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The National Center for Complementary and Integrative Health recommends that research be judged on the merit of scientific findings rather than on the basis of professional degrees held by investigators.
In this spirit, the American Academy of Osteopathy provides OsteoBlast citations that are likely to be of interest to AAO members. The AAO offers these items from peer-reviewed journals without comment, and it endorses neither the research nor the advertisements contained in OsteoBlast.
Effects of thrust magnitude and duration on immediate postspinal manipulation trunk muscle spindle responses
Journal of Manipulative and Physiological Therapeutics
The purpose of this study was to characterize trunk muscle spindle responses immediately after high-velocity, low-amplitude spinal manipulation (HVLA-SM) delivered at various thrust magnitudes and thrust durations.
Secondary analysis from multiple studies involving anesthetized adult cats (N = 70; 2.3-6.0 kg) receiving L6 HVLA-SM. Muscle spindle afferent recordings were obtained from L6 dorsal rootlets before, during, and immediately after HVLA-SM. L6 HVLA-SM was delivered posteriorly-to-anteriorly using a feedback motor with peak thrust magnitudes of 25%, 55%, and 85% of cat body weight (BW) and thrust durations of 25, 50, 75, 100, 150, 200, and 250 ms. Time to the first action potential and muscle spindle discharge frequency at 1 and 2 seconds post–HVLA-SM were determined.
A significant association between HVLA-SM thrust magnitude and immediate (≤2 s) muscle spindle response was found (P < .001). For non-control thrust magnitude, pairwise comparisons (25%, 55%, 85% BW), 55% BW thrust magnitude had the most consistent effect on immediate post–HVLA-SM discharge outcomes (false discovery rate < 0.05). No significant association was found between thrust duration and immediate post–HVLA-SM muscle spindle response (P > .05).
The present study found that HVLA-SM thrust magnitudes delivered at 55% BW were more likely to affect immediate (≤2 s) post–HVLA-SM muscle spindle response.
(This is a hyperlink to the abstract for this article. To view the full article, you will need to log in to the journal's website.)
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Effectiveness of manual therapy in patients with thumb carpometacarpal osteoarthritis: A systematic review and meta-analysis
Physiotherapy Theory and Practice
The effectiveness of Manual Therapy (MT) in thumb carpometacarpal osteoarthritis (OA) is unclear.
This study aimed to determine the effectiveness of MT for functional outcomes in patients with thumb carpometacarpal OA.
An electronic search was performed in the Medline, Central, Embase, PEDro, Lilacs, Cinahl, SPORTDiscus, and Web of Science databases. The eligibility criteria for selecting studies included randomized clinical trials that compared MT versus other interventions in functional outcomes, such as thumb and/or hand function questionnaires, pinch and/or grip strength, thumb and/or hand range of motion, and pain intensity or pressure pain threshold in patients with thumb carpometacarpal OA.
Five clinical trials met the eligibility criteria; for the quantitative synthesis, four studies were included. The mean difference (MD) for grip strength was 0.87kg (95% CI = 0.29–1.44, p = .003), for pinch strength was 0.10kg (95% CI = –0.01–0.20, p = .06), and for the pressure pain threshold was 0.64kg/cm2 (95% CI = 0.07–1.20, p = .03). All differences were in favor of the MT group.
In the short-term, there was moderate to high evidence, with statistically significant differences in the functional outcomes, in favor of MT versus sham interventions in patients with thumb carpometacarpal OA. However, these differences are not clinically important. (This is a hyperlink to the abstract for this article. To view the full article, you will need to log in to the journal's website.)
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Pressure pain thresholds in individuals with knee pain: A cross-sectional study
BMC Musculoskeletal Disorders
Knee osteoarthritis (KOA), chronic widespread pain (CWP) and overweight/obesity are public health problems that often coincide, and there is a multifactorial and unclear relationship between them. The study aimed to (1) investigate pain sensitivity, assessed by pressure pain thresholds (PPTs), among women and men with knee pain and (2) associations with, respectively, radiographic KOA (rKOA), CWP, and overweight/obesity.
Baseline data from an ongoing longitudinal study involving 280 individuals with knee pain in the 30–60 age group. Pain sensitivity was assessed by PPTs on eight different tender points using a pressure algometer. The participants’ knees were x-rayed. Self-reported CWP and number of pain sites were assessed with a pain figure, and overweight/obesity was measured using body mass index (BMI), visceral fat area (VFA), and body fat percentage, assessed with a bioimpedance. Associations were analyzed using regression analyses.
Women reported lower PPTs than men (p < 0.001), but no PPTs differences were found between those with and without rKOA. Low PPTs was associated with female sex, more pain sites, CWP, and a higher VFA and body fat percentage. The tender points second rib and the knees were most affected. The prevalence of CWP was 38 %.
