Journal of Manipulative and Physiological Therapeutics最新文献

{"title":"Utilization of Chiropractic Care at The World Games 2017: A Retrospective Descriptive Study","authors":"Debra D. Nook MBA ,&nbsp;Erik C. Nook PhD ,&nbsp;Brian C. Nook DC","doi":"10.1016/j.jmpt.2024.03.001","DOIUrl":"10.1016/j.jmpt.2024.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to report utilization of chiropractic care during The World Games 2017 in Wroclaw, Poland.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on treatment records. Thirty-five chiropractors trained in sports injuries provided care for athletes and non-athletes (support personnel) who voluntarily sought chiropractic care. Data included demographics (age, sex, role, country, and sport), category of anatomical regions treated, treatment modality (manipulation, myotherapy, mobilization, taping, and other), and participants’ self-reported pain ratings.</div></div><div><h3>Results</h3><div>A total of 1902 completed treatment forms representing 1902 encounters were included for athletes (n = 1238, 65%) and non-athletes (n = 664, 35%). There were 9385 individuals (athlete or non-athlete). Five hundred ninety of 3666 (16%) athletes and 422 of 5719 (7%) non-athletes received chiropractic treatment. Athletes represented 28 of 31 (90%) sports and 79 of 108 (73%) countries present. The thoracic spine was the most frequently treated spinal region (n = 846, 44%), followed by lumbar spine (n = 831, 44%) and cervical spine (n = 725, 38%). Frequency of treatment modalities was manipulation (n = 1610, 82%), myotherapy (n = 1522, 80%), mobilization (n = 607, 32%), and taping (n = 380, 20%). Acute injuries were more prevalent for athletes (61%) than non-athletes (35%), and athletes sought follow-up care (54%) more than non-athletes (36%). Overall, 89% of participants reported pain reduction immediately after treatment.</div></div><div><h3>Conclusion</h3><div>This article describes chiropractic care utilization at a multisport event as part of a health care team. The range of treatments included manipulation myotherapy, mobilization, and taping. Although a minority of athletes and non-athletes received chiropractic treatment, many participants reported pain reduction immediately after treatment.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"46 5","pages":"Pages 271-279"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Interplay Between Kinesiophobia, Lumbar Joint Position Sense, Postural Stability, and Pain in Individuals With Chronic Low Back Pain: A Cross-Sectional Analysis","authors":"Ravi Shankar Reddy PhD,&nbsp;Mastour Saeed Alshahrani PhD,&nbsp;Jaya Shanker Tedla PhD,&nbsp;Snehil Dixit PhD,&nbsp;Kumar Gular MPT,&nbsp;Venkata Nagaraj Kakaraparthi MPT","doi":"10.1016/j.jmpt.2024.09.004","DOIUrl":"10.1016/j.jmpt.2024.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>The objectives of the study were to (1) determine the association between kinesiophobia and lumbar joint position sense (JPS) in individuals with chronic low back pain (CLBP); (2) examine the relationship between kinesiophobia and postural stability in individuals with CLBP; and (3) investigate whether pain intensity mediates the relationship between kinesiophobia, lumbar JPS, and postural stability in individuals with CLBP.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, a total of 83 individuals diagnosed with CLBP were included. The level of fear of movement was assessed using the Tampa Scale for Kinesiophobia (TSK). Lumbar JPS was measured using the active target repositioning technique, which involved evaluating JPS in 3 directions: lumbar flexion, side-bending to the left, and side-bending to the right. The repositioning accuracy of the lumbar joint was quantified in degrees using a dual digital inclinometer. Postural stability was assessed using a stabilometric force platform, which measured anterior to posterior (A-P) sway, medial to lateral (M-L) sway, and the ellipse area in mm².