Journal of chiropractic medicine最新文献_第5页

Chiropractic Management using Cox Technic Flexion Distraction for a Patient With Tandem Spinal Stenosis 采用Cox技术屈曲牵引治疗串联式椎管狭窄患者的捏脊治疗

Journal of chiropractic medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jcm.2025.08.018

Nate McKee DC , James M. Cox DC , Kurt J. Olding DC

Objective

The purpose of this case report is to increase awareness of the early signs of tandem spinal stenosis with associated degenerative cervical myelopathy and to outline the possible role of chiropractic care in the collaborative management of this condition in the ageing population.

Clinical Features

The patient was a 69-year-old man with left-sided neck pain that radiated into his left shoulder and markedly limited left rotation and extension in the cervical spine. The pain had been present for “months” and, since the pain started, he had noticed a loss of balance and had fallen numerous times. The patient noted that extension of the head was a trigger for his falls. The patient also reported suffering from chronic lower back pain since a disc injury years ago.

Intervention and Outcome

Treatment consisted of Cox Technic Flexion Distraction and Decompression both protocol 1 and 2 to the full spine. The patient experienced only low levels of neck pain after 4 weeks of care, the arm pain totally resolved, and the lower back pain was minimal. At 10 weeks he reported no falls.

Conclusion

Conservative care with Cox Technic Flexion Distraction and Decompression may be an option when early signs of cervical myelopathy are present with tandem stenosis. Co-management with a neurologist or a neurosurgeon, as in this case, was prudent.

目的：本病例报告的目的是提高人们对串联椎管狭窄合并退行性颈椎病早期症状的认识，并概述在老年人群中脊椎病协同治疗中脊椎指压治疗的可能作用。临床特征：患者为69岁男性，左侧颈部疼痛，并辐射至左肩，颈椎左侧旋转和伸展明显受限。这种疼痛已经持续了“几个月”，自从疼痛开始以来，他就发现自己失去了平衡，摔倒了很多次。病人注意到头部的伸展是他摔倒的诱因。患者还报告说，由于多年前椎间盘损伤，患有慢性腰痛。干预和结果治疗包括Cox技术屈曲、撑开和减压，方案1和方案2均为全脊柱。经过4周的治疗，患者仅经历了轻度的颈部疼痛，手臂疼痛完全缓解，腰痛最小。在10周时，他没有跌倒。结论Cox技术屈曲撑开减压术是早期颈椎病合并串联狭窄患者的一种保守治疗方法。在这种情况下，与神经科医生或神经外科医生共同治疗是谨慎的。

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引用次数: 0

Mulligan Concept for the Conservative Treatment of Lateral Epicondylalgia: A Case Report Mulligan概念保守治疗外侧上髁痛1例报告

Journal of chiropractic medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jcm.2025.08.005

Jason Bartholomew DAT , Shayane V. Santiago DAT , Moni Syeda DAT , Russell Baker PhD, DAT

Objective

The purpose of this case study was to describe the use of the Mulligan Concept (MC) Manual Lateral Glide Mobilization with Movement (MWM) with gripping on an adult tennis player with lateral epicondylalgia (LE).

Clinical Features

A 40-year-old adult male tennis player presented with pain and perceived weakness at the lateral elbow while lifting, pulling, and gripping. Clinical examination noted pain with elbow extension and wrist flexion, tenderness to palpation at the origin of the common extensor tendon, and positive Cozen test. The working diagnosis was LE with a differential diagnosis of radial nerve entrapment.

Intervention and Outcome

The patient completed 5 treatments of MC Manual Lateral Glide MWM with gripping over 13 days. The MC Manual Lateral Glide MWM with gripping was composed of the clinician providing a laterally directed glide across the elbow joint while the patient performed pain-free gripping. Patient outcomes, including Numeric Rating Scale for pain, the Patient-Specific Functional Scale, Patient-Rated Tennis Elbow Evaluation, the Disablement in the Physically Active Scale Short Form-8, grip strength (ie, hand dynamometer measurements), and algometer pressure pain threshold measurements were collected. Improvements exceeding minimal clinically important differences and minimal detectable change values were noted on all outcomes after the third treatment. After 5 treatment sessions, spanning a total of 13 days, clinical evaluation was performed, noting total resolution of symptoms. Patient outcomes supported clinical findings, and the patient was discharged.

