-
Chiropractic & Manual Therapies Jun 2020According to the American Physical Therapy Association, there is strong evidence to show that vertebral mobilization and manipulation procedures can be used to improve... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
According to the American Physical Therapy Association, there is strong evidence to show that vertebral mobilization and manipulation procedures can be used to improve spinal and hip mobility and reduce pain and incapacity in low back pain patients that fit the clinical prediction rule.
OBJECTIVES
To evaluate the immediate effects of high-velocity low-amplitude (HVLA) manipulation on pain and postural control parameters in individuals with nonspecific low back pain.
METHODS
This study used a participant-blinded and assessor-blinded randomized controlled clinical trial involving a single session, in which 24 participants were randomly distributed into control (simulated manipulation) and intervention (HVLA lumbar manipulation) groups. The primary (pain: subjective pain intensity and pressure pain threshold) and secondary outcomes (postural control: ellipse area, center of pressure [COP] excursion, COP RMS velocity, and differences between the COP and center of projected gravity) were evaluated before and after the session using a numerical pain scale, algometer, and a force platform. For all outcomes, multiple mixed 2 (group) × 2 (time) ANOVAs were performed.
RESULTS
For the subjective pain intensity, only time was significant as a main effect, where pre-intervention presented a greater value then post-intervention (F [1.44] = 4.377; p = 0.042; r = 0.30). For the pressure pain threshold no significant effect was found. For the postural control parameters, as a main effect, only the ellipse area was significantly greater in the control group (F [1.44] = 6.760; p = 0.013; effect size = 0.36).
CONCLUSIONS
There was a reduction in subjective pain intensity, evaluated using a numerical scale, in both the intervention and control groups immediately after the intervention, suggesting that the spinal manipulation had a similar effect to the placebo procedure. No effect of HVLA lumbar manipulation was identified for postural control variables in either the intervention or control groups.
TRIAL REGISTRATION
The study was registered at ClinicalTrials.gov under the number NCT02312778, registered at 14 September 2014.
Topics: Adult; Double-Blind Method; Female; Humans; Low Back Pain; Male; Manipulation, Spinal; Middle Aged; Pain Measurement; Pain Threshold; Postural Balance; Young Adult
PubMed: 32487243
DOI: 10.1186/s12998-020-00316-7 -
BMC Musculoskeletal Disorders Oct 2019Few studies have investigated the effects of mobilization with movement (MWM) in patients with knee osteoarthritis (OA) compared to other procedures. Sham procedures are... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Few studies have investigated the effects of mobilization with movement (MWM) in patients with knee osteoarthritis (OA) compared to other procedures. Sham procedures are generally more appropriate control than using no or usual treatments. Moreover, studies investigating the widespread hypoalgesic effects of MWM in patients with knee OA are lacking. The aim was to investigate the effect of MWM on function and pain in patients with knee OA compared to sham MWM.
METHODS
This is a randomized double-blind (patients and assessor) controlled trial. Forty adult patients with knee OA of grade II and above were recruited to receive either MWM treatment or sham MWM for the knee. The outcome measures included the following: a visual analogue scale (VAS) for pain, the pressure pain threshold (PPT) test, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, the timed up and go (TUG) test, knee strength and knee range of motion (ROM). The measurements were taken at baseline, immediately after intervention and 2 days later.
RESULTS
Compared with sham MWM, MWM resulted in greater immediate improvement in pain [mean difference (95% CI): - 2.2 (- 2.8, - 1.6)], PPT at both the knee [176 (97, 254)] and shoulder [212 (136, 288)], TUG time [- 1.6 (- 2.1, - 1.1)], knee flexor strength [2.0 (1.3, 2.7)] and extensor strength [5.7 (4.1, 7.2)] and knee flexion ROM [12.8 (9.6, 15.9)] (all, p < 0.001) but not knee extension ROM [- 0.8 (- 1.6, 0.1)] (p = 0.067). After 2 days of intervention, patients who received MWM also demonstrated a greater improvement in pain [- 1.0 (- 1.8, - 0.1)], PPT at the shoulder [107 (40, 175)], TUG time [- 0.9 (- 1.4, - 0.4)], knee flexor strength [0.9 (0.2, 1.7)] and extensor strength [2.9 (2.1, 3.9)] and knee flexion ROM [8.3 (4.7, 11.9)] (all, p ≤ 0.026). However, WOMAC scores and knee extension ROM showed no evidence of change at any stage after intervention (p ≥ 0.067).
CONCLUSIONS
MWM provided superior benefits over sham MWM in terms of local and widespread pain, physical function (walking), knee flexion and extension muscle strength and knee flexion ROM for at least 2 days in patients with knee OA.