</div></div><div><h3>Results</h3><div>The findings of this study revealed a statistically significant and moderate positive correlation between kinesiophobia and lumbar JPS in various directions, including flexion (r = 0.51, <em>P</em> &lt; .001), side-bending to the left (r = 0.37, <em>P</em> = .001), and side-bending to the right (r = 0.34, <em>P</em> = .002). Similarly, a significant positive association was observed between kinesiophobia and postural stability, as indicated by the correlation coefficients: A-P sway (r = .47, <em>P</em> &lt; .001), M-L sway (r = 0.58, <em>P</em> &lt; .001), and ellipse area (r = 0.51, <em>P</em> &lt; .001). Furthermore, the analysis revealed that pain significantly mediated the relationship between kinesiophobia and both lumbar JPS (<em>P</em> &lt; .05) and postural stability (<em>P</em> &lt; .05). These findings were demonstrated through mediation analysis.</div></div><div><h3>Conclusions</h3><div>This study identified a significant association between kinesiophobia, lumbar JPS, and postural stability. Additionally, we observed the presence of pain as a potential mediator in this relationship. However, it is important to note that our cross-sectional study design precludes establishing causality or determining the direct mediation effect of pain on adverse outcomes.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"46 5","pages":"Pages 294-304"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Approaches Utilized in Africa for the Management of Low Back Pain: A Scoping Review","authors":"Hiwot A. Melka DC ,&nbsp;Raheleh Khorsan MS, PHD ,&nbsp;James Whedon DC, MS ,&nbsp;Robb Russell DC ,&nbsp;Scott Haldeman DC, MD, PhD","doi":"10.1016/j.jmpt.2024.08.002","DOIUrl":"10.1016/j.jmpt.2024.08.002","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to review and describe the scientific literature on approaches used for the management of nonspecific low back pain (NSLBP) in Africa.</div></div><div><h3>Methods</h3><div>For this scoping review, a comprehensive literature search was conducted using the EBSCO host platform to search the following databases: CINAHL with full text, MEDLINE with Full Text, PubMed, Springer Nature Journals, Directory of Open Access Journals, Science Direct, Gale OneFile: Health &amp; Med, Google Scholar, and Gale Health &amp; wellness. Articles published between January 1990 and March 2021 were included. We used Boolean operators and Medical Subject Headings (MeSH) with the JBI Scoping Review Methodology framework. Results were reported using the PRISMA extension for scoping reviews (PRISMA-ScR).</div></div><div><h3>Results</h3><div>The search yielded 425 articles; 22 articles met the criteria for inclusion. Various disciplines were consulted for the management of NSLBP including primary care medical physicians, physiotherapists, chiropractors, orthopedic surgeons, pastors, and traditional healers. Management of NSLBP involves pain medication as the most common form of treatment. The review suggests that understanding cultural beliefs and biopsychosocial factors is important for managing NSLBP in Africa. Although attempts are being made in some countries to encourage the adoption of international and locally developed evidence-based guidelines, very few practitioners are providing such care.</div></div><div><h3>Conclusion</h3><div>The peer-reviewed published literature on the treatment of NSLBP in Africa is limited and with few exceptions of low quality. In order to provide a higher level of care for people disabled with NSLBP in Africa considerable further research and greater collaboration and utilization of limited clinical resources are needed.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"46 5","pages":"Pages 366-376"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Connective Tissue Massage and Classic Massage in Women With Primary Dysmenorrhea: A Randomized Clinical Trial","authors":"Seyda Toprak Celenay PhD, PT ,&nbsp;Ozge Barut PT ,&nbsp;Aysenur Karakus PT ,&nbsp;Afra Alkan PhD","doi":"10.1016/j.jmpt.2024.09.005","DOIUrl":"10.1016/j.jmpt.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to compare the short-term effects of connective tissue massage (CTM) and classic massage (CM) on pain, functional and emotional status, and menstrual complaints in women with primary dysmenorrhea (PD).</div></div><div><h3>Methods</h3><div>Women with PD were randomly assigned to 2 groups: CTM (n = 19) and CM (n = 19). CTM or CM was applied 5 days a week from the estimated date of ovulation to the onset of the next menstruation. The pain intensity with the Visual Analog Scale and functional and emotional status with the Functional and Emotional Dysmenorrhea Scale (FEDS) were assessed before and after the applications. Pain duration and the presence of menstrual complaints were recorded.