Conclusion

Following 5 visits, the patient in this case study achieved restored function, pain reduction, and resolution of LE symptoms. The patient also maintained this at the 1-year follow-up.

目的本病例研究的目的是描述Mulligan概念（MC）手动侧滑动运动（MWM）与抓握对患有外侧上髁痛（LE）的成年网球运动员的应用。临床特征：一名40岁成年男子网球运动员，在举、拉、握时表现为肘部外侧疼痛和虚弱。临床检查发现肘部伸展和腕屈曲疼痛，总伸肌腱起始处触痛，Cozen试验阳性。工作诊断为LE，鉴别诊断为桡神经卡压。干预和结果患者在13天内完成了5次手动侧滑MWM治疗。MC手动侧滑MWM与夹持是由临床医生提供横向定向滑过肘关节，而患者进行无痛夹持。收集患者结果，包括疼痛数值评定量表、患者特定功能量表、患者评定网球肘评估、体力活动量表短表-8中的残疾、握力（即手测力仪测量）和疼痛阈值测量。在第三次治疗后，所有结果的改善都超过了最小的临床重要差异和最小的可检测变化值。5次治疗后，共13天，进行临床评估，注意症状的完全缓解。患者结果支持临床发现，患者出院。经过5次就诊，患者功能恢复，疼痛减轻，LE症状缓解。患者在1年的随访中也保持了这种状态。

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引用次数: 0

Effect of Counterforce Brace Placement on Muscle Activation in Healthy Adults 反力支具放置对健康成人肌肉激活的影响

Journal of chiropractic medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jcm.2025.09.012

Mohsen Radpasand MD, DC, MS , Hamed Radpasand DC

Objective

This study aimed to determine the optimal placement of a counterforce brace in muscle activation and strength in healthy participants.

Methods

Seven healthy participants (14 hands) with no history of lateral humeral epicondylitis were randomly assigned to two groups from an initial pool of 12 participants. Group A (4 participants, 8 hands) wore a hard knob-padded counterforce brace near the lateral epicondyle, while Group B (Control Group) (3 participants, 6 hands) wore the brace in its customary location, aligned with the lateral epicondyle over the proximal third of the forearm near the muscle belly. Brace placement was assigned to the dominant hand for each participant, while the nondominant hand received the alternative brace placement (ie, the other position of the counterforce brace). Acceleration amplitude and integrals were dependent variables. The design allowed for comparison of outcomes from 2 different brace placements within the same individual.

Results

The hard knob-padded counterforce brace positioned near the lateral epicondyle demonstrated better outcomes compared to the customary placement.

Conclusion

This study offers insights into the influence of counterforce brace placement on muscle activation and strength in healthy participants. In this study, placement of the brace at the lateral epicondyle showed better muscle strength and reduced acceleration amplitude, compared to traditional placement.

目的本研究旨在确定反力支具对健康参与者肌肉激活和力量的最佳放置位置。方法将7名无肱骨外上髁炎病史的健康参与者（14只手）从初始池的12名参与者中随机分为两组。A组（4名参与者，8只手）在外上髁附近佩戴硬旋钮衬垫反力支架，B组（对照组）（3名参与者，6只手）在其习惯位置佩戴支架，在前臂近三分之一处靠近肌肉腹部的外上髁。支撑物的放置被分配给每个参与者的优势手，而非优势手接受替代支撑物的放置（即反力支撑物的另一个位置）。加速度振幅和积分是因变量。该设计允许比较同一个体内2种不同支架放置的结果。结果硬旋钮填充反力支具放置于外侧上髁处，效果优于常规位置。结论本研究揭示了反力支具放置对健康受试者肌肉活动和力量的影响。在本研究中，与传统的放置位置相比，在外侧上髁放置支具显示出更好的肌肉力量和更小的加速度振幅。

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引用次数: 0

Platelet Rich-Plasma in MRI-Confirmed Tear of Posterior Cruciate Ligament: 4-Year Follow-up Case Report mri证实的后交叉韧带撕裂的富血小板血浆：4年随访病例报告

Journal of chiropractic medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jcm.2025.09.004

Ivan Medina-Porqueres PT, RN, MSc , Pablo Martin-Garcia RN , Sofia Sanz-De Diego RN , Marcelo Reyes-Eldblom MD , Rafael Mondragon-Cortes BSc , Daniel Rosado-Velazquez MD , Abel Gomez-Caceres MD

Objective

The purpose of this case report is to describe the management of a professional soccer player with a knee Posterior Cruciate Ligament (PCL) tear using platelet-rich plasma (PRP) injections.