TRIAL REGISTRATION
ClinicalTrials.gov ( NCT02865252 ), registered on August 12, 2016.
Topics: Arthralgia; Double-Blind Method; Female; Humans; Knee Joint; Male; Manipulation, Orthopedic; Middle Aged; Osteoarthritis, Knee; Pain Measurement; Range of Motion, Articular; Treatment Outcome
PubMed: 31627723
DOI: 10.1186/s12891-019-2841-4 -
Headache Mar 2022The aim of this study was to identify the manual therapy (MT) methods and techniques that have been evaluated for the treatment of cervicogenic headache (CH) and their... (Review)
Review
OBJECTIVE
The aim of this study was to identify the manual therapy (MT) methods and techniques that have been evaluated for the treatment of cervicogenic headache (CH) and their effectiveness.
BACKGROUND
MT seems to be one of the options with the greatest potential for the treatment of CH, but the techniques to be applied are varied and there is no consensus on which are the most indicated.
METHODS
A systematic search in Scopus, Medline, PubMed, Cinahl, PEDro, and Web of Science with the terms: secondary headache disorders, physical therapy modalities, musculoskeletal manipulations, cervicogenic headache, manual therapy, and physical therapy. We included articles published from 2015 to the present that studied interventions with MT techniques in patients with CH. Two reviewers independently screened 365 articles for demographic information, characteristics of study design, study-specific intervention, and results. The Oxford 2011 Levels of Evidence and the Jadad scale were used.
RESULTS
Of a total of 14 articles selected, 11 were randomized control trials and three were quasi-experimental studies. The techniques studied were: spinal manipulative therapy, Mulligan's Sustained Natural Apophyseal Glides, muscle techniques, and translatory vertebral mobilization. In the short-term, the Jones technique on the trapezius and ischemic compression on the sternocleidomastoid achieved immediate improvements, whereas adding spinal manipulative therapy to the treatment can maintain long-term results.
CONCLUSIONS
The manual therapy techniques could be effective in the treatment of patients with CH. The combined use of MT techniques improved the results compared with using them separately. This review has methodological limitations, such as the inclusion of quasi-experimental studies and studies with small sample sizes that reduced the generalizability of the results obtained.
Topics: Humans; Manipulation, Spinal; Neck Muscles; Post-Traumatic Headache; Research Design; Tension-Type Headache
PubMed: 35294051
DOI: 10.1111/head.14278 -
Nurse Researcher Sep 2019Quantitative research designs are broadly classified as either experimental or quasi-experimental. The main distinguishing feature of the quasi-experiment is the... (Review)
Review
BACKGROUND
Quantitative research designs are broadly classified as either experimental or quasi-experimental. The main distinguishing feature of the quasi-experiment is the manipulation of the independent variable without randomisation. When randomisation or use of a control group is unfeasible, a researcher can choose from a range of quasi-experimental designs.
AIM
To present the features of the quasi-experimental 'non-equivalent control group post-test-only' design, which aims to demonstrate causality between an intervention and an outcome.
DISCUSSION
This paper provides an overview of the non-equivalent control group post-test-only design in terms of its design features, applications and statistical analysis, as well as its advantages and disadvantages.
CONCLUSION
The non-equivalent control group post-test-only design can be used in natural settings, where randomisation cannot be conducted for ethical or practical reasons. Although the design is less complex than some other designs, with low error propagation, it is vulnerable to threats to internal validity.
Topics: Control Groups; Data Collection; Nursing Research; Research Design
PubMed: 30226337
DOI: 10.7748/nr.2018.e1582 -
Physical Therapy Aug 2021Distal fibular mobilization with movement (MWM), with and without a posterior gliding fibular tape, and anteroposterior mobilization of the talus (MOB) are widely used... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Distal fibular mobilization with movement (MWM), with and without a posterior gliding fibular tape, and anteroposterior mobilization of the talus (MOB) are widely used to treat acute lateral ankle sprains. The purpose of this study was to investigate the short-term and long-term relative effectiveness of these techniques.
METHODS
In this double-blind randomized controlled trial, 45 amateur soccer players with acute (<72 hours) lateral ankle sprain were randomly allocated to 6 sessions (3/wk within the first 2 weeks) of either MWM, MWM with tape (MWMtape), or MOB. All participants also received general advice, transcutaneous electrical nerve stimulation, edema draining massage, and a program of proprioception exercises. Participant ratings of function on the Foot and Ankle Ability Measure and Patient Global Impression of Improvement Scale were the primary outcomes measured over 52 weeks. Secondary outcomes were ankle pain, pressure pain threshold, range of motion, volume, and strength.