</div></div><div><h3>Results</h3><div>In the postintervention period, both groups had decreased menstrual pain intensity and duration, drug use, and FEDS scores (<em>P</em> &lt; .001). Pain duration and FEDS-functional scores decreased more in the CTM group than in the CM group (<em>P</em> &lt; .05). Moreover, in the postintervention period, fewer women were nervous in the CM group, whereas low back pain, constipation, and sleeplessness were less frequent in the CTM group, compared with their preintervention period (<em>P</em> &lt; .05). A difference was observed between groups only in terms of the changes in sleeplessness between before and after intervention (<em>P</em> = .016).</div></div><div><h3>Conclusion</h3><div>CTM and CM improved menstrual pain and functional and emotional status, and decreased drug use. Moreover, CTM was superior in improving pain duration, functional status, and sleeplessness compared with CM in PD. CTM and CM might be useful treatment methods for PD.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"46 5","pages":"Pages 305-314"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Predicting Nonadherence to Treatment Recommendations for Patients With Chronic Low Back Pain in India: A Cross-Sectional Survey","authors":"G. Shankar Ganesh MPT ,&nbsp;Abdur R Khan PhD ,&nbsp;Ashfaque Khan PhD ,&nbsp;Sapna Dhiman MPT ,&nbsp;Ausaf Ahmad PhD","doi":"10.1016/j.jmpt.2024.02.007","DOIUrl":"10.1016/j.jmpt.2024.02.007","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to examine patients' expectations and factors that influence adherence to physiotherapists' treatment recommendations on chronic low back pain (CLBP).</div></div><div><h3>Method</h3><div>One hundred and forty seven patients with CLBP were included in this study. Predictive indicators including demographic information, views, expectations, and opinions regarding the health status and treatment expectations of patients were derived from questionnaires. The dependent outcome variables were the absence of trust in treatment recommendations provided by physiotherapists, the anticipation of treatment recommendations based on patient expectations, and the resistance to modifying expectations despite efforts by physiotherapists to persuade otherwise. The study was carried out between April 2022 and January 2023 in 2 regions located in India.</div></div><div><h3>Results</h3><div>Multivariate regression analyses show that age, expectations about diagnosis, preference for passive therapies and medical care, and information seeking behavior emerged as independent predictors of a lack of trust in physiotherapists' treatment recommendations. The information-seeking behavior of the patients’ alone predicted the anticipation of treatment recommendations based on patient expectations and the reluctance to alter those expectations despite the physiotherapists' persuasion.</div></div><div><h3>Conclusion</h3><div>Our results suggest that information seeking behavior is the most consistent independent predictor of treatment expectations that will align with physiotherapist recommendations. This indicates the importance of screening for such factors and the importance of patient education to optimize the management of CLBP. However, larger studies incorporating all variables associated with patient expectations in similar patient populations are needed to confirm these results.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"46 5","pages":"Pages 239-253"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Pain and Bullying in Australian Adolescents: A Secondary Analysis of Cross-Sectional Data From the Australian Child Wellbeing Project","authors":"Nichole Phillips MOst ,&nbsp;Benjamin T. Brown PhD ,&nbsp;Huan Lin PhD ,&nbsp;Michael S. Swain PhD","doi":"10.1016/j.jmpt.2024.08.009","DOIUrl":"10.1016/j.jmpt.2024.08.009","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to describe the frequency, and the strength of the association, between bullying and pain in Australian schoolchildren.</div></div><div><h3>Methods</h3><div>We used nationally representative data from the 2014 Australian Child Wellbeing Project, comprised students aged 8 to 14 years from 180 schools. Weighted, multiple logistic regression models (adjusting for sex and school year) were constructed to quantify the association between weekly or more frequent bullying and weekly or more frequent pain. Estimates of association for the relationship between bullying and pain were reported as odds ratios (OR).