demonstrated symptoms of depression or anxiety and in 2 cases indicated passive suicidal ideation.</span></span></p></div><div><h3>Intervention and Outcome</h3><p>The chiropractors<span><span><span> referred the patients to a mental health provider for co-management. Different approaches to mental health care were offered to each of these patients to meet their individual preferences and needs as part of an evidence informed approach. One patient underwent individual cognitive behavioral therapy<span>; 1 patient responded well to individual cognitive behavioral therapy before transitioning to group-based pain skills, resiliency, and mindfulness therapy; and 1 patient required additional referral to Primary Care-Mental Health Integration for pharmacologic </span></span>treatment<span>. The 3 patients responded positively to interdisciplinary care and realized functional improvements and improved patient reported outcomes as assessed with the 11-point </span></span>Numerical Pain Rating Scale and Neck or Back Bournemouth Questionnaire.</span></p></div><div><h3>Conclusion</h3><p>This case series describes the recognition of mental health symptoms, referral to behavioral health providers, and the subsequent treatment approaches. This case series presents the first description of co-managed care for US veterans by a chiropractor and psychologist.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 1","pages":"Pages 1-8"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393945","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}
The purpose of this study was to investigate the reliability of measuring the lumbar motion angle using a small accelerometer for movement tests in the sagittal plane, and to determine the number of measurements required to obtain reliable data.
Methods
In total, 102 healthy adults (56% women, 44% men; 20.1 ± 1.1 years of age) participated in this study. The intra- and interexaminer reliability of lumbar motion angle measurements during forward and backward trunk bending and prone hip extension were investigated. Lumbar motion angles were measured with small accelerometers placed at the thoracolumbar transition, lumbosacral transition, and thigh, during motion and at the final position. Intraclass correlation coefficients and Bland-Altman analysis were used for statistical analysis.
Results
The intraclass correlation coefficients ranged from 0.6 to 0.8 in intraexaminer analyses and from 0.5 to 0.7 in interexaminer analyses. Intraexaminer systematic biases were found only in the maximum angle of trunk forward bending. Interexaminer biases were found in all angles of trunk forward bending.
Conclusion
In the measurement of lumbar motion angle in the sagittal plane using a small accelerometer, it was necessary to repeat measurements 2 to 4 times, because a single measurement was not sufficiently reliable either within or between examiners.
{"title":"Measuring Lumbar Motion Angle With a Small Accelerometer: A Reliability Study","authors":"Ryo Miyachi PhD , Ayaka Sano BS(Physio) , Nana Tanaka BS(Physio) , Misaki Tamai BS(Physio) , Junya Miyazaki PhD","doi":"10.1016/j.jcm.2022.02.010","DOIUrl":"10.1016/j.jcm.2022.02.010","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to investigate the reliability of measuring the lumbar motion angle using a small accelerometer for movement tests in the sagittal plane, and to determine the number of measurements required to obtain reliable data.</p></div><div><h3>Methods</h3><p>In total, 102 healthy adults (56% women, 44% men; 20.1 ± 1.1 years of age) participated in this study. The intra- and interexaminer reliability<span> of lumbar motion angle measurements during forward and backward trunk bending and prone hip extension were investigated. Lumbar motion angles were measured with small accelerometers placed at the thoracolumbar transition, lumbosacral transition, and thigh, during motion and at the final position. Intraclass correlation coefficients and Bland-Altman analysis were used for statistical analysis.</span></p></div><div><h3>Results</h3><p>The intraclass correlation coefficients ranged from 0.6 to 0.8 in intraexaminer analyses and from 0.5 to 0.7 in interexaminer analyses. Intraexaminer systematic biases were found only in the maximum angle of trunk forward bending. Interexaminer biases were found in all angles of trunk forward bending.</p></div><div><h3>Conclusion</h3><p>In the measurement of lumbar motion angle in the sagittal plane using a small accelerometer, it was necessary to repeat measurements 2 to 4 times, because a single measurement was not sufficiently reliable either within or between examiners.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 1","pages":"Pages 32-38"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393948","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 : 2022-03-01DOI: 10.1016/j.jcm.2022.01.001
Ayman A. Mohamed PhD , Yih-Kuen Jan PhD , Neveen Abdel Raoof PhD , Omaima Kattabei PhD , Ibrahim Moustafa PhD , Hanan Hosny MD
Objective
The purpose of this study was to examine the effect of 8 weeks of biofeedback on reaction time and central somatosensory conduction time in patients with forward head posture and cervical radiculopathy.
Methods
We performed a double-blinded randomized controlled trial. Seventy patients with forward head posture and cervical radiculopathy were randomly distributed into study and control groups. The study group received biofeedback forward head posture corrective exercise for 8 weeks, while the control group did not receive any treatment. The main outcome measures were reaction time and central somatosensory conduction time. The secondary outcome measures were the craniovertebral angles, nerve conduction time at N13 and N20, referred arm pain, and neck disability index.
Results
After 4 weeks, there were nonsignificant differences between both groups in reaction time and central somatosensory conduction time (P > .05); while there were significant differences between both groups in N13, N20, craniovertebral angle, referred arm pain, and neck disability index scores (P < .05). After 8 weeks, there were significant differences between both groups in all outcome measures (P < .05).
Conclusion
In this study, participants receiving biofeedback forward head posture corrective exercise improved both reaction time and central somatosensory conduction time after 8 weeks when compared to a control, nontreatment group.