RESULTS
MWM and MWMtape were equally effective and participants demonstrated greater function on the Foot and Ankle Ability Measure at 12 and 52 weeks when compared with those receiving MOB; however, the latter demonstrated superior function at 2 weeks. No differences between groups were observed for Patient Global Impression of Improvement Scale or any of the secondary outcomes.
CONCLUSION
There are limited differences in the short term among techniques, with the exception of better sport function with MOB. Over the longer term, the distal fibular MWM is most effective to achieve activities of daily living and sport function when added to usual physical therapy care. The addition of a posterior gliding fibular tape provides no additional benefit.
IMPACT
Distal fibular mobilization with movement may be the most appropriate choice of treatment for acute lateral ankle sprain to achieve long-term activities of daily living and sport function. In the short term, anteroposterior mobilization of the talus offers greater improvement in sport function. The use of fibular tape provides no added benefit as an adjunct to a treatment that includes distal fibular mobilization with movement.
Topics: Activities of Daily Living; Adult; Ankle Injuries; Athletic Injuries; Athletic Tape; Combined Modality Therapy; Double-Blind Method; Female; Fibula; Humans; Male; Muscle Strength; Musculoskeletal Manipulations; Pain Measurement; Range of Motion, Articular; Return to Sport; Sprains and Strains; Surveys and Questionnaires; Talus; Young Adult
PubMed: 33877325
DOI: 10.1093/ptj/pzab111 -
Journal of Korean Medical Science Mar 2021In the era of digitization and Open Access, article-level metrics are increasingly employed to distinguish influential research works and adjust research management... (Review)
Review
In the era of digitization and Open Access, article-level metrics are increasingly employed to distinguish influential research works and adjust research management strategies. Tagging individual articles with digital object identifiers allows exposing them to numerous channels of scholarly communication and quantifying related activities. The aim of this article was to overview currently available article-level metrics and highlight their advantages and limitations. Article views and downloads, citations, and social media metrics are increasingly employed by publishers to move away from the dominance and inappropriate use of journal metrics. Quantitative article metrics are complementary to one another and often require qualitative expert evaluations. Expert evaluations may help to avoid manipulations with indiscriminate social media activities that artificially boost altmetrics. Values of article metrics should be interpreted in view of confounders such as patterns of citation and social media activities across countries and academic disciplines.
Topics: Bibliometrics; Journal Impact Factor; Publishing; Research Design; Scholarly Communication; Social Media
PubMed: 33754507
DOI: 10.3346/jkms.2021.36.e74 -
Journal of Personality and Social... Sep 2019Using a novel technique known as network meta-analysis, we synthesized evidence from 492 studies (87,418 participants) to investigate the effectiveness of procedures in... (Meta-Analysis)
Meta-Analysis
Using a novel technique known as network meta-analysis, we synthesized evidence from 492 studies (87,418 participants) to investigate the effectiveness of procedures in changing implicit measures, which we define as response biases on implicit tasks. We also evaluated these procedures' effects on explicit and behavioral measures. We found that implicit measures can be changed, but effects are often relatively weak (|s| < .30). Most studies focused on producing short-term changes with brief, single-session manipulations. Procedures that associate sets of concepts, invoke goals or motivations, or tax mental resources changed implicit measures the most, whereas procedures that induced threat, affirmation, or specific moods/emotions changed implicit measures the least. Bias tests suggested that implicit effects could be inflated relative to their true population values. Procedures changed explicit measures less consistently and to a smaller degree than implicit measures and generally produced trivial changes in behavior. Finally, changes in implicit measures did not mediate changes in explicit measures or behavior. Our findings suggest that changes in implicit measures are possible, but those changes do not necessarily translate into changes in explicit measures or behavior. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Topics: Humans; Network Meta-Analysis; Psychological Tests; Psychology, Social; Social Perception
PubMed: 31192631
DOI: 10.1037/pspa0000160 -
Journal of Back and Musculoskeletal... 2020Osteopathic manipulation treatment is widely used in the clinical practice in the care of patients with chronic nonspecific low back pain, however, its benefits still... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Osteopathic manipulation treatment is widely used in the clinical practice in the care of patients with chronic nonspecific low back pain, however, its benefits still seem uncertain.
OBJECTIVE
This study aimed to verify the efficacy of osteopathic manipulation for chronic nonspecific low back pain.