</div></div><div><h3>Results</h3><div>The sample was comprised of 5,440 schoolchildren (51.9% female). The prevalence rates of weekly or more frequent pain in the sample were headache (32.3%), backache (23.5%), and stomach ache (21.7%). Between 4.3% and 7.9% of participants reported weekly or more frequent bullying. In schoolchildren reporting bullying, the prevalence of pain ranged from 43.1% to 64.3%. Logistic regression modeling showed moderate-to-strong positive associations (OR, 2.1 [95% CI, 1.8-2.5] to 4.5 [95% CI, 3.7-5.6]) between the experiences of schoolchildren reporting any bullying type and any pain type.</div></div><div><h3>Conclusion</h3><div>Australian schoolchildren who reported bullying were more likely to experience headache, stomach ache, and backache. The moderate-to-strong positive association is consistent with previous international studies that have examined the association between bullying and pain in young people. These findings have significant implications for clinicians who provide care for young people, as well as educators and healthcare policymakers, highlighting the important role of coexisting psychosocial factors in the management of adolescents who report pain.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"46 5","pages":"Pages 377-384"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressure Pain Threshold Protocols With Pressure Algometer in Patients With Low Back Pain: A Systematic Review With Meta-Analysis","authors":"Verena Calmon Almeida Msc ,&nbsp;Luana Caroline Dantas Pereira Msc ,&nbsp;Saira Waqqar Msc ,&nbsp;Ariane Ethur Flores PhD ,&nbsp;Walderi Monteiro da Silva Junior PhD ,&nbsp;Leonardo Yung dos Santos Maciel PhD ,&nbsp;Jader Pereira de Farias Neto PhD ,&nbsp;Rodrigo Zacca PhD ,&nbsp;Valter Joviniano de Santana Filho PhD","doi":"10.1016/j.jmpt.2024.08.007","DOIUrl":"10.1016/j.jmpt.2024.08.007","url":null,"abstract":"<div><h3>Objective</h3><div>The pressure pain threshold is commonly employed to assess pain in various conditions. Despite its widespread use, the measurement of pressure pain thresholds is not consistently described across studies. Therefore, this review aimed to systematically examine the evidence regarding the assessment of pressure pain thresholds in patients with low back pain, including the protocols and body sites employed.</div></div><div><h3>Methods</h3><div>Six databases were systematically screened from their earliest records to May 2023 to identify studies utilizing pressure pain thresholds. Eligibility screening was conducted for the identified studies, and the included studies underwent appraisal using the appropriate tool corresponding to their study design.</div></div><div><h3>Results</h3><div>Upon categorizing based on the type of pain, we included 5 studies involving acute low back pain and 43 studies with chronic pain. The meta-analysis was conducted to compare subjects with and without pain, revealing no significant difference for the paraspinal region (SMD = −4.19, 95%CI = −11.7 to 3.32, z = −1.09, <em>p</em> = .27), piriformis (SMD = −1.24, 95%CI = −4.25 to 1.76, z = −0.81, <em>p</em> = .42) and quadratus lumborum musculature (SMD = −0.37, 95%CI = −1.35 to 0.60, z = −0.75, <em>p</em> = .45).</div></div><div><h3>Conclusion</h3><div>The paraspinal and gluteal musculature are the most frequently evaluated. Concerning the protocols for assessment, no consensus was identified. However, studies that assessed chronic low back pain typically adhered to a similar approach regarding the number of measures and a constant increase in pressure.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"46 5","pages":"Pages 327-345"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0161-4754(24)00075-7","DOIUrl":"10.1016/S0161-4754(24)00075-7","url":null,"abstract":"","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"46 5","pages":"Page A2"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143311139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Umbrella Review of Primary Care Treatments for Adults With Chronic Low Back Pain","authors":"Filip Gedin PhD ,&nbsp;Tobias Sundberg PhD ,&nbsp;Vibeke Sparring PhD ,&nbsp;Martin Skeppholm PhD ,&nbsp;Emelie Heintz PhD ,&nbsp;Niklas Zethraeus PhD","doi":"10.1016/j.jmpt.2024.03.002","DOIUrl":"10.1016/j.jmpt.2024.03.002","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this study was to identify, critically assess, and summarize evidence of the effectiveness of primary care treatments for adults with non-specific chronic low back pain (NSCLBP).