{"title":"Effect of Biofeedback Corrective Exercise on Reaction Time and Central Somatosensory Conduction Time in Patients With Forward Head Posture and Radiculopathy: A Randomized Controlled Study","authors":"Ayman A. Mohamed PhD , Yih-Kuen Jan PhD , Neveen Abdel Raoof PhD , Omaima Kattabei PhD , Ibrahim Moustafa PhD , Hanan Hosny MD","doi":"10.1016/j.jcm.2022.01.001","DOIUrl":"10.1016/j.jcm.2022.01.001","url":null,"abstract":"<div><h3>Objective</h3><p><span>The purpose of this study was to examine the effect of 8 weeks of biofeedback on reaction time and central somatosensory conduction time </span>in patients<span><span> with forward head posture and </span>cervical radiculopathy.</span></p></div><div><h3>Methods</h3><p><span>We performed a double-blinded randomized controlled trial<span>. Seventy patients with forward head posture and cervical radiculopathy were randomly distributed into study and control groups. The study group received biofeedback forward head posture corrective exercise for 8 weeks, while the control group did not receive any treatment. The main outcome measures were reaction time and central somatosensory conduction time. The secondary outcome measures were the craniovertebral angles, </span></span>nerve conduction time<span> at N13<span> and N20, referred arm pain, and neck disability index.</span></span></p></div><div><h3>Results</h3><p>After 4 weeks, there were nonsignificant differences between both groups in reaction time and central somatosensory conduction time (<em>P</em> > .05); while there were significant differences between both groups in N13, N20, craniovertebral angle, referred arm pain, and neck disability index scores (<em>P</em> < .05). After 8 weeks, there were significant differences between both groups in all outcome measures (<em>P</em> < .05).</p></div><div><h3>Conclusion</h3><p>In this study, participants receiving biofeedback forward head posture corrective exercise improved both reaction time and central somatosensory conduction time after 8 weeks when compared to a control, nontreatment group.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 1","pages":"Pages 39-50"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393949","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}
The purpose of this study was to compare the effects of dry needling and inhibitory Kinesio taping on the pressure pain threshold and muscle thickness in women with myofascial pain syndrome in the upper trapezius muscle.
Methods
The present study was a single-blind randomized controlled clinical trial. Seventy-five women with active trigger points in the upper trapezius muscle were included and randomly divided into 3 groups of equal sizes. Groups 1 and 2 were treated in 2 sessions with a 3-day interval by dry needling and inhibitory Kinesio taping, respectively. Group 3 did not receive treatment (ie, the control group). Pressure pain threshold and muscle thickness were measured using a pressure algometer and an ultrasound device, respectively, and this was done before, 3 days after, and 10 days after the treatment.
Results
Pressure pain threshold increased significantly in groups 1 and 2 (P < .001) after the intervention. Muscle thickness reduced significantly in group 1 (P = .015) and group 2 (P = .010) after the intervention. No significant differences were observed between these 2 intervention groups in terms of these variables. Meanwhile, the changes in the control group in muscle thickness (P = .430) and pressure pain threshold (P = .230) were not significant.
Conclusion
Both dry needling and inhibitory Kinesio taping increased pressure pain threshold and reduced muscle thickness in participants with active trigger points in the upper trapezius muscle. These 2 therapeutic techniques appear to cause similar positive changes in pain and muscle function but may do so through different mechanisms.
{"title":"Comparison of Dry Needling and Inhibitory Kinesio Taping in Treatment of Myofascial Pain Syndrome of the Upper Trapezius Muscle: A Randomized Controlled Trial","authors":"Rasool Bagheri PT, PhD , Cyrus Taghizadeh Delkhoush PT, PhD , Majid Mirmohammadkhani MD, PhD , Ziaeddin Safavi Farokhi PT, PhD , Soghra Bakhshi PT, MSc","doi":"10.1016/j.jcm.2022.01.003","DOIUrl":"10.1016/j.jcm.2022.01.003","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this study was to compare the effects of dry needling<span><span><span> and inhibitory Kinesio taping on the pressure pain threshold<span> and muscle thickness in women with </span></span>myofascial pain syndrome in the upper </span>trapezius muscle.</span></p></div><div><h3>Methods</h3><p><span>The present study was a single-blind randomized controlled clinical trial<span>. Seventy-five women with active trigger points in the upper trapezius muscle were included and randomly divided into 3 groups of equal sizes. Groups 1 and 2 were treated in 2 sessions with a 3-day interval by dry needling and inhibitory Kinesio taping, respectively. Group 3 did not receive treatment (ie, the control group). Pressure pain threshold and muscle thickness were measured using a pressure </span></span>algometer and an ultrasound device, respectively, and this was done before, 3 days after, and 10 days after the treatment.</p></div><div><h3>Results</h3><p>Pressure pain threshold increased significantly in groups 1 and 2 (<em>P</em> < .001) after the intervention. Muscle thickness reduced significantly in group 1 (<em>P</em> = .015) and group 2 (<em>P</em> = .010) after the intervention. No significant differences were observed between these 2 intervention groups in terms of these variables. Meanwhile, the changes in the control group in muscle thickness (<em>P</em> = .430) and pressure pain threshold (<em>P</em> = .230) were not significant.</p></div><div><h3>Conclusion</h3><p>Both dry needling and inhibitory Kinesio taping increased pressure pain threshold and reduced muscle thickness in participants with active trigger points in the upper trapezius muscle. These 2 therapeutic techniques appear to cause similar positive changes in pain and muscle function but may do so through different mechanisms.</p></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"21 1","pages":"Pages 23-31"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40393947","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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