Clinical Features

A case of magnetic resonance imaging (MRI) confirmed type II injury of PCL with correlated physical signs of PCL insufficiency in a 21-year-old, white, professional soccer player is reported herein.

Intervention and Outcome

A PRP regimen was administered intra-articularly in 3 applications at weekly intervals to the affected knee. Follow-up assessment showed complete, pain-free ROM, a clinically normal joint, and complete ligament healing after PRP. The healing was supported by magnetic resonance imaging performed 48 months after the treatment.

Conclusion

This is the first reported case of a PCL type II injury in a professional soccer player with an isolated PRP application. This case expands the treatment options for PCL injuries and highlights another potential effect of PRP within the field of regenerative medicine.

目的：本病例报告的目的是描述使用富血小板血浆（PRP）注射治疗职业足球运动员膝关节后交叉韧带（PCL）撕裂。临床特点：本文报告1例21岁白人职业足球运动员，经核磁共振证实PCLⅱ型损伤伴PCL功能不全相关体征。干预和结果：PRP方案被给予关节内特别是3次应用，每隔一周给患处膝关节。随访评估显示完整，无痛的ROM，临床正常关节，PRP后韧带完全愈合。治疗后48个月磁共振成像支持愈合。结论：这是第一例报道的PCL II型损伤，发生在一个孤立的PRP应用的职业足球运动员身上。本病例扩展了PCL损伤的治疗选择，并强调了PRP在再生医学领域的另一个潜在作用。

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引用次数: 0

Trunk Muscle Activity During Seated Strength Exercise With Resistance Wheeled Training Equipment 用阻力轮式训练器材进行坐式力量训练时躯干肌肉活动

Journal of chiropractic medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jcm.2025.08.013

Shinya Ogaya PhD, Aoi Uchida BS, Rena Yamamoto BS, Ryosuke Momose BS, Shiuba Kudo BS

Objective

This study aimed to measure muscle activity during seated trunk strength training using resistance-wheeled training equipment at different resistance levels.

Methods

The participants were 19 healthy males. Resistance-wheeled training equipment, such as the small vehicle used in this study, had a mechanical braking function that locked the wheels and unlocked the brakes while only pressing downward with a constant force. The subjects moved the equipment forward and backward on a desk with an unlocked brake status. The participants performed under 3 conditions; (1) unlocked with no force, (2) unlocked with low force, and (3) unlocked with high force.

Results

Muscle activity increased significantly with increasing locked strength in the deltoid posterior, internal and external oblique, rectus abdominis, erector spinae thorax, and lumbar muscles. Some muscles reached over 50% of the maximum voluntary contraction when unlocked with a high force.

Conclusion

The muscle activity measured during trunk training that exceeded 50% of the maximum voluntary activation level corresponds to be sufficiently high for strength training and the activity level required for muscle hypertrophy. We believe that this research equipment may be a useful seated trunk strength training device.

目的研究不同阻力水平下阻力轮式训练器材对坐式躯干力量训练中肌肉活动的影响。方法健康男性19例。阻力轮训练设备，如本研究中使用的小型车辆，具有机械制动功能，只需用恒定的力向下按压，即可锁定车轮并解锁制动器。受试者将设备放在一张没有刹车的桌子上前后移动。参与者在三种条件下进行表演；(1)无力解锁，(2)低力解锁，(3)高力解锁。结果后三角肌、内外斜肌、腹直肌、胸竖脊肌和腰肌的肌肉活动随着锁定强度的增加而明显增加。一些肌肉在用大力量解锁时达到最大自愿收缩的50%以上。结论躯干训练时测得的肌肉活动超过最大自主活动水平的50%，对应于力量训练和肌肉肥大所需的活动水平足够高。我们认为该研究设备可能是一种有用的坐式躯干力量训练装置。

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引用次数: 0

Prevalence of Low Back Pain in Competitive Dressage Riders: A Cross-Sectional Study 竞技盛装舞步骑手腰痛的流行：一项横断面研究

Journal of chiropractic medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jcm.2025.08.012

Dirkie M. Landman MTech Chiropractic, Ashleigh Handley MHSc Chiropractic, Cynthia Peterson RN, DC, DACBR, MMedEd

Objective

The purpose of this study was to identify the point and lifetime prevalence of low back pain (LBP) among dressage riders and identify riding-related variables that may precipitate LBP.