</div></div><div><h3>Methods</h3><div>We conducted an umbrella review of systematic reviews focusing on primary care treatments for NSCLBP. We searched the PubMed and Cochrane library databases for systematic reviews of randomized controlled trials (RCTs) evaluating primary care treatments for adults with NSCLBP published between January 2007 and March 2021. Two reviewers independently assessed the quality of these systematic reviews using the AMSTAR checklist. We selected systematic reviews with a low or moderate risk of bias and graded the evidence based on Grading of GRADE criteria.</div></div><div><h3>Results</h3><div>Among the initial 66 systematic reviews meeting our inclusion criteria, 19 systematic reviews with low or moderate bias risk were selected for analysis. These reviews included a total of 365 studies involving 62 832 participants. The evidence suggested moderate to high support for the effectiveness of certain primary care treatments in improving pain and function in NSCLBP patients. These treatments included NSAIDs and opioids compared to placebos, spinal manipulation versus exercise/physical therapy, and MBR versus exercise/education/advice/no treatment.</div></div><div><h3>Conclusions</h3><div>Recommendations for specific primary care treatments for NSCLBP in adults remain inconclusive. Further high-quality systematic reviews and RCTs are needed to better understand the effectiveness of these treatments. Future RCTs should prioritize the assessment of NSAIDs, opioids, spinal manipulation, and MBR, as they appear promising for improving NSCLBP outcomes in certain comparisons.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"46 5","pages":"Pages 315-326"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Sensorimotor Effects of Chiropractic Spinal Manipulation: Preliminary Results From an Experimental Study","authors":"Carlos Gevers-Montoro PhD ,&nbsp;Zoha Deldar PhD ,&nbsp;Arantxa Ortega-De Mues PhD","doi":"10.1016/j.jmpt.2024.08.006","DOIUrl":"10.1016/j.jmpt.2024.08.006","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to assess the effects of different spinal manipulation (SM) techniques and target segments on a specific dermatome and myotome, when compared with a remote spinal cord segment that served as a control location.</div></div><div><h3>Methods</h3><div>Twenty-nine healthy volunteers were randomized to receive instrumental (Activator IV, Activator Methods International Ltd) or manual SM at the C6, C1, and T4 vertebral segments in 3 independent sessions. Pressure pain thresholds (PPTs) and muscle strength were examined at the C6 (test) and L4 (control) dermatomes and myotomes, at baseline and after intervention. Linear mixed-effects models were used to analyze changes over time and interindividual variability.</div></div><div><h3>Results</h3><div>Pressure pain thresholds significantly increased at both proximal and distal C6 dermatome locations (<em>P</em> &lt; .05), irrespective of the technique and segment of application (<em>P</em> &gt; .2). No significant changes were observed at the L4 dermatome. Muscle strength remained unchanged throughout the study. Multilevel modeling revealed significant associations between increased PPTs along the C6 dermatome (<em>P</em> &lt; .001), whereas the combination of technique and target segment predicted PPT increases at the proximal C6 dermatome.</div></div><div><h3>Conclusion</h3><div>These findings support regional, rather than segmental mechanisms underlying the sensory effects of SM. Specifically, significant increases in PPTs along the C6 dermatome suggest localized effects on pain sensitivity, which may depend on the target spinal region. Further investigation is needed to better understand these regional changes of SM and their potential clinical implications.</div></div>","PeriodicalId":16132,"journal":{"name":"Journal of Manipulative and Physiological Therapeutics","volume":"46 5","pages":"Pages 280-293"},"PeriodicalIF":1.2,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}