MATERIALS AND METHODS
Forty-two participants with chronic nonspecific low back pain were selected and randomized into two groups: active control group (ACG - n= 19) and osteopathic manipulation treatment group (OMTG - n= 23). Therapeutic exercises were performed with the ACG and osteopathic manipulation techniques with the OMTG. The interventions were carried out over 5 weeks of treatment, totaling 10 treatments for the ACG and 5 for the OMTG.The visual analogue scale (VAS) was used to measure chronic nonspecific low back pain and the Oswestry Disability Index 2.0, Tampa Scale of Kinesiophobia and Beck Depression Inventory were used to measure disability, kinesiophobia and depression, respectively.
RESULTS
The final chronic nonspecific low back pain in both groups was significantly lower than the initial low back pain (p⩽ 0.01) and the final chronic nonspecific low back pain of the OMTG was significantly lower than that of the ACG (p= 0.001).
CONCLUSION
This study demonstrated that the treatments were effective in both groups. However, the efficacy of the osteopathic manipulation treatment was greater than that of the therapeutic exercises.
Topics: Adult; Depression; Double-Blind Method; Exercise Therapy; Female; Humans; Low Back Pain; Male; Manipulation, Osteopathic; Middle Aged; Pain Measurement; Treatment Outcome; Visual Analog Scale
PubMed: 31658037
DOI: 10.3233/BMR-181355 -
Psicothema Feb 2023Repeated measures designs are commonly used in health and social sciences research. Although there are other, more advanced, statistical analyses, the F-statistic of...
BACKGROUND
Repeated measures designs are commonly used in health and social sciences research. Although there are other, more advanced, statistical analyses, the F-statistic of repeated measures analysis of variance (RM-ANOVA) remains the most widely used procedure for analyzing differences in means. The impact of the violation of normality has been extensively studied for between-subjects ANOVA, but this is not the case for RM-ANOVA. Therefore, studies that extensively and systematically analyze the robustness of RM-ANOVA under the violation of normality are needed. This paper reports the results of two simulation studies aimed at analyzing the Type I error and power of RM-ANOVA when the normality assumption is violated but sphericity is fulfilled.
METHOD
Study 1 considered 20 distributions, both known and unknown, and we manipulated the number of repeated measures (3, 4, 6, and 8) and sample size (from 10 to 300). Study 2 involved unequal distributions in each repeated measure. The distributions analyzed represent slight, moderate, and severe deviation from normality.
RESULTS
Overall, the results show that the Type I error and power of the F-statistic are not altered by the violation of normality.
CONCLUSIONS
RM-ANOVA is generally robust to non-normality when the sphericity assumption is met.
Topics: Humans; Research Design; Sample Size; Computer Simulation; Analysis of Variance
PubMed: 36695847
DOI: 10.7334/psicothema2022.292 -
Chiropractic & Manual Therapies Nov 2023Temporomandibular disorders (TMDs) are the most common cause of orofacial pain of non-dental origin, with approximately 42% of diagnoses corresponding to myofascial... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Temporomandibular disorders (TMDs) are the most common cause of orofacial pain of non-dental origin, with approximately 42% of diagnoses corresponding to myofascial pain. Manual therapy and dry needling are commonly used interventions for the treatment of myofascial temporomandibular disorders. However, it is unclear whether one of them could be superior to the other.
OBJECTIVES
The aim of the present systematic review and network meta-analysis was to compare the effectiveness of manual therapy and dry needling in patients with myofascial TMD.
METHODS
This is a systematic review and network meta-analysis. Randomized clinical trials were searched in the databases of Pubmed, PEDro, CINAHL, Web of Science, Scopus, Cochrane, Google Academic and EMBASE. The methodological quality of studies included in this review was judged using the Physiotherapy Evidence Database (PEDro) scale. A frequentist network meta-analysis was carried out, assuming random effects, to estimate the effects of interventions for temporomandibular joint pain measured on a 10-point visual analogue scale.
RESULTS
Out of 3190 records identified, 17 met the inclusion criteria for qualitative analysis and eight were included in the network meta-analysis. Indirect comparisons between dry needling and manual therapy showed no significant differences in their effects on pain reduction (Odds Ratio [95%CI]; - 0.263 [- 1.517, 0.992]). The ranking of treatments shows that manual therapy (SUCRA = 0.932) followed by deep dry needling (SUCRA = 0.775) present the highest values of estimation and can be considered the most likely to reduce pain.
CONCLUSIONS
The results of the network meta-analysis should be considered with caution due to the low quality of the evidence available and the high variability of the study protocols in terms of the method of application of dry needling and manual therapy interventions. PROSPERO under identifier: (CRD42020186470).
Topics: Humans; Dry Needling; Network Meta-Analysis; Musculoskeletal Manipulations; Pain; Temporomandibular Joint Disorders
PubMed: 37924127
DOI: 10.1186/s12998-023-00489-x