Methods

A cross-sectional, exploratory, quantitative study was conducted using an online questionnaire. One hundred dressage riders competing at preliminary and higher levels were recruited at the South African Equestrian Federation’s registered shows. Frequencies and descriptive statistics were performed on each question in addition to cross-tabulations for associations between variables or differences between riding practices and experiences.

Results

Participants were between the ages of 18 and 66 years. The questionnaire identified that 71% of participants reported point prevalence of LBP and 56% reported lifetime prevalence of LBP. Spearman ρ correlations showed positive correlations between how often participants believed their LBP was horse riding–related and how often they experienced LBP while competing/riding (r[75] = 0.46, P = .00) and how often their pain got worse with competing/riding (r[75] = 0.49, P = .00) and negative correlations with the number of hours spent in sitting trot and an increase in LBP (r[75] = −0.13, P = .28) and the number of hours spent cantering and an increase in LBP (r[75] = −0.19, P = .94).

Conclusion

This study reports point and lifetime prevalence of LBP among competitive dressage riders in South Africa. Training/riding-specific horse gaits were associated with LBP in dressage riders.

目的：本研究的目的是确定盛装舞步骑手腰痛（LBP）的时点和终生患病率，并确定可能导致腰痛的骑行相关变量。方法采用在线问卷进行横断面、探索性、定量研究。100名盛装舞步选手在南非马术联合会的注册比赛中参加初级和更高级别的比赛。对每个问题进行频率和描述性统计，并对变量之间的关联或骑乘练习和经验之间的差异进行交叉表。结果研究对象年龄在18 ~ 66岁之间。问卷显示71%的参与者报告了LBP的点患病率，56%的参与者报告了LBP的终生患病率。斯皮尔曼ρ的相关性显示出频率之间的正向关系参与者认为他们的枸杞多糖是马riding-related和他们经历了枸杞多糖而竞争/骑(r [75] = 0.46, P =美元)以及经常与竞争/骑他们的疼痛变得更糟(r [75] = 0.49, P =美元)和负相关性的时间坐在小跑,增加枸杞多糖(r[75] =−0.13,P =陈霞)和时间奔跑的数量和增加枸杞多糖(r[75] =−0.19,P =总收入)。结论：本研究报告了南非竞技盛装舞步运动员腰痛的时点和终生患病率。训练/骑马特有的步态与盛装舞步骑手的LBP有关。

{"title":"Prevalence of Low Back Pain in Competitive Dressage Riders: A Cross-Sectional Study","authors":"Dirkie M. Landman MTech Chiropractic, Ashleigh Handley MHSc Chiropractic, Cynthia Peterson RN, DC, DACBR, MMedEd","doi":"10.1016/j.jcm.2025.08.012","DOIUrl":"10.1016/j.jcm.2025.08.012","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to identify the point and lifetime prevalence of low back pain (LBP) among dressage riders and identify riding-related variables that may precipitate LBP.</div></div><div><h3>Methods</h3><div>A cross-sectional, exploratory, quantitative study was conducted using an online questionnaire. One hundred dressage riders competing at preliminary and higher levels were recruited at the South African Equestrian Federation’s registered shows. Frequencies and descriptive statistics were performed on each question in addition to cross-tabulations for associations between variables or differences between riding practices and experiences.</div></div><div><h3>Results</h3><div>Participants were between the ages of 18 and 66 years. The questionnaire identified that 71% of participants reported point prevalence of LBP and 56% reported lifetime prevalence of LBP. Spearman ρ correlations showed positive correlations between how often participants believed their LBP was horse riding–related and how often they experienced LBP while competing/riding (r[75] = 0.46, <em>P</em> = .00) and how often their pain got worse with competing/riding (r[75] = 0.49, <em>P</em> = .00) and negative correlations with the number of hours spent in sitting trot and an increase in LBP (r[75] = −0.13, <em>P</em> = .28) and the number of hours spent cantering and an increase in LBP (r[75] = −0.19, <em>P</em> = .94).</div></div><div><h3>Conclusion</h3><div>This study reports point and lifetime prevalence of LBP among competitive dressage riders in South Africa. Training/riding-specific horse gaits were associated with LBP in dressage riders.</div></div>","PeriodicalId":94328,"journal":{"name":"Journal of chiropractic medicine","volume":"24 1","pages":"Pages 84-91"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694894","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}