The modifiable factors, increased VFA, and body fat could be associated with increased pain sensitivity among individuals with knee pain. Longitudinal studies are needed to further investigate the associations.
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Efficacy of cervical manual therapy plus conventional physical therapy on clinical outcomes in patients with carpal tunnel syndrome: A double blind randomized controlled trial
The International Journal of Clinical Practice
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Current physical therapy treatment options show limited effects or low-quality evidence, especially in the long-term. To date, there has been little research to look at the effects of treating the cervical spine for decreasing symptoms distally to the carpal tunnel. So the aim of this study was to compare the effects of cervical manual therapy plus conventional physical therapy with conventional physiotherapy only in Carpal Tunnel Syndrome Subjects.
A group of 46 patients with CTS was randomly allocated into two groups: Cervical manual therapy plus conventional physiotherapy (n = 23), and conventional physiotherapy (n = 22). All patients received 10 sessions of supervised intervention treatment for 2 weeks. The efficacy of the therapies was assessed before initiation of therapy and after completion of therapy using a visual analog scale (VAS), a symptom severity scale, the functional capacity scale of the Boston Carpal Tunnel Questionnaire (BCTQ), functional status of DASH questionnaire, measurement of median nerve motor distal latency (mMDL) and median sensory nerve conduction velocity (mSNCV).
Cervical manual therapy plus conventional physiotherapy group showed significantly greater improvement in VAS, DASH score, mMDL and mSNCV (p < 0.05) compared to the conventional group. There was no significant difference in BCTQ for two groups (p > 0.05).
The analysis of the results showed that conventional physiotherapy combined with Cervical manual therapy could be more effective in improving the pain, functional abilities, median nerve motor distal latency and median sensory nerve conduction velocity of patients with CTS compared with conventional physiotherapy only.
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Efficacy of pediatric integrative manual therapy in positional plagiocephaly: A randomized controlled trial
Italian Journal of Pediatrics
Positional plagiocephaly frequently affects healthy babies. It is hypothesized that manual therapy tailored to pediatrics is more effective in improving plagiocephalic cranial asymmetry than just repositioning and sensory and motor stimulation.
Thirty-four neurologically healthy subjects aged less than 28 weeks old with a difference of at least 5 mm between cranial diagonal diameters were randomly distributed into 2 groups. For 10 weeks, the pediatric integrative manual therapy (PIMT) group received manual therapy plus a caregiver education program, while the controls received the same education program exclusively. Cranial shape was evaluated using anthropometry; cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated. Parental perception of change was assessed using a visual analogue scale (− 10 cm to + 10 cm).
CVAI presented a greater decrease in PIMT group: 3.72 ± 1.40% compared with 0.34 ± 1.72% in the control group (p = 0.000). CI did not present significant differences between groups. Manual therapy led to a more positive parental perception of cranial changes (manual therapy: 6.66 ± 2.07 cm; control: 4.25 ± 2.31 cm; p = 0.004).
Manual therapy plus a caregiver education program improved CVAI and led to parental satisfaction more effectively than solely a caregiver education program.
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Immediate and short-term effects of kinesiotaping and lower extremity stretching on pain and disability in individuals with plantar fasciitis: A pilot randomized, controlled trial
Physiotherapy Theory and Practice
Plantar fasciitis (PF) can disturb individual’s weight-bearing activities. Hence, conservative treatments with immediate effect in reducing pain and improving foot function is required.
This study compared the effect of kinesiotaping and stretching exercise in individuals with PF.
Thirty patients with PF were randomly divided into three groups, and received kinesiotaping, stretching exercise, and a combination of the two aforementioned interventions. Pain intensity and foot disability were measured at baseline, immediately after the first treatment, and at one week.
Immediately after the first treatment, all groups showed significant changes in heel pain intensity (p ≤ .012) with the standardized response mean (SRM) of 2.85, 1.96, and 1.43 for the taping, stretching, and the combination groups, respectively. Nevertheless, no significant change in foot disability was found (p > .05). At the one week, all groups continued to demonstrate significant reduction in heel pain (p ≤ .012) with the SRM of 1.78, 2.84, and 2.09 for the taping, stretching, and the combination groups, respectively. While the combination group showed significant reduction in foot disability (p = .024). However, there was no significant difference of the change score in all parameters among the three groups (p > .05).
Improvement in heel pain was observed in all groups after the first treatment. However, improvement in foot function over one week was observed only among those who received the combined treatment. Further studies on larger samples are required to establish the superiority of the combined treatment over kinesiotaping or stretching alone.
(This is a hyperlink to the abstract for this article. To view the full article, you will need to log in to the journal's website.)
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