引用次数: 0

Goniometric and 3D Motion Analysis in Shoulder ROM Assessment: A Reliability and Agreement Study Comparing Patients With Restricted Shoulder Range of Motion to Healthy Subjects 肩关节活动度评估中的角度测量和三维运动分析：一项比较肩关节活动度受限患者与健康受试者的可靠性和一致性研究

Journal of chiropractic medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jcm.2025.08.015

Sezen Karaşin MSc , Yılmaz Yıldırım MSc , Kadriye Tombak PhD , İlhan Sezer MD , Özkan Köse MD , Umut Özsoy PhD

Objective

This study aimed to examine the reliability and agreement of goniometric measurements in assessing the range of motion (ROM) within the shoulder joint utilizing a 3D marker-based motion analysis system.

Methods

The study comprised 30 healthy volunteers and 35 patients diagnosed with unilateral restricted shoulder range of motion (ROM). Agreement analysis was conducted using Bland–Altman methods, while intra- and interobserver reliability for flexion, abduction, internal rotation, and external rotation measurements was assessed using the Intraclass Correlation Coefficient (ICC).

Results

When goniometric measurements were compared with the 3D method, ICC values in the patient group were found to be 0.85 for flexion, 0.81 for abduction, 0.80 for external rotation, and 0.74 for internal rotation. In healthy individuals, the values were found to be 0.80, 0.90, 0.56, and 0.69. Additionally, all measurements fell within acceptable limits of agreement, with no significant differences in measurement biases, except for internal rotation.

Conclusion

This study highlights that the goniometer exhibited higher reliability when assessing movements with larger ROM, particularly within heterogeneous groups like those with injured shoulders. However, its reliability decreased when used in homogeneous groups, such as healthy individuals, especially when evaluating movements with narrower ROM, such as rotations. These findings emphasize the need for a nuanced interpretation of results in clinical and research settings when assessing shoulder joint mobility.

目的：本研究旨在利用基于3D标记的运动分析系统来评估肩关节内运动范围（ROM）的角度测量的可靠性和一致性。方法本研究纳入30名健康志愿者和35名单侧肩关节活动受限（ROM）患者。使用Bland-Altman方法进行一致性分析，而使用类内相关系数（ICC）评估屈曲、外展、内旋和外旋测量的观察者内部和观察者之间的可靠性。结果与3D方法比较，患者组屈曲时ICC值为0.85，外展时为0.81，外旋时为0.80，内旋时为0.74。在健康个体中，该值分别为0.80、0.90、0.56和0.69。此外，除内旋外，所有测量结果均在可接受的一致范围内，测量偏差无显著差异。结论：本研究强调，在评估关节活动度较大的运动时，角计表现出更高的可靠性，特别是在肩部受伤的异质群体中。然而，当在同质人群（如健康个体）中使用时，其可靠性降低，特别是在评估ROM较窄的运动（如旋转）时。这些发现强调在评估肩关节活动度时，需要对临床和研究结果进行细致入微的解释。

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引用次数: 0

Comparison Among Heart Rate, Perceived Exertion, and Blood Lactate Concentration for 2 Different Submaximal Exercise Testing Protocols in Recreational Cricket Players 两种不同亚极限运动测试方案下休闲板球运动员心率、感知运动强度和血乳酸浓度的比较

Journal of chiropractic medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jcm.2025.09.026

Deepika Singla PhD , Ruchi Basista MPT , Aqsa Mujaddadi MPT , Pooja Bhati PhD , Monis Khan MBBS , M. Ejaz Hussain PhD

Objective

The purpose of the study was to determine the relationship between heart rate, rate of perceived exertion, and blood lactate concentration in recreational cricket players between the modified Bruce protocol and the continuous backward medicine ball throw (CBMB) test. The goal was to develop an alternate, inexpensive test for submaximal exercise testing.

Methods

Thirteen recreational cricket players were recruited from Jamia Millia Islamia, New Delhi. The heart rate and rate of perceived exertion were recorded at rest during standing, at the time of reaching the ventilatory threshold, and after 1, 2 and 3 minutes of the recovery period during the modified Bruce protocol and continuous backward medicine ball throw test. The blood lactate levels were recorded at rest while standing, at the time of reaching VT, and after 3 minutes of the recovery period during the modified Bruce protocol and the continuous backward medicine ball throw (CBMB) test, and also at the end of stage 1 for modified Bruce protocol and at the end of 10 reps for continuous backward medicine ball throw test.

Results

The mean age of the recreational cricket player in the study was 22.23±1.87 years. Significant ‘r’ values were found for heart rate (r=.975, p<.001), and blood lactate concentration (r=.824, p=.001) between the modified Bruce protocol and the continuous backward medicine ball throw test.

Conclusion

The continuous backward medicine ball throw (CBMB) test for submaximal exercise testing showed validity when compared to the Bruce protocol in recreational cricket players.

目的探讨改良布鲁斯方案与连续向后投球（CBMB）试验对休闲板球运动员心率、感觉用力率和血乳酸浓度的影响。目标是开发一种替代的、廉价的亚极限运动测试。方法从新德里的Jamia Millia Islamia招募13名休闲板球运动员。在改良布鲁斯方案和连续抛药球试验中，分别记录站立休息时、达到通气阈值时、恢复期1、2、3分钟后的心率和感觉用力率。分别在站立休息时、到达VT时、改良布鲁斯方案和连续向后扔药球（CBMB）试验恢复期3分钟后、改良布鲁斯方案第一阶段结束时和连续向后扔药球试验10次结束时记录血乳酸水平。结果本组业余板球运动员平均年龄为22.23±1.87岁。改良布鲁斯方案与连续向后掷药球试验在心率（r= 0.975, p= 0.001）和血乳酸浓度（r= 0.824, p= 0.001）方面均有显著的r值。结论连续后向投球（CBMB）测试在休闲板球运动员亚极限运动测试中与布鲁斯方案相比具有一定的有效性。

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引用次数: 0

Primary, Secondary, and Tertiary Prevention of Metabolic Syndrome: A Narrative Literature Review and Resource for Chiropractors 代谢性综合征的一级、二级和三级预防：脊骨按摩师的文献综述和资源

Journal of chiropractic medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jcm.2025.07.002

Krista L. Ward DC, MPH , Victor O. Asemota MD, MS, MBA , Koen P. Kallop DC , Dale F. Johnson PhD , Suzanne L. Ray MS , Sergio T. Fernando DC , Monica Smith DC, PhD

Objective

The objective of this review is to summarize current information for chiropractors on Metabolic Syndrome (MetS) related to prevention and health promotion.

Methods

Research staff and faculty of a doctor of chiropractic program performed a narrative review, which included guidelines from the United States Preventative Task Force and meta-analyses. We performed a PubMed search of meta-analyses published in English between 2019 to 2024, indexed with the Medical Subject Heading “Metabolic Syndrome,” and which had free-text availability. Meta-analyses were included if they were relevant to chiropractic practice and health promotion/prevention.

Results

The PubMed search resulted in 156 citations of which 38 meta-analyses were selected for inclusion in this review. Clinical intervention strategies identified that may reduce MetS risk and negative sequelae include screening for MetS, such as measuring waist circumference, blood pressure and biomarker levels. In addition, chiropractors can support lifestyle behavior changes that may help patients lose weight such as increasing protein intake from plant-based diets, increasing physical activity, optimizing sleep and reducing sugar-sweetened beverage consumption.

Conclusions

This review summarizes current information on MetS related to prevention and health promotion. Chiropractors and other health care professionals knowledgeable of the lifestyle-related risk factors associated with MetS can use this information to better screen and manage at-risk patients.

目的总结按摩师在代谢综合征（MetS）预防和健康促进方面的最新信息。方法脊椎指压治疗项目的研究人员和教师进行了一项叙述性回顾，其中包括美国预防工作组的指导方针和荟萃分析。我们对2019年至2024年间发表的英文荟萃分析进行了PubMed检索，索引为医学主题标题“代谢综合征”，并且具有免费文本可用性。如果meta分析与脊椎指压疗法和健康促进/预防相关，则纳入meta分析。结果PubMed检索结果为156篇引用，其中38篇荟萃分析被选择纳入本综述。确定可能降低MetS风险和负面后遗症的临床干预策略包括MetS筛查，如测量腰围、血压和生物标志物水平。此外，脊椎按摩师可以支持生活方式行为的改变，这可能有助于患者减肥，例如增加植物性饮食中的蛋白质摄入量，增加体力活动，优化睡眠和减少含糖饮料的消费。结论综述了MetS在预防和促进健康方面的研究进展。脊椎按摩师和其他了解与MetS相关的生活方式相关风险因素的医疗保健专业人员可以利用这些信息更好地筛查和管理高危患者。

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引用次数: 0

Adding Manual Therapy to a Respiratory-Rehabilitation Program in Patients with Respiratory Disorders: A Systematic Review and Meta-Analysis with a Meta-Regression 在呼吸系统疾病患者的呼吸康复计划中加入手工治疗：一项系统回顾和meta -回归分析

Journal of chiropractic medicine

Pub Date : 2025-01-01 DOI: 10.1016/j.jcm.2025.09.003

Ferran Cuenca-Martínez PhD , Núria Sempere-Rubio PhD , Enrique Carrasco-González MSc , Francisco M. Martínez-Arnau PhD

Objective

The main aim of this study was to assess the effects of adding MT to a Respiratory Rehabilitation (RR) program in patients with Respiratory Disorders (RD).

Methods

A systematic search was carried out in PubMed, EMBASE, CINAHL, PEDro and Google Scholar (February 1^st 2023). The outcome measures were pulmonary function parameters (FEV₁ and FVC); and exercise capacity, through the 6-minute walk test (6-MWT). Standardized mean differences (SMDs) and 95% confidence intervals were calculated and were pooled in a meta-analysis with a random effects model.

Results

In total, 6 studies were included. Regarding the pulmonary function parameters, no significant effects were found in favor of adding MT to a RR program. However, the meta-analysis showed a significant improvement of 6-MWT when MT were added to a RR with a small clinical effect (n = 6, SMD = –0.55 (–1.01 to –0.09)). Lastly, the meta-regression analysis revealed that the intervention time of MT was not significantly correlated with the improvement of FEV1 (R2 = 52.49%, P = .16), FVC (R2=4.22%, P = .70), or 6-MWT (R²=9.95%, P = .62).

Conclusions

There is low-quality evidence that adding MT to an RR program can improve the exercise capacity in patients with RD. However, MT plus RR showed no effect on pulmonary function parameters, also with low-quality evidence.

目的本研究的主要目的是评估在呼吸系统疾病（RD）患者的呼吸康复（RR）计划中加入MT的效果。方法系统检索PubMed、EMBASE、CINAHL、PEDro和谷歌Scholar（2023年2月1日）的文献。结局指标为肺功能参数（FEV1和FVC）；和运动能力，通过6分钟步行测试（6-MWT）。计算标准化平均差异（SMDs）和95%置信区间，并在随机效应模型的荟萃分析中合并。结果共纳入6项研究。关于肺功能参数，没有发现支持将MT加入RR计划的显著影响。然而，meta分析显示，当MT添加到临床效果较小的RR中时，6- mwt显著改善（n = 6, SMD = -0.55(-1.01至-0.09)）。最后，meta回归分析显示，MT干预时间与FEV1 （R2= 52.49%, P = 0.16）、FVC （R2=4.22%, P = 0.70）、6-MWT （R2=9.95%, P = 0.62）的改善无显著相关。结论有低质量证据表明，在RR方案中加入MT可以提高RD患者的运动能力。然而，MT加RR对肺功能参数没有影响，证据质量